Wender Utah Rating Scale Research Articles

No Link Between Date of Birth and ADHD Symptoms in Adults

Objective: Research has highlighted several negative consequences for individuals born in the later part of the academic year, including increased likelihood of being diagnosed with learning disabilities. In this study, we considered whether birthdate predicted ADHD symptomatology using two well known mechanisms, the relative age effect (RAE) and the season of birth effect (SOBE). Methods: Study participants completed two ADHD measures: Conners Adult ADHD Rating Scales (CAARS) and the Wender Utah Rating Scale (WURS). Results: There were gender effects in the WURS data indicating that males scored higher than females on ADHD symptoms as well as a significant interaction in the CAARS data to support differential patterns among males and females. Conclusion: Overall, results did not support a RAE or SOBE among males or females. Possible reasons for these findings and their implications are discussed.

Prevalence of adult attention deficit hyperactivity disorder in the relatives of patients with bipolar disorder

Objective. We hypothesized that relatives of bipolar patients would have increased rate of attention deficit hyperactivity disorder (ADHD) and subsyndromal manifestations compared to demographically matched relatives of healthy controls. Method. Forty consecutive patients with bipolar disorder were recruited from inpatient and outpatient units of Sisli Etfal Teaching and Research Hospital, Psychiatry Department. Seventy-three first-degree relatives of bipolar disorder group were included. A control group of first-degree relatives of individuals without DSM-IV Axis I psychopathology were also recruited. The Turkish version of the Structural Clinical Interview for DSM-IV, Wender Utah Rating Scale, Turgay's Adult ADD/ADHD DSM-IV based Diagnostic and Rating Scale were administered to participants. Results. Overall rate of adult ADHD in RBD group was significantly higher than RC group (9.6 vs. 1.5%; P = 0.04). Participants with adult ADHD in the RBD group had significantly higher rate of alcohol abuse compared to those without adult ADHD (14.3 vs. 1.5%; P = 0.05). Rates of OCD and dysthimia were significantly higher in the subjects with ADHD in the RBD group than the subjects without ADHD (28.6 vs. 4.5%; P = 0.02, 14.3 vs. 1.5%; P = 0.05 respectively). Conclusion. Our findings indicate that relatives of bipolar patients have a risk for suffering from ADHD, and support the hypothesis that relatives of bipolar patients are at a risk for developing attentional and behavioral problems.

Poster #166 NEGATIVE SCHEMATIC BELIEFS ABOUT SELF AND OTHERS DIFFERENTIALLY PREDICT SUSPICIOUSNESS IN AT-RISK STATES

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental and psychiatric disorder that affects different aspects of an individual life, such as cognitive functions. ADHD comprise a complex symptomatology such as cognitive flexibility and inappropriate risk-taking. We aimed to compare cognitive flexibility and appropriate risk-taking of adults with and without ADHD. For this purpose, the Conners’ Adult ADHD Rating Scale (CAARS) was used to screen 580 students of Tehran University in Iran. Forty participants who scored highest in CAARS were invited to have a clinical interview with a trained psychiatrist. The diagnosis was made based on the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), using the Wender Utah Rating Scale (WURS). Finally, thirty individuals were diagnosed with ADHD. Meanwhile, the 30 students with the lowest scores on the CAARS and General Health Questionnaire (GHQ) were included as the control group. The two groups then were compared using the Cognitive Flexibility Inventory (CFI) and the Iowa Gambling Task (IGT). The results of the one-way ANOVA indicated that scores of case group in the components of cognitive flexibility were significantly lower in the patients compared to the control group. Also, the ADHD group had lower scores concerning appropriate risk-taking and had a shorter reaction time. Findings of the current study might help to open further avenues in the rehabilitation of cognitive flexibility and controlling reward-seeking and risk-seeking impulses.

Adolescent Outcome of Child ADHD in Primary Care Setting

Objective: The aim of the study was to assess the functioning of patients with ADHD 6 to 7 years after the diagnosis. One objective was to determine the stability of diagnosis, symptoms decline, subtype change, remission, and change of diagnosis. Method: In all, 101 participants were chosen for testing. All were interviewed for the presence of ADHD and social, academic, and peer functioning, and completed Youth Self-Report. The caregivers completed a Wender Utah Rating Scale and Child Behavior Checklist, and were asked to assess the social, academic, and peer functioning of their offspring. Results: A total of 56% (n = 57) still met the criteria for ADHD and 24.7% (n = 25) still met the criteria for hyperkinetic disorder (HKD). Subtype migration was observed. In all, 7.7% (n = 14) were rediagnosed with Asperger’s syndrome, 2.2% (n = 4) received a diagnosis of bipolar disorder, 2.2% (n = 4) were diagnosed with mental retardation, 1 with schizophrenia, and 1 with genetic disorder. Conclusion: The reliability of diagnosis was high. The rates of all subtypes of ADHD decreased. More measures need to be taken in terms of differential diagnosis of ADHD and Asperger’s Syndrome.

Retrospective Assessment of ADHD Symptoms in Childhood

Objective: To examine the discriminatory validity of the Wender Utah Rating Scale (WURS) and its five suggested subscales (Conduct Problems, Impulsivity Problems, Mood Difficulties, Inattention/Anxiety, Academic Concerns) in a Finnish sample. Method: WURS was administered to 114 adults, aged 18 to 55 years. Participants with ADHD (n = 37) and dyslexia (n = 36) were compared with healthy controls (n = 41). Results: The ADHD group scored significantly higher than the control group on all subscales. Compared with the dyslexia group, the ADHD group did not differ in Mood Difficulties or Academic Concerns. Using the total score, the positive predictive value was .53 in this sample and only .21 when the prevalence of ADHD was taken into account. Conclusion: Three out of five domains of WURS are reliable indicators of ADHD. Domains with low discriminatory power, low general prevalence of ADHD, and other developmental disorders within the population decrease the accuracy.

Attention Deficit/Hyperactivity Disorder (ADHD) in a Group of Patients with Addictive Problems: Exploratory Study in France

High rates of childhood ADHD has been found among substance users, revealing an important role of ADHD in addictive disorders. Compared to non-hyperactive, people with ADHD reported higher rates of co-accuracy with substance use. ADHD appears to be a risk factor for developing a consummation of one of these substances and complicates even access to the abstinence. The present study examines the prevalence of ADHD in adult patients with addictive problems (alcoholism, tobacco consumption, pathological gambling and compulsive buying). The authors compared 117 patients with and without ADHD, according to evaluations made with the Wender Utah Rating Scale (WURS) and the Adult Deficit Disorders Scale [1]. Various differences were observed between the group with ADHD and that without ADHD. The percentage of adults with positive scores in scales of ADHD in the sample group was 35%, compared to average 3.4% [2] in the general population. Different trends were observed, in accord to literature, the age at beginning of addictive behaviours are more earlier in ADHD group, and the cigarette consummation are as well elevated in ADHD group. Beside the use of psychoactive substances (cocaine, heroin and cannabis) are more elevated, as well as cognitive and motor impulsivity (Barratt Impulsivity Scale BIS-10) in the ADHD group. These data show the value of early detection of ADHD in order to prevent complications during adolescence and adulthood.

P-52 - Screening adult attention deficit hyperactivity disorder in adults diagnosed with substance abuse disorder

ADHD is not only a risk factor to the beginning of substance abuse but also is a determining factor in terms of long-term use and difficult treatment. Therefore, detection of the presence of comorbidity is important in terms of treatment approach. The aim of this study is to screen the presence of adult ADHD in patients diagnosed with substance abuse disorder. 120 patients who were diagnosed as substance abuse disorder according to DSM-IV were included in the study. Wender-Utah Rating Scale and Adult ADD/ADHD (attention deficit disorder/attention deficit hyperactivity disorder) inventory were performed to the patients. Patients who scored above the cut-off score of these scales were evaluated clinically in terms of adult ADHD. 16 of 120 patients (13.3%) included in the study were diagnosed as adult ADHD on the basis of scales and clinical evaluation. When the abused substances were evaluated; 36% alcohol, 21% cannabis, 11% cocaine or other stimulants and 5% multi-drug addiction have been identified. Overall, 15%–25% of adults with drug and alcohol use disorders have current ADHD. ADHD itself appears to be a risk factor for later substance use disorders, with onset typically around 17–19 years of age.Individuals with both diagnoses have been reported to have an earlier onset, a longer course, and greater severity, with more relapses and greater difficulty remaining abstinen. In summary, the neuropsychological and neurobiological literature indicates important overlaps between ADHD and substance use disorders, and the two need to be treated in tandem.

O-19 - Attention deficit hyperactivity disorder in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is characterized by androgen excess, chronic oligoanovulation and polycystic ovaries on ultrasound. Its etiology remains largely unknown however several studies suggested that prenatal androgen exposure might contribute to development of PCOS. An association between androgen dysfunction and attention deficit hyperactivity sendrome (ADHD) is established. The aim of this study was to investigate the ADHD symptoms in women with PCOS. Forty females who had a clinical diagnosis of PCOS based on Rotterdam diagnostic criteria were recruited for the study group. For comparison, regularly cycling healthy controls who agreed to participate in the study (n = 40) were recruited in control groups. A physical examination was performed by the same physician on all women in Gynecology Department. All participants were then invited to complete the Wender Utah Rating Scale (WURS - 25) and the Adult ADHD Self-Report Scale (ASRS-v1.1). There were no significant differences in age, education, and BMI between groups. Total WURS and ASRS scores were statistically higher in females with PCOS. Hyperactivity subscore of ASRS and Irritability, School Problems and Behavioral Problems/Impulsivity subscores of WURS were significantly higher in females with PCOS than controls. Our results showed that ADHD symptoms are higher in women with PCOS than healthy controls. These findings suggest that prenatal exposure to high levels of androgen influences some ADHD symptoms and that hormonal factors may be involved in ADHD.

Screening for ADHD in an Adult Social Phobia Sample

Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult ADHD Self-Report Scale). Results: Childhood symptoms of ADHD were reported by 7.8% of the social phobia participants, and 5.1% scored within the range of adult ADHD. The social phobia group reported significantly fewer ADHD symptoms than both of the comparison groups, who frequently reported social anxiety. Conclusion: Participants with social phobia recruited from the general population are less likely to suffer from ADHD. In contrast, patients with ADHD and patients with other psychiatric disorders appear to be likely to suffer from social anxiety.

Conceptual Structure of the Symptoms of Adult ADHD According to the DSM-IV and Retrospective Wender-Utah Criteria

Objective: Adult Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) and retrospective childhood Wender-Utah ADHD criteria are implemented in self-report measures to assess adult ADHD and its required onset in childhood. Yet their dimensional structure and relationship to adult ADHD depressivity is still at debate. Therefore, both aspects were investigated, applying two respective German instruments (ADHD–Self-Report [ADHD-SR] and Wender Utah Rating Scale–German [WURS-G]) to two student samples. Method: ADHD-SR and WURS-G dimensions were identified by nonlinear confirmatory factor analyses, and their interrelations and relationship with adult depressivity were identified by structural equation modeling. Results: Adult ADHD-SR symptoms were organized into inattention, hyperactivity, and impulsivity, and WURS-G symptoms were organized into inattention/hyperactivity, affect lability, depressivity, and conduct problems. Yet only the first two WURS factors directly affected adult ADHD facets, though childhood depressivity influenced them indirectly via adult depressivity. Conclusion: Only criteria of the first two WURS factors can be considered valid childhood ADHD indicators. Thus, only they should be used as an aid in the retrospective assessment of ADHD symptoms.

Frequency of attention-deficit hyperactivity disorder in substance-dependent patients hospitalised in Mashhad Ebn-e-Sina hospital

Dual diagnosis of attention-deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) in adults has been an area of clinical and research interest. In the present study, we assessed the frequency of ADHD in drug-dependent patients. This is a descriptive cross-sectional study. We assessed the frequency of ADHD in 144 drug-dependent patients who were admitted for detoxification at Ebn-e-Sina psychiatric hospital between August 2007 and June 2008. All patients met DSM-IV-R criteria for substance dependency; diagnosis was made by two psychiatrists. Patients completed demographic characteristics questionnaire and were rated on Wender Utah Rating Scale and adult ADHD measurement scale. Those with higher than cut-off point of both scales were interviewed directly by a psychiatrist based on DSM-IV-R criteria for the best estimate diagnoses of ADHD. Eighteen (12.5%) of the substance-dependent patients were found to have ADHD as a child that persists to adulthood. Starting age of substance use was 22.0...

Retrospective Evaluation of Attention Deficit Hyperactivity Disorder with the Wender Utah Rating Scale in a Sample of Spanish Prison Inmates

The aim of this study is to determine the prevalence of childhood history of attention deficit hyperactivity disorder (ADHD) in a sample of prison inmates. This is a descriptive, cross-sectional study, which consisted of a sample of 100 inmates from penitentiary centers in Madrid. The instruments used were the Wender Utah Rating Scale (WURS), the International Personality Disorder Examination, and a questionnaire of demographic, penitentiary, and toxicological data. For statistical analysis, the SPSS program was used with confidence interval estimation of 95%. The mean score of the WURS was 65.7 points. Fifty percent of the sample surpassed the cut-off point of 32 for the 25 best discriminative items in the Spanish validated version. A significant association was found between a childhood history of ADHD and antisocial and borderline personality disorders. The disorder was also found to be associated with autoaggressive behavior, more probability to be sanctioned in prison, and have a history of substance dependence.

Childhood attention deficit hyperactivity disorder features in adult mood disorders

A significant overlap between childhood mood disorders and many aspects of attention deficit hyperactivity disorder (ADHD) has been established. High rates of co-occurrence, familial aggregation, and more severe clinical manifestations of the illnesses when they are comorbid suggest that common genetic and environmental factors may contribute to the development of both disorders. Research on the co-occurrence of childhood ADHD and mood disorders in childhood has been conducted. We retrospectively investigated childhood ADHD features in adults with mood disorders. Childhood ADHD features were measured with the Korean version of the Wender Utah Rating Scale (WURS). The sample consisted of 1305 subjects: 108 subjects were diagnosed with bipolar disorder type I, 41 with bipolar disorder type II, 101 with major depressive disorder, and 1055 served as normal controls. We compared total WURS scores as well as scores on 3 factors (impulsivity, inattention, and mood instability and anxiety) among the 4 different diagnostic groups. The 4 groups differed significantly from one another on all scores. The group with bipolar disorder type II obtained the highest total scores on the WURS. The impulsivity and inattention associated with childhood ADHD were more significantly related to bipolar disorder type II than with bipolar disorder type I. The mood instability and anxiety associated with childhood ADHD seem to be significantly related to major depressive disorder in adulthood. In conclusion, multifactorial childhood ADHD features were associated with mood disorders of adulthood.

Sustained Attention and Behavioral Characteristics Associated with ADHD in Adults

The goal of the current study was to investigate whether two cognitive functions (i.e., sustained attention and response inhibition) were related to a general model of personality traits and behavioral characteristics associated with attention-deficit hyperactivity disorder (ADHD). To examine these relations, the Conjunctive Continuous Performance Test was used to measure the two cognitive functions, the Mini-Marker was used to measure the Big Five domains of personality, and the Wender Utah Rating Scale (WURS) was used to index ADHD symptoms. Correlations and multiple regression analyses showed that difficulties in sustained attention were associated with the WURS behavioral symptoms of inattention, oppositional/defiant behavior, impulsivity, and Big Five low conscientiousness, but were not associated with emotional problems such as neuroticism or low agreeableness (Big Five). Difficulties in response inhibition were marginally correlated with behavioral symptoms of inattention and low conscientiousness. Surprisingly, response inhibition was also highly correlated with sustained attention. In addition, neuroticism independently was highly associated with the WURS emotional and oppositional/defiant behavior symptoms. The findings suggest that deficient sustained attention relates specifically to the main ADHD behaviors but not to the emotional problems typically associated with the disorder.

The impact of ADHD symptoms on intelligence test achievement and speed of performance

There is evidence of an association between Attention Deficit Hyperactivity Disorder (ADHD) and impaired performance on neuropsychological tests. Nevertheless, there is a dearth of research on this topic, particularly among forensic populations where rates of ADHD are notably high. This study aims to investigate the effect of ADHD symptoms on speed and performance on a non-verbal intellectual test. Forty three Icelandic male prisoners were screened for childhood ADHD using the Wender Utah Rating Scale (WURS), and for adult ADHD using the DSM-IV checklist of symptoms. IQ was measured using the Ravens Standard Progressive Matrices (RSPM) total score, and test completion time was also recorded. Correlations were conducted on the measures and the effect sizes ranged between small (childhood ADHD with RSPM total score and completion time) to large (adult ADHD with childhood symptoms, RSPM total score and completion time). Multiple regression analysis indicated that intellectual performance was significantly negatively affected by fast test completion time (medium effect size), but even after controlling for this, performance was further impaired by adult ADHD symptoms (large effect size). The results indicate that ADHD symptoms in adulthood adversely affect intellectual test performance above the speed of performance alone.

German validation of the Conners Adult ADHD Rating Scales (CAARS) II: Reliability, validity, diagnostic sensitivity and specificity

BackgroundThe German version of the Conners Adult ADHD Rating Scales (CAARS) has proven to show very high model fit in confirmative factor analyses with the established factors inattention/memory problems, hyperactivity/restlessness, impulsivity/emotional lability, and problems with self-concept in both large healthy control and ADHD patient samples. This study now presents data on the psychometric properties of the German CAARS-self-report (CAARS-S) and observer-report (CAARS-O) questionnaires. MethodsCAARS-S/O and questions on sociodemographic variables were filled out by 466 patients with ADHD, 847 healthy control subjects that already participated in two prior studies, and a total of 896 observer data sets were available. Cronbach's-alpha was calculated to obtain internal reliability coefficients. Pearson correlations were performed to assess test-retest reliability, and concurrent, criterion, and discriminant validity. Receiver Operating Characteristics (ROC-analyses) were used to establish sensitivity and specificity for all subscales. ResultsCoefficient alphas ranged from .74 to .95, and test-retest reliability from .85 to .92 for the CAARS-S, and from .65 to .85 for the CAARS-O. All CAARS subscales, except problems with self-concept correlated significantly with the Barrett Impulsiveness Scale (BIS), but not with the Wender Utah Rating Scale (WURS). Criterion validity was established with ADHD subtype and diagnosis based on DSM-IV criteria. Sensitivity and specificity were high for all four subscales. ConclusionThe reported results confirm our previous study and show that the German CAARS-S/O do indeed represent a reliable and cross-culturally valid measure of current ADHD symptoms in adults.

P01-415 - Association between albumin and social cognition in attention-deficit-hyperactivity-disorder (ADHD)

IntroductionAlbumin is a protein which serves as a transporter for a variety of metabolites and as a storage for a lot of substances. Although albumin cannot pass the blood-brain-barrier and thus influence the CNS directly, a negative relation between cognitive impairment and serum albumin level has been observed in studies of normal and pathological aging.The aim of the present study was to investigate the association between albumin and social cognition in ADHD.Method20 adult patients with ADHD and 20 healthy controls participated in a double-blind within subjects crossover study. Participants completed the Moral-Judgment-Test, Tuebingen Affect Battery, the Movie for the Assessment of Social Cognition (MASC) and Cambridge Behaviour Scale (EQ). In addition, ADHD symptoms were assessed by the Wender Utah Rating Scale (WURS-K) and ADHD Self Rating Scale. Serum albumin levels were determined after blood withdrawal.ResultsIn the patient group serum albumin levels were negatively associated with ADHD pathology measured by WURS-K. In addition, a low level of albumin was related with poorer performance in theory of mind, moral judgment competence and affective prosody tasks.ConclusionsThe results suggest that albumin is related to social cognition in younger patients with ADHD. This is, to the knowledge of the authors, the first investigation, in which the association between albumin and cognition has been investigated in ADHD. Thus the findings of the present study need replication and the neural mechanisms have to be explored in future studies. Further studies are needed to exclude a possible medication effect.

COMT Val158Met variant and functional haplotypes associated with childhood ADHD history in women with bulimia nervosa

Up to one third of patients with bulimia nervosa (BN) report a history of ADHD symptoms, and both disorders may also be associated with dopaminergic abnormalities. COMT gene, coding for an enzyme responsible for the degradation of dopamine, may play a part in the etiology of ADHD and BN. This study aimed to (1) examine if certain variants of the COMT genetic markers (rs6269, rs4633, rs4818 and rs4680) are more common in BN versus controls; (2) assess transmission of COMT alleles in BN families; and (3) explore the role of COMT genotypes and haplotypes in bulimic women with childhood ADHD history. 72 BN probands and unaffected relatives were genotyped for COMT rs4680 (Val158Met) and three adjacent markers. The remaining 165 probands were matched with nonpsychiatric controls. We also investigated if COMT variants and haplotypes were associated with childhood ADHD history in a subgroup of 86 BN probands who completed the Wender Utah Rating Scale (WURS). Our results showed that cases and controls did not differ in COMT allele and haplotype frequencies. In contrast, specific alleles of all four COMT markers and the medium-activity haplotype were preferentially transmitted to the offspring with BN. COMT Val158 allele was overrepresented and the medium-activity haplotype was underrepresented in BN with childhood ADHD history (p=0.010). These findings suggest a possible role for COMT variants and related haplotypes in BN and its subphenotypes. If replicated, these preliminary findings may have implications for the prevention and treatment of BN that emerges in the context of childhood ADHD.

Severity of Childhood Attention-Deficit Hyperactivity Disorder—A Risk Factor for Personality Disorders in Adult Life?

Some evidence points to an increased rate of cluster B and C personality disorders (PDs) in adult ADHD patients. In order to assess axis II disorders comprehensively we used the diagnostic instrument of the WHO. In sixty adult out-patients with ADHD according to DSM-IV criteria PDs were assessed with the International PD Examination (IPDE) and severity of childhood ADHD with the Wender-Utah-Rating Scale (WURS). We found at least one PD in 25% of cases. Cluster C PDs were most common (36.6%) followed by Cluster B (23.3%) and A (8.3%). Avoidant (21.7%) and borderline (18.3%) were the most frequent single PD entities. ADHD patients with PD suffered from significantly more severe childhood ADHD compared to those without co-occurring PD. Applying the IPDE we confirmed a high number of PDs among adult ADHD patients. Our findings point to a higher vulnerability for the development of PDs in patients with severe childhood ADHD.

Prevalencia del trastorno por déficit de atención/hiperactividad en adictos a sustancias: del cribado al diagnóstico

There is a rich body of literature on the coexistence of diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and substance abuse/dependence. Prevalence, however, varies considerably from one work to another. To apply an algorithm that takes into account all the criteria needed to reach an adequate diagnosis and to explore the conditions associated with false positives. The diagnostic algorithm was applied using several tests in the different phases, i.e. the Attention Deficit Hyperactivity Disorder Self-Report Scale was used for screening, the Wender-Utah Rating Scale and the Parents' Rating Scale were administered for the retrospective diagnosis, and the self-administered Spanish version of the frontal behaviour scale and the perceived stress scale were used to study false positives. Symptoms of other axis I disorders were also explored and a battery of classic neuropsychological tests was administered. All this was carried out with a sample of 696 subjects whose treatment began in a care centre for drug addicts. The final prevalence was found to be 6.89%. The symptoms of the false positives in the screening test prior to consumption were similar to those of the true negatives, but in that moment those symptoms were similar to those of the true positives, with whom no differences were found in the neuropsychological performance. Generalised anxiety disorder was the one that showed the highest relation with false positives. The diagnostic category of ADHD is usually utilised indiscriminately to classify subjects with early-onset neurological disorders and those who present similar manifestations following the phase of active addiction to substances. There is a need for a neurological and neuropsychological study that goes beyond the mere symptoms so as to be able to carry out a suitable characterisation and treatment of a set of similar symptomatic manifestations, but with a very wide range of developmental and aetiopathogenic components.