Assessment Of ADHD Research Articles

The Utility of Neuromuscular Assessment to Identify ADHD Among Patients with a Complex Symptom Picture

Objective: Diagnostic assessment of ADHD is challenging due to comorbid psychopathologies and symptoms overlapping with other psychiatric disorders. In this study, we investigate if a distinct pattern of neuromuscular dysregulation previously reported in ADHD, can help identifying ADHD in psychiatric patients with diverse and complex symptoms. Method: We explored the impact of neuromuscular dysregulation, as measured by The Motor Function Neurologic Assessment (MFNU), on the likelihood of being diagnosed with ADHD, affective disorder, anxiety disorder, or personality disorder among adults (n = 115) referred to a psychiatric outpatient clinic. Results: Logistic regression revealed that neuromuscular dysregulation was significantly associated with ADHD diagnosis only (OR 1.15, p < .01), and not with affective-, anxiety-, or personality disorders. Sensitivity and specificity for ADHD at different MFNU scores is provided. Conclusions: A test of neuromuscular dysregulation may promote diagnostic accuracy in differentiating ADHD from other psychiatric disorders in patients with an overlapping symptom picture. This may have important implications for clinical practice. More studies are needed.

Developing a Sustainable Education Protocol for Children with Attention Deficit Hyperactivity Disorder (adhd) in the Context of Developing Country

Abstract Attention Deficit Hyperactivity Disorder (adhd) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, and impulsivity that may significantly impact children’s academic, social, and emotional health. This study has examined the most recent scholarly research on the influence of adhd on children’s academic performance as well inclusive education protocol in different country contexts. Legal and academic interventions for adhd are well-established in developed countries, but there is a significant gap in addressing the needs of children with adhd in developing countries. This research study aims to fill the gap by suggesting a sustainable formal education protocol designed to meet the specific problems and situations of developing countries. The proposed Strategies-Support Services-Collaboration (ssc) protocol is influenced by concepts of inclusion, equity, and sustainability, aiming to address the different challenges encountered by children with adhd in obtaining quality education. The protocol includes measures for early detection and assessment of adhd, customised academic accommodations and support services, teacher training and capacity-building programmes, and collaborations with community resources and healthcare professionals. This research intends to empower educators, policymakers, and communities by proposing a sustainable formal education protocol. The goal is to establish more inclusive and supportive learning settings for children with adhd, thereby enhancing their academic success and general well-being. Integrating children with adhd into formal school aligns with the Sustainable Development Goal (sdg) 4 which aims to offer inclusive and quality education for everyone.

“Thoroughly out of my depth - A quality improvement project to improve junior clinician’s confidence in undertaking adult ADHD clinic appointments

IntroductionThere has been a 1000% increase in referrals for assessment of adult ADHD within Scotland over the past three years (The Scottish Government. 2023. NAIT adult Neurodevelopmental Pathways Report). These referrals are sent by general practitioners to the local community mental health team. The most junior clinicians (doctors who are pre-membership with the Royal College of Psychiatrists) in the team are often responsible for undertaking the initial assessment of these patients. Patients have on average waited almost a year to be seen and expectations are high.ObjectivesThe diagnosis of ADHD can be challenging, and adult ADHD is still a relatively new and evolving diagnostic entity. We set out to explore how junior clinicians were coping with this in their daily practice.MethodsWe developed a questionnaire that was sent to all junior clinicians working within Argyll &amp; Bute (n=8) via an anonymised email link. The link was open for 1 week and then results were analysed.ResultsThe response rate to our survey was 87.5%. Prior to starting their current roles none of the respondents had ever undertaken an ADHD assessment before. All respondents answered “No” when asked if they felt they had adequate knowledge on ADHD in order to perform assessments. Only 14% (n=1) felt they had access to adequate resources about how to make an ADHD diagnosis. Participants were asked on a scale of 1-10 (1= not at all,10= very) to rate their confidence in conducting ADHD assessments. The average confidence score was 2.43. There was a space for free text feedback in which participants reported the following: “felt thoroughly out my depth”, “I felt chucked in the deep end”, “I felt very under qualified”Image:ConclusionsOur results showed that junior clinicians did not feel confident or knowledgeable about undertaking adult ADHD assessments. In response to this we have now produced, in association with the consultant psychiatrists within our health board, an informative and engaging quick reference poster which explains how to undertake an ADHD assessment (see QR code attached as Image 1). It contains useful pointers about diagnosis, and more importantly guidance on language/phrases to use when explaining to patients whether or not you feel a diagnosis of ADHD is appropriate. It then also explains next steps that can be offered i.e. psychological support/medication options and how to prescribe these. We plan to send out a repeat questionnaire to the next cohort of junior clinicians to assess if they have improved confidence in managing and diagnosing ADHD following this intervention.Disclosure of InterestNone Declared

ADHD in a women during (peri)menopause: missed diagnoses and cardiac complaints

Introduction(Abstract for the accepted case-based workshop by the NDAL section at EPA)Women with ADHD are underdiagnosed in mental health care, and although ADHD starts in early childhood, the symptoms and impairment of women with ADHD may only be recognised for the first time during (peri)menopause.ObjectivesThe relationship between decreasing levels of estrogen and the interaction with dopamine function in the brain in women with ADHD will be discussed and illustrated by a clinical case vignet of Mary, age 54.MethodsMary presents with a history of repeated burnout episodes, mood swings, lifetime difficulty concentrating, planning and organising daily life, restlessness, sleep problems, and cardiac complaints.Mary has been working hard her whole life to overcome all difficulties, but her problem is she can never stop, leading to getting burnout several times. This time she is exhausted and can no longer cope; she is visiting the cardiologist for palpitations, hypertension and a recent myocardial infarction.ResultsAfter a positive screening for ADHD, based on her lifetime symptoms of inattention, restlessness and impulsivity, as well as mood swings, she is referred to a psychiatrist for assessment of ADHD, mood and sleep problems. The pathophysiology behind this cluster of disorders during (peri)menopause, as well as the treatment options will be discussed based on Mary’s case.ConclusionsBoth ADHD in women, (peri)menopausal mood disorders as well as the heart complaints in women during menopause are underrecognised and undertreated, leading to unneccesary suffering and cardiac death in women. It is time for psychiatry to join forces with cardiology and gynaecology for better recognition, sharing knowledge and multidisciplinary treatment of women with mental disorders such as ADHD during menopausal transition (see www.h3-netwerk.nl).Disclosure of InterestNone Declared

What does an ADHD-friendly university look like? A case study from Ireland

In Ireland, 5 % of university students registering with disability services in higher education have ADHD, increasing annually. Student services nationally report a significant increase in requests for assessment, diagnosis, and support for ADHD in university. This mixed method study investigated the experiences of undergraduate and postgraduate students with a diagnosis of ADHD in one HEI in Ireland to determine (i) institutional and systemic challenges, (ii) facilitators of successful progression through university, and (iii) an evidence-base to inform effective support. Data analysis encompassed responses from an online survey, anonymized longitudinal data extracted from disability services student progression reports, and qualitative data extrapolated from open-ended survey responses and individual, in-depth interviews. Findings indicate a need for ADHD friendly university campuses, adoption of Universal Design for Learning, increasing ADHD awareness within the university community, targeted ADHD supports, and optimizing the sensory environment.

Objective Parameters in Attention Deficit Hyperactivity Disorder: Eye and Head Movements

Objective: We aimed to evaluate eye and head movements, which are objective parameters in ADHD. Method: While the children were watching the course video task, which included the relevant (teacher and smart board) and irrelevant (any regions outside the relevant area) areas of interest, their eye movements were evaluated through eye tracking, and video recordings were made simultaneous. Head position estimation was made using through video recordings. The proportion of total fixation duration on areas of interest (PFDAOI) and saccade count, amplitude, velocity for eye movements, number of total head movements and angular change of head movement in x-y-z axes for head movements were compared. Results: Children with ADHD had lower PFDAOI on the relevant area, and had more saccade and head movements The angular change of head movement in the x-axis was higher in the ADHD group. Conclusion: In the assessment of ADHD, the eye and head movements may be particulary useful.

Cross-Cultural Adult ADHD Assessment in 42 Countries Using the Adult ADHD Self-Report Scale Screener

Objective: We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener. Method: Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57). Results: The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed. Conclusions: Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.

Attention-deficit Hyperactivity Disorder and Autism Spectrum Disorder: Towards Better Diagnosis and Management.

Attention-deficit hyperactivity disorder (ADHA) is one of the most common comorbid disorders of autism spectrum disorder (ASD) that can accompany autism, triggered by it, or be a consequence of it. This review explored the prevalence of the comorbidity of both disorders, neurobiological background, symptoms, latest assessment methods, and therapeutic approaches. Results and Discussion: It concluded that effective assessment, diagnosis and management of ADHD in ASD children and adults is essential for this group of patients to thrive and live a good quality of life. Further research is recommended to explore the most effective intervention for such important members of our society. More studies are needed to understand the mechanisms underlying these comorbidities, and to prevent the misdiagnosis and mismanagement of these disorders. Also, to develop up to date personalized therapeutic plans for such children.

Reflections on the current challenges in children’s ADHD assessment services

This article shares the personal reflections of two staff members on the current challenges in children and young people’s ADHD assessment services. We reflect on a range of challenges which impact on children and young people’s sense of self and mental health, and reduces their likelihood of receiving timely and effective support. The challenges discussed are waiting times, a deficit-based criteria, the impact of masking, signs of ADHD being overlooked, inaccurate perceptions of ADHD, overlapping symptoms with other conditions, and a lack of research and support. We suggest some potential areas of focus for service developments and future research.

0082 The Role of Sleep Duration and Daytime Sleepiness on Neurocognitive Functioning

Abstract Introduction Studies examining the impact of sleep on neurocognitive functioning have broadly found that poor sleep and daytime sleepiness manifest in poorer performance on tasks involving attention, concentration, memory, reasoning and thinking. Given the expansive nature of neurocognition, the current study assessed the role of sleep duration and daytime sleepiness broadly on overall neurocognitive functioning as well as more specifically on executive functioning when controlling for age and gender identity. We hypothesized that both sleep duration and reported daytime sleepiness would be associated with a lower neurocognitive status and poorer executive functioning as observed through computerized assessment. Methods Participants included 148 (50.7% male; µage=34.58) patients who presented to a Neuropsychological practice for the assessment of ADHD through a structured assessment battery. All patients completed a multi-component computerized assessment of overall neurocognitive status (CNS Vital Signs) and pen-and-paper questionnaires targeting the subjective reporting of sleep duration (Pittsburgh Sleep Quality Index) and daytime sleepiness (Epworth Sleepiness Scale). Two separate multiple regressions were run to determine the association of sleep duration and daytime sleepiness to overall neurocognitive status and executive functioning abilities when controlling for age and gender identity of patients. Results The full model demonstrated that when considered together sleep duration and daytime sleepiness significantly aided in the prediction of neurocognitive status, F(4,143)=3.81, p=.006, R2 =.096, and executive functioning abilities, F(4,143)=3.90, p=.005, R2 =.098, of patients when controlling for age and gender identity. Of note, only daytime sleepiness was a statistically significant sleep predictor of both neurocognitive status (β=-.172, p=.035) and executive function (β=-.197, p=.016). Conclusion Broadly, these findings suggest that sleep is an important predictor of neurocognitive functioning. Within the clinical field, these results support the inclusion of sleep measurement, whether objective or subjective, during the assessment of neurocognitive functioning to better account for the role played by sleep on patient performance. To this end, it would be beneficial to assess a greater range of sleep factors and how they may be associated with the various neurocognitive domains. Support (if any)

Self-Reported Adult ADHD Symptoms: Evidence Supporting Cautious Use in an Assessment-Seeking Sample

Objective: Self-report symptom inventories are commonly used in adult ADHD assessment, and research indicates they should be interpreted with caution. This study investigated one self-report symptom inventory for adult ADHD in a clinical sample. Method: Archival data were used to evaluate diagnostic utility of the Conners Adult ADHD Rating Scale—Self-Report: Long Version (CAARS-S:L) in a sample of 122 adults seeking ADHD assessment. Results: Overall, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) estimates for the ADHD Index and other CAARS-S:L scales demonstrated weak accuracy. Anxiety and depression were the most common diagnoses present when a false positive on the ADHD Index was observed. PPV and specificity for the ADHD Index were higher in males compared to females. Conclusion: The CAARS-S:L may be useful for screening purposes in some cases, but should not be the main method used for diagnostic purposes. Clinical implications of findings are discussed.

Suicidality risk in children and adolescents with externalizing disorders: symptoms profiles at high risk and the moderating role of dysregulated family relationships.

Children and adolescents with externalizing disorders are at risk for suicidal ideation or behavior. Factors that put them at risk could be symptoms related or facilitated by their environment. We evaluated the links of symptoms profiles with suicidality, and the effects of family relationship characteristics on these links. Latent profile analysis was used to subgroup participants referred for ADHD assessment (n = 1249, aged 6-17) based on their externalizing and internalizing symptoms. Self- and parent-reported child suicidal ideation (S-SI, P-SI), and parent-reported self-harm behavior (P-SHB) were compared across profiles. The moderating effects of parent-reported marital conflict and parenting practices were examined. A four-profile model showed optimal fit. Participants of the Low Symptoms profile followed by the Inattentive-Hyperactive/Impulsive profile showed lower P-SI compared to those of the Irritable-Defiant and the Conduct Problems profiles. Low Symptoms participants also reported lower S-SI compared to those of the Inattentive-Hyperactive/Impulsive and the Irritable-Defiant profiles. Participants of the Irritable-Defiant and the Conduct Problems profiles had higher P-SHB compared to the Low Symptoms and the Inattentive-Hyperactive/Impulsive participants. Dysregulated marital conflict practices were associated with greater increase in P-SI in all profiles compared to the Low Symptoms profile. Aggressive marital conflict practices were associated with increased P-SHB in the Conduct Problems profile compared to the Inattentive-Hyperactive/Impulsive profile. Children and adolescents with irritability and defiance symptoms with or without conduct problems show higher risk for suicidal ideation and behavior compared to those with ADHD symptoms alone. Dysregulated and aggressive marital conflict practices might pose additional suicidality risk in children and adolescents with disruptive behavior.

Assessing Adult ADHD Through Objective Neuropsychological Measures: A Critical Overview

Objective: This review examines the role of neuropsychological tests in the diagnostic assessment of adult ADHD, focusing on their ability to discriminate individuals with ADHD from those with other psychiatric conditions. Method: PubMed, Embase, and PsycINFO were searched for eligible peer-reviewed studies from inception to September 2022. Results: Ten studies were included. Among the objective measures analyzed, Continuous Performance Tests were the only capable to reliably distinguish individuals with ADHD from other psychiatric patients, in a combined approach with clinical interview instruments. The other objective tests showed mixed and inconsistent results. Conclusion: This finding suggest that further studies are needed to develop objective measures more tailored to the core symptoms of ADHD, in order to improve the discriminatory ability of the tests and help the clinicians in the complex differential diagnosis between ADHD and other psychiatric disorders.

Divergent Mentalization Types in Adolescent Borderline Personality Disorder and Attention Deficit/Hyperactivity Disorder

IntroductionAttention Deficit/Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD) have several similarities and it is difficult to distinguish these disorders in adolescents.ObjectivesWe aimed to identify the unique correlates of mentalization abilities that may distinguish these two disorders, and to investigate the mentalization abilities of adolescents with ADHD, BPD and ADHD+BPD in an inpatient sample (n=550) to determine the effect of co-morbidity on mentalization abilities.MethodsWe have explored the relationship between Child Eye Test (CET) scores, Movie for the Assessment of Social Cognition (MASC) subscales, and ADHD and BPD symptoms in adolescent inpatients. In addition, we compared ADHD, BPD and ADHD+BPD groups in terms of their mentalization abilities.ResultsCorrect MASC scores were negatively associated with both ADHD and BPD symptoms in girls, and negatively associated with ADHD symptoms in boys. In addition, hypermentalization scores were associated with BPD symptoms in girls, and hypomentalization and no mentalization scores were associated with ADHD symptoms in girls. CET scores were negatively associated with ADHD symptoms in girls, but no relations with BPD were found. Group comparisons revealed no significant difference among groups.ConclusionsWe found that while ADHD symptoms are related to hypomentalization, BPD symptoms are rather related to hypermentalization. We believe that these findings make significant contributions to literature aimed at understanding the differences between two disorders which have great commonalities in terms of clinical appearance and developmental course.Disclosure of InterestNone Declared

ADHD Assessment Recommendations for Children in Practice Guidelines: A Systematic Review

Objective: The current review sought to synthesise and evaluate ADHD guidelines to identify recommended procedures for co-occurring and differential diagnosis for ADHD assessments of school aged children. Method: A systematic literature review was conducted by searching PsycInfo, Medline, CINAHL and Web of Science. A grey literature search was also performed. ADHD guidelines that described a diagnostic process for school aged children, published between 2013 and 2021, by Government organisations or a national professional association, and written in English were included. Results: Each of the six included guidelines were produced by panels consisting primarily of paediatricians and psychiatrists. All guidelines recommended assessing for co-occurring conditions. Five of the guidelines recommended consideration of a differential diagnosis. Five guidelines also recommended referral to a specialist, mental health clinician or psychologist when diagnostic uncertainty exists. Conclusions: Guidelines to assist in the assessment of referred cases were not discovered. There is a need for recommendations to be developed to supplement existing guidelines to aid psychologists and mental health clinicians in a systematic ADHD assessment process, particularly in complex cases.

Chlorpyrifos residue level and ADHD among children aged 1-6 years in rural China: A cross-sectional study.

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and is caused by both genetic and environmental factors. As genetic factors are nonmodifiable, environmental factors have attracted increasing attention.ObjectiveTo investigate the relationships between urinary chlorpyrifos (CPF) levels, blood micronutrient levels, and ADHD prevalence in children living in rural areas of China.MethodsThis cross-sectional study collected data on CPF exposure (according to urinary levels), blood micronutrient levels, and ADHD prevalence in children aged 1–6 years in rural China. The CPF levels were determined by mass spectrometry. Blood levels of micronutrients, including zinc, iron, calcium, copper, magnesium, and vitamin D, were measured by professional detection kits. ADHD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Descriptive statistics and univariate analysis were conducted using SPSS 21.0, and path analysis was conducted using Mplus 8.0.ResultsOf the 738 children who met the eligibility criteria, 673 children (673/738, 91.2%) were included in the final analysis. Baseline questionnaires and urine samples were collected from all 673 subjects. A total of 672 children provided blood samples for micronutrient testing, and 651 completed the ADHD assessment. Approximately one-fifth of children (144/673, 21.4%) had detectable levels of CPF in their urine, and 6.9% (45/651) were diagnosed with ADHD. Path analysis showed that the total effect of CPF exposure on ADHD risk was 0.166 (P < 0.05), with a direct effect of 0.197 (P < 0.05) and an indirect effect of −0.031 (P < 0.05) via vitamin D. The mediating effect of urinary CPF levels on ADHD risk via vitamin D was 18.67%.ConclusionHigher levels of CPF exposure are associated with higher risk of ADHD. Additionally, increasing vitamin D levels may have a beneficial effect on the relationship between CPF exposure and ADHD risk. Our findings highlight the importance of modifying environmental factors to reduce ADHD risk and provide insight into future ADHD interventions.

Correlation of attention deficit hyperactivity disorder with gut microbiota according to the dietary intake of Korean elementary school students.

We investigated the impact of dietary patterns on the gut microbiota and concentration of short-chain fatty acids in the feces of Korean elementary school students. The dietary intake and ADHD assessment of 40 Korean elementary school students were analyzed using a dish-based semi-quantitative food frequency questionnaire. Analysis of gut microbiota and short-chain fatty acids composition were performed using the real-time polymerase chain reaction, metagenomics, and gas chromatography methods. The dietary patterns of participants were divided into four groups: healthy, processed food, fish and shellfish, and meat. The participants were also divided into two groups according to their ADHD scores: 0–30, control group; over 30, ADHD group. The ADHD score of the processed food group was significantly higher than that of the healthy group. The processed food and ADHD groups showed significantly higher abundance of harmful bacteria, such as the Enterobacter, Escherichia coli, and Clostridium strains, and markedly lower abundance of beneficial bacteria, such as the Bifidobacterium and Ruminococcus strains, than the control group. The heat maps of metagenomics indicated that each group was separated into distinct clusters, and the processed food and ADHD groups showed significantly lower α-diversity of gut microbiota than the control group. In these groups, the concentration of acetate or butyrate in the feces was significantly lower than that in the control group. These results may indicate that imbalanced diets can disturb the colonic microbial balance and are likely to become a potential risk factor for the prevalence of ADHD.

Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability.

The ability to recognize emotions evident in people's faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6-14years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.

Age-Related Variance in Performance versus Ratings of Attention and Impulse Regulation in Children: Implications for the Assessment of ADHD.

Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old were assessed longitudinally. Growth curve analyses and correlations were conducted to better understand how these two types of measures relate to one another across development, as well as the impact of age-related variance. EF was assessed using the Stroop Task and Trail Making test and behavioral ratings of self-regulation were captured using the SWAN scale. EF task performance improved steeply until age 14–15, whereas the SWAN Scale showed small age-related decreases. EF task performance was moderately correlated with age among 8–13-year-olds and to a lesser extent among 14–20-year-olds. SWAN scores were not significantly related to age in either group. Correlations were similar in an ADHD “at-risk” subgroup. EF task performance and parent ratings of attention regulation have different developmental trajectories, which may partly explain why correlations are low to modest in these samples. In particular, age-related variance is an important methodological consideration with significant implications for the assessment of self-regulation in children and youth with ADHD.

Differences in executive functioning between adults with ADHD and those diagnosed with other psychiatric diagnoses: Utility of the CTMT and the WAIS-IV

In this study, the utility of the Comprehensive Trail Making Test (CTMT) and WAIS-IV working memory (WMI) and processing speed (PSI) indices in assessment of ADHD were examined. Using retrospective analysis of data from two private practices, patients were classified as having ADHD, having another psychiatric disorder, or having comorbid ADHD and other psychiatric disorder. Results indicated that significant differences existed in performance across the three groups [F(6, 246) = 3.38, p = .003; Pillai’s Trace = 0.152, partial η 2 = 0.076] on CTMT scores (p < .05), WMI scores (p ≤ .001) and PSI scores (p < .05). Logistic regression analyses indicated WMI and CTMT trail 5 scores were individually useful indicators in identifying the presence of ADHD. Analysis also indicated minimal increase in correct classification of presence or absence of ADHD through combining CTMT, WMI, and PSI scores. Clinical implications for neuropsychological assessment and differential diagnosis of ADHD are discussed.