C-42 Is “Clinical Impairment” Normative in College Populations? Identifying Base Rates of Self-Reported Impairment in a Non-Treatment Seeking Population

Abstract

Abstract Objective Individuals presenting with concerns of Attention Deficit Hyperactivity Disorder (ADHD) report impairment and may seek academic or disability accommodations related to perceived impairment. Problematically, the legal definition of impairment remains poorly understood by clinicians, and there is little consensus regarding credibility of self-reported impairment. Furthermore, many impairments reported by individuals seeking evaluation for ADHD appear to be general and non-specific, but base rates of reports of these impairments in non-treatment seeking populations remain unclear. We examined base rates of impairment associated with ADHD in a sample of non-treatment seeking college students. Method Participants were undergraduate students who completed online surveys (N = 175). Participants who failed measures of validity, reported a past diagnosis of ADHD, or endorsed clinically significant symptoms of ADHD were excluded from analyses (final N = 89). Participants largely identified as white (88.8%) and female (85.4). Participants completed measures of impairment (Barkley Functional Impairment Scale) and ADHD symptoms (Conners’ Adult Attention Rating Scale). Base rates of clinically significant impairment among this sample were analyzed. Results Clinically significant levels of impairment were reported at high levels within the following categories; at home (15.1%), interacting with strangers (13.5%) and friends (20.2%), performing daily self-care (7.9%), and managing health (12.4%). Conclusions Base rates of clinically significant self-reported impairment are high among a non-clinical, non-treatment seeking sample of college students without ADHD symptoms. Results raise questions about the validity of self-reported impairment in diagnostic decision making, suggesting that experiences of difficulty in these areas may be normative among college populations and not specific to ADHD.