A-042 Incongruence Between Self- and Parent- Report Measures of Executive Function on the Behavior Rating Inventory of Executive Function (BRIEF) in Adolescents with Attention Deficit Hyperactivity Disorder

Abstract

Abstract Objective Research has demonstrated that adolescents with ADHD show executive dysfunction, although they do not always endorse such difficulties. We investigated inter-rater agreement between parent- and self-reported executive function (EF) in adolescents with ADHD, using the BRIEF. We also sought to investigate the relationship between scores on parent and self-report EF measures with performance on objective EF measures. Method Utilizing a clinical database, we identified 75 participants (13-17 years; Mage = 14.9; 60% male; 27% African American, 63% White, 3% Hispanic, 7% Other) with a diagnosis of ADHD. We examined inter-rater reliability between parent and self-reported factors on the BRIEF. We then examined the association between parent and self-report BRIEF Inhibition scores and the D-KEFS Color Word Interference (CWI) Inhibition trial, and parent and self-report BRIEF Shift scores and the D-KEFS CWI Inhibition/Switching trial and Trails Letter Number Sequencing trial. Results Significant associations were found between parent and self-ratings on BRIEF Inhibition (ICC = .22; 95% CI = -.24-.50), Shift (ICC = .24; 95% CI = -.21-.52), Emotional Control (ICC = .45, 95% CI = .137-.655), Plan/Organize (ICC = -.143; 95% CI = -.81–28), and Working Memory (ICC = -.193; 95% CI = -.89-.25) subscales. Correlation comparisons were significant for BRIEF self-report Inhibition and CWI Inhibition (r(73) = −.405, p = .000) only. Conclusion Results support standing findings regarding poor interrater reliability between parent and self-ratings of daily executive functioning in adolescents with ADHD. Self-report was seen to correlate with performance on objective EF tasks. Clinically, these results highlight the need for multidimensional assessment of ADHD in adolescents.