Self-Reported Adult ADHD Symptoms: Evidence Supporting Cautious Use in an Assessment-Seeking Sample

J Atten Disord. 2023 Aug;27(10):1156-1166. doi: 10.1177/10870547231172764. Epub 2023 May 9.

Abstract

Objective: Self-report symptom inventories are commonly used in adult ADHD assessment, and research indicates they should be interpreted with caution. This study investigated one self-report symptom inventory for adult ADHD in a clinical sample.

Method: Archival data were used to evaluate diagnostic utility of the Conners Adult ADHD Rating Scale-Self-Report: Long Version (CAARS-S:L) in a sample of 122 adults seeking ADHD assessment.

Results: Overall, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) estimates for the ADHD Index and other CAARS-S:L scales demonstrated weak accuracy. Anxiety and depression were the most common diagnoses present when a false positive on the ADHD Index was observed. PPV and specificity for the ADHD Index were higher in males compared to females.

Conclusion: The CAARS-S:L may be useful for screening purposes in some cases, but should not be the main method used for diagnostic purposes. Clinical implications of findings are discussed.

Keywords: CAARS; adult ADHD; adult ADHD assessment; self-report.

MeSH terms

  • Adult
  • Anxiety
  • Anxiety Disorders
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Female
  • Humans
  • Male
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Self Report