Validity and Reliability of the Persian Version of Conner’s Adult ADHD Rating Scales : Observer and Self-report Screening Versions

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Abstract Purpose: To adapt and assess the validity and Reliability of the Persian Observer and Self-report Screening Versions of Conner’s Adult ADHD Rating Scales Methods: The Self-report Screening Version of the Conner’s Adult ADHD Rating Scales(CAARS-S:SV) and Observer Screening Version of the Conner’s Adult ADHD Rating Scales(CAARS-O:SV) were translated into Persian by two bilingual experts and after minor changes by an expert panel were back-translated into English and were confirmed for compatibility with the original version. The Persian version of CAARS-S:SV was completed by 80 patients with confirmed adult ADHD as well as 160 healthy adults without ADHD. The Persian version of CAARS-O:SV was completed by a family member of the patients and controls who had close observation on their behaviors. Participants in all groups repeated completing the Persian versions of CAARS-S:SV and CAARS-O:SV after two weeks. Two other instruments were completed in parallel with Persian versions of CAARS-S:SV and CAARS-O:SV to assess the concurrent validity. The content validity, concurrent validity, diagnostic accuracy, internal consistency and test-retest reliability of the two CAARS scales adapted in Persian were assessed using appropriate statistical methods. Results : Internal consistency of both the CAARS-S:SV and CAARS-O:SV using Cronbach’s alpha were recorded to be high for both scales including all four subscales within an alpha range of 0.82-0.97. Both CAARS-S:SV and CAARS-O:SV showed high test-retest reliability. Content validity of the Persian version of CAARS-S:SV and CAARS-O:SV were confirmed according to the modified kappa value above 0.76 for all items included in CAARS-S:SV and CAARS-O:SV. Concurrent validity of CAARS-S:SV and CAARS-O:SV was generally confirmed both for assessing inattentive symptoms, and hyperactivity/impulsive symptoms . Both CAARS-S:SV and CAARS-O:SV scales had an area under Receiver Operating Characteristic(ROC) curve above 0.88 for all subscales indicating high validity of the scales to be used as screening tools for adult ADHD. Conclusion: Persian version of the CAARS-S:SV and CAARS-O:SV scales could be used as valid and reliable measures of adult ADHD-related symptoms and behaviors.