Advertisement

European Child & Adolescent Psychiatry

, Volume 15, Supplement 1, pp i46–i55 | Cite as

Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study

  • Manfred DöpfnerEmail author
  • Hans-Christoph Steinhausen
  • David Coghill
  • Søren Dalsgaard
  • Lynne Poole
  • Stephen J. Ralston**
  • Aribert Rothenberger
  • ADORE Study Group*
Article

Abstract

Objectives

To provide psychometric information on the Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV (ADHD-RS-IV) in a large population of children with ADHD.

Methods

Patients aged 6–18 years (n=1,478 in baseline analysis) were rated by 244 physicians on the ADHD-RS-IV based on a semistructured interview with the patient's parent. Physicians additionally rated functional impairment (CGAS) and health status (CGI-S), and parents rated their child's behavioural and emotional problems (SDQ) and quality of life (CHIPCE).

Results

Inattention and hyperactivity-impulsivity as dimensions of ADHD were replicated. 3-factor solutions reflecting the ICD-10 definition, with hyperactivity, impulsivity and inattention as separate dimensions were extracted in some national sub-samples and in separate analyses for boys and younger children.Good internal consistencies, strong country effects and small effects of age were found. Based on ADHD-RS-IV, 88.5% of patients met the criteria for any ADHD diagnosis. Correlations between ADHD-RS-IV and measures of functional impairment were low but statistically significant. The correlations with SDQ and CHIPCE scales confirm the convergent and divergent validity of ADHDRS-IV.

Conclusions

Impressive evidence for the cross-cultural factorial validity, internal consistency as well as convergent and divergent validity of ADHD-RS-IV was found. ADHD can be assessed reliably and validly in routine care across Europe. The ICD-10 3-factor model seems to be less robust than the DSM-IV 2-factor model, but may be a good description for special populations (boys, younger children).

Key words

ADHD ADORE assessment children cross-cultural validation 

Abbreviations

ADHD

Attention-Deficit/Hyperactivity Disorder

ADORE

Attention-deficit/hyperactivity Disorder Observational Research in Europe

ADHD-RS-IV

ADHD Rating Scale-IV

CHIP-CE

Child Health and Illness Profile – Child Edition

CGAS

Children's Global Assessment Scale

CGI-S

Clinical Global Impression-Severity scale

SDQ

Strengths and Difficulties Questionnaire

References

  1. 1.
    Becker A, Woerner W, Hasselhorn M, Banaschewski T, Rothenberger A (2004) Validation of the parent and teacher SDQ in a clinical sample. Eur Child Adolesc Psychiatry 13(Suppl 2):11–16Google Scholar
  2. 2.
    Becker A, Steinhausen HC, Baldursson G, Dalsgaard S, Lorenzo MJ, Ralston SJ, Döpfner M, Rothenberger A and the ADORE study group (2006) Psychopathological screening of children with ADHD: Strengths and Difficulties Questionnaire in a pan-European study. Eur Child Adolesc Psychiatry 15(Suppl 1):56–62Google Scholar
  3. 3.
    Brühl B, Döpfner M, Lehmkuhl G (2000) The parent rating scale for ADHD (FBB-HKS) – Prevalence of ADHD by the estimate of parents and psychometric criteria. Kindheit und Entwicklung 9:116–126 [in German]CrossRefGoogle Scholar
  4. 4.
    Cohen J (1988) Statistical power analysis for the behavioral sciences (2nd Edition). Lawrence Erlbaum Associates, New JerseyGoogle Scholar
  5. 5.
    Collett BR, Ohan JL, Myers KM (2003) Ten-year review of rating scales. V: scales assessing attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 42:1015–1037PubMedCrossRefGoogle Scholar
  6. 6.
    Dominguez de Ramirez R, Shapiro E (1998) Teacher ratings of attention deficit hyperactivity disorder symptoms in Hispanic children. J Psychopathol Behav Assess 20:275–293CrossRefGoogle Scholar
  7. 7.
    Döpfner M, Lehmkuhl G (2000) Diagnostics system for psychological disturbances in the child and jugendalter after ICD-10 and DSM-IV (DISYPS-KJ) (2nd Edition). Huber, BernGoogle Scholar
  8. 8.
    DuPaul G, Power T, Anastopoulos A, Reid R (1998) ADHD Rating Scale-IV: Checklist, Norms, and Clinical Interpretation. Guilford Press, New YorkGoogle Scholar
  9. 9.
    DuPaul G, Power T, Anastopoulos A, Reid R, McGoey K, Ikeda M (1997) Teacher ratings of attention deficit hyperactivity disorder symptoms: factor structure and normative data. Psychol Assess 9:436–444CrossRefGoogle Scholar
  10. 10.
    DuPaul G, Power T, McGoey K, Ikeda M, Anastopoulos A (1998) Reliability and validity of parent and teacher ratings of attention-deficit/hyperactivity disorder symptoms. J Psychoeducational Assess 16:55–68Google Scholar
  11. 11.
    Gadow KD, Sprafkin J (1997) ADHD Symptom Checklist-4 Manual. Checkmate Plus, Stiny BrookGoogle Scholar
  12. 12.
    Gomez R, Burns GL, Walsh JA, de Moura MA (2003) A multitrait-multisource confirmatory factor analytic approach to the construct validity of ADHD rating scales. Psychol Assess 15:3–16PubMedCrossRefGoogle Scholar
  13. 13.
    Gomez R, Burns GL, Walsh JA, Hafetz N (2005) A multitrait-multisource confirmatory factor analytic approach to the construct validity of ADHD and ODD rating scales with Malaysian children. J Abn Child Psychol 33:241–254CrossRefGoogle Scholar
  14. 14.
    Gomez R, Harvey J, Quick C, Scharer I, Harris G (1999) DSM-IV AD/HD: confirmatory factor models, prevalence, and gender and age differences based on parent and teacher ratings of Australian primary school children. J Child Psychol Psychiatry 40:265–274PubMedCrossRefGoogle Scholar
  15. 15.
    Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586PubMedCrossRefGoogle Scholar
  16. 16.
    Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345PubMedCrossRefGoogle Scholar
  17. 17.
    Görtz-Dorten A, Döpfner M (2007) Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen von Kindern und Jugendlichen im Elternurteil – eine Analyse an einer Feldstichprobe mit dem Diagnostiksystem DISYPS-KJ 2. Huber, Bern, Switzerland (in press)Google Scholar
  18. 18.
    Görtz A, Döpfner M, Nowak A, Bonus B, Lehmkuhl G (2002) Are self-reports of adolescents helpful in the assessment of attention deficit/hyperactivity disorders? An analysis with the assessment system DISYPS. Kindheit und Entwicklung 11:82–89 [in German]CrossRefGoogle Scholar
  19. 19.
    Guy W (1976) Subject's treatment emergent symptom scale. In: Guy W (ed) Assessment Manual for Psychopharmacology. Washington, US Government Printing Office, pp 347–350Google Scholar
  20. 20.
    Kadesjö C, Kadesjö B, Hagglof B, Gillberg C (2001) ADHD in Swedish 3- to 7-year-old children. J Am Acad Child Adolesc Psychiatry 40:1021–1028PubMedCrossRefGoogle Scholar
  21. 21.
    Michelson D, Allen AJ, Busner J, Casat C, Dunn D, Kratochvil C, Newcorn J, Sallee FR, Sangal RB, Saylor K, West S, Kelsey D, Wernicke J, Trapp NJ, Harder D (2002) Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo-controlled study. Am J Psychiatry 159:1896–1901PubMedCrossRefGoogle Scholar
  22. 22.
    Michelson D, Faries D, Wernicke J, Kelsey D, Kendrick K, Sallee FR, Spencer T (2001) Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. Pediatrics 108:E83PubMedCrossRefGoogle Scholar
  23. 23.
    Pillow DR, Pelham WE Jr, Hoza B, Molina BS, Stultz CH (1998) Confirmatory factor analyses examining attention deficit hyperactivity disorder symptoms and other childhood disruptive behaviours. J Abn Child Psychol 26:293–309CrossRefGoogle Scholar
  24. 24.
    Pineda D, Ardila A, Rosselli M, Arias BE, Henao GC, Gomez LF, Mejia SE, Miranda ML (1999) Prevalence of attention-deficit/hyperactivity disorder symptomsin 4- to 17-year-old children in the general population. J Abn Child Psychol 27:455–462CrossRefGoogle Scholar
  25. 25.
    Power T, Andrews T, Eiraldi RB, Doherty BJ, Ikeda MJ, DuPaul GJ, Landau S (1988) Evaluating attention deficit hyperactivity disorder using multiple informants: the incremental utility of combining teacher with parent reports. Psychol Assess 10:250–260CrossRefGoogle Scholar
  26. 26.
    Power T, Doherty B, Panichelli-Mindel S, Karustis JL, Eiraldi RB, Anastopoulos AD, DuPaul GJ (1998) The predictive validity of parent and teacher reports of ADHD symptoms. J Psychopathol Behav Assess 20:57–81CrossRefGoogle Scholar
  27. 27.
    Preuss U, Ralston SJ, Baldursson G, Falissard B, Lorenzo MJ, Pereira RR, Valsveld L, Coghill D and the ADORE study group (2006) Study design, baseline characteristics and interventions in a cross-cultural framework: results from the ADORE study. Eur Child Adolesc Psychiatry 15(Suppl 1):4–14Google Scholar
  28. 28.
    Ralston SJ, Lorenzo MJ, ADORE Study Group (2004) ADORE-Attention-Deficit Hyperactivity Disorder Observational Research in Europe. Eur Child Adolesc Psychiatry 13(Suppl 1):36–42CrossRefGoogle Scholar
  29. 29.
    Reid R, DuPaul GJ, Power TJ, Anastopoulos AD, Rogers-Adkinson D, Noll MB, Riccio C (1998) Assessing culturally different students for attention deficit hyperactivity disorder using behavior rating scales. J Abn Child Psychol 26:187–198CrossRefGoogle Scholar
  30. 30.
    Riley AW, Coghill D, Forrest CB, Lorenzo MJ, Ralston SJ, Spiel G and the ADORE study group (2006) Validity of the health-related quality of life assessment in the ADORE study: Parent Report Form of the CHIP-Child Edition. Eur Child Adolesc Psychiatry 15(Suppl 1):63–71CrossRefGoogle Scholar
  31. 31.
    Riley AW, Forrest CB, Starfield B, RebokGW, Robertson JA, Green BF (2004) The Parent Report Form of the CHIP-Child Edition: reliability and validity. Med Care 42:210–220PubMedCrossRefGoogle Scholar
  32. 32.
    Riley AW, Robertson JA, Forrest CB, Green BF, Rebok G, Starfield B (2001) Technical Manual for the Child Health and Illness Profile – Child Edition (CHIP-CE) Parent and Child Report Forms. Johns Hopkins University, Baltimore, MDGoogle Scholar
  33. 33.
    Rothenberger A, Woerner W (2004) Strengths and Difficulties Questionnaire (SDQ)–evaluations and applications. Eur Child Adolesc Psychiatry 13(Suppl 2):1–2Google Scholar
  34. 34.
    Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40:1228–1231PubMedGoogle Scholar
  35. 35.
    Stevens J, Quittner AL, Abikoff H (1998) Factors influencing elementary school teachers’ ratings of ADHD and ODD behaviours. J Clin Child Psychol 27:406–414PubMedCrossRefGoogle Scholar
  36. 36.
    Swanson J (1992) School based assessment and interventions for ADD students.KC Press, Irvine, CAGoogle Scholar
  37. 37.
    Wolraich ML, Hannah JN, Baumgaertel A, Feurer ID (1998) Examination of DSM-IV criteria for attention deficit/hyperactivity disorder in a county-wide sample. J Devel Behav Pediatr 19:162–168Google Scholar
  38. 38.
    Wolraich ML, Lambert EW, Baumgaertel A, Garcia-Tornel S, Feurer ID, Bickman L, Doffing MA (2003) Teachers' screening for attention deficit/hyperactivity disorder: comparing multinational samples on teacher ratings of ADHD. J Abn Child Psychol 31:445–455CrossRefGoogle Scholar
  39. 39.
    Wolraich ML, Lambert W, Doffing MA, Bickman L, Simmons T, Worley K (2003) Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol 28:559–567PubMedCrossRefGoogle Scholar
  40. 40.
    World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines WHO, Geneva, SwitzerlandGoogle Scholar

Copyright information

© Steinkopff Verlag 2006

Authors and Affiliations

  • Manfred Döpfner
    • 1
    Email author
  • Hans-Christoph Steinhausen
    • 2
  • David Coghill
    • 3
  • Søren Dalsgaard
    • 4
  • Lynne Poole
    • 5
  • Stephen J. Ralston**
  • Aribert Rothenberger
    • 6
  • ADORE Study Group*
  1. 1.Dept. of Child and Adolescent PsychiatryUniversity of CologneKölnGermany
  2. 2.Dept. of Child and Adolescent PsychiatryUniversity of ZürichZürichSwitzerland
  3. 3.Section of Psychiatry Division of Pathology and NeuroscienceUniversity of DundeeDundee, ScotlandUK
  4. 4.Dept. of Child and Adolescent PsychiatryUniversity of AarhusAarhusDenmark
  5. 5.Eli Lilly and CompanyBasingstoke, HampshireUK
  6. 6.Dept. of Child and Adolescent PsychiatryUniversity of GöttingenGöttingenGermany

Personalised recommendations