Abstract
There is scarcity of research investigating the validity of self-report of attention deficit hyperactivity disorder (ADHD) symptoms compared to other informants, such as parents. This study aimed to compare the predictive associations of ADHD symptoms rated by parents and their children across adolescence on a range of adverse socioeconomic and health outcomes in early adulthood. Parent- and self-rated ADHD symptoms were assessed in 2960 individuals in early (13–14 years) and late adolescence (16–17 years). Logistic regression analyses were used to compare the associations between parent- and self-rated ADHD symptoms at both time points and adverse life outcomes in young adulthood obtained from Swedish national registries. Both parent- and self-ratings of ADHD symptoms were associated with increased risk for adverse outcomes, although associations of parent-ratings were more often statistically significant and were generally stronger (OR = 1.12–1.49, p < 0.05) than self-ratings (OR = 1.07–1.17, p < 0.05). After controlling for the other informant, parent-ratings of ADHD symptoms in both early and late adolescence significantly predicted academic and occupational failure, criminal convictions and traffic-related injuries, while self-ratings of ADHD symptoms only in late adolescence predicted substance use disorder and academic failure. Our findings suggest that both parent- and self-ratings of ADHD symptoms in adolescence provides valuable information on risk of future adverse socioeconomic and health outcomes, however, self-ratings are not valuable once parent-ratings have been taken into account in predicting most outcomes. Thus, clinicians and researchers should prioritize parent-ratings over self-ratings.
Highlights
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can have debilitating effects on individuals throughout the lifespan
We investigated the discriminative accuracy of models including both parent- and self-ratings of ADHD symptoms
Population-based study, we found that both parent- and self-ratings of ADHD symptoms rated in adolescence predicted several important adverse life outcomes in early adulthood
Summary
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can have debilitating effects on individuals throughout the lifespan. There is scarcity of research that has studied how well parent- and self-ratings of ADHD symptoms in adolescence predict adverse socioeconomic and health outcomes in adulthood This is an essential issue to investigate, as prevention of serious outcomes later in life is an important task for clinicians working with ADHD. Results from a study using a clinical adolescent ADHD sample found that low academic achievers, compared to high academic achievers, displayed more ADHD symptoms, group differences were larger for parent-ratings (medium effect size; Cohen’s d = 0.60) than self-ratings (small effect size; Cohen’s d = 0.26) [8] Another clinical study of young adults investigated how strongly parent- and selfreports of ADHD during interviews were associated with life events, including academic, occupational and criminal events, after accounting for reports from the other informant [9]. Large-scale and longitudinal populationbased studies that compare the predictive value of parentand self-ratings of ADHD symptoms in adolescence are currently lacking
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