How much impairment is required for ADHD? No evidence of a discrete threshold / T. W. ARILDSKOV in Journal of Child Psychology and Psychiatry, 63-2 (February 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-2 (February 2022) . - p.229-237 Titre : How much impairment is required for ADHD? No evidence of a discrete threshold Type de document : Texte imprimé et/ou numérique Auteurs : T. W. ARILDSKOV, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur ; P. H. THOMSEN, Auteur ; A. VIRRING, Auteur ; S. D. ØSTERGAARD, Auteur Article en page(s) : p.229-237 Langues : Anglais (eng) Mots-clés : Attention-deficit/hyperactivity disorder  continuity  diagnosis  schoolchildren  symptomatology Index. décimale : PER Périodiques Résumé : BACKGROUND: A diagnosis of attention-deficit/hyperactivity disorder (ADHD) requires the presence of impairment alongside symptoms above a specific frequency and severity threshold. However, the question of whether that symptom threshold represents anything more than an arbitrary cutoff on a continuum of impairment requires further empirical study. Therefore, we present the first study investigating if the relationship between ADHD symptom severity and functional impairment is nonlinear in a way that suggests a discrete, nonarbitrary symptom level threshold associated with a marked step increase in impairment. METHODS: Parent reports on the ADHD-Rating Scale (ADHD-RS-IV), the Weiss Functional Impairment Rating Scale (WFIRS-P), and the Strengths and Difficulties Questionnaire were collected in a general population sample of 1st, 2nd, and 3rd graders (N?=?1,914-2,044). RESULTS: Piecewise linear regression analyses and nonlinear regression modeling both demonstrated that the relationship between symptom severity (ADHD-RS-IV total score) and impairment (WFIRS-P mean score) was characterized by a gradual linear increase in impairment with higher symptom severity and no apparent step increase or changing rate of increase in impairment at a certain high ADHD-RS-IV total score level. Controlling for socioeconomic status, sex, and co-occurring conduct and emotional symptoms did not alter these results, though comorbid symptoms had a significant effect on impairment. CONCLUSIONS: There was no clear evidence for a discrete, nonarbitrary symptom severity threshold with regard to impairment. The results highlight the continued need to consider both symptoms and impairment in the diagnosis of ADHD. En ligne : http://dx.doi.org/10.1111/jcpp.13440 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=457 [article] How much impairment is required for ADHD? No evidence of a discrete threshold [Texte imprimé et/ou numérique] / T. W. ARILDSKOV, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur ; P. H. THOMSEN, Auteur ; A. VIRRING, Auteur ; S. D. ØSTERGAARD, Auteur . - p.229-237. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-2 (February 2022) . - p.229-237 Mots-clés : Attention-deficit/hyperactivity disorder  continuity  diagnosis  schoolchildren  symptomatology Index. décimale : PER Périodiques Résumé : BACKGROUND: A diagnosis of attention-deficit/hyperactivity disorder (ADHD) requires the presence of impairment alongside symptoms above a specific frequency and severity threshold. However, the question of whether that symptom threshold represents anything more than an arbitrary cutoff on a continuum of impairment requires further empirical study. Therefore, we present the first study investigating if the relationship between ADHD symptom severity and functional impairment is nonlinear in a way that suggests a discrete, nonarbitrary symptom level threshold associated with a marked step increase in impairment. METHODS: Parent reports on the ADHD-Rating Scale (ADHD-RS-IV), the Weiss Functional Impairment Rating Scale (WFIRS-P), and the Strengths and Difficulties Questionnaire were collected in a general population sample of 1st, 2nd, and 3rd graders (N?=?1,914-2,044). RESULTS: Piecewise linear regression analyses and nonlinear regression modeling both demonstrated that the relationship between symptom severity (ADHD-RS-IV total score) and impairment (WFIRS-P mean score) was characterized by a gradual linear increase in impairment with higher symptom severity and no apparent step increase or changing rate of increase in impairment at a certain high ADHD-RS-IV total score level. Controlling for socioeconomic status, sex, and co-occurring conduct and emotional symptoms did not alter these results, though comorbid symptoms had a significant effect on impairment. CONCLUSIONS: There was no clear evidence for a discrete, nonarbitrary symptom severity threshold with regard to impairment. The results highlight the continued need to consider both symptoms and impairment in the diagnosis of ADHD. En ligne : http://dx.doi.org/10.1111/jcpp.13440 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=457

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