Quality of Life Research

, Volume 15, Issue 1, pp 117–129 | Cite as

Validation of the Adult Attention-Deficit/Hyperactivity Disorder Quality-of-Life Scale (AAQoL): A Disease-Specific Quality-of-Life Measure

  • Meryl Brod
  • Joseph Johnston
  • Stephen Able
  • Ralph Swindle


Introduction: A growing body of evidence suggests that symptoms of attention-deficit/hyperactivity disorder (ADHD) persist into adulthood and are associated with ongoing impairment and co-morbidity. The absence of a conceptually sound and well-validated ADHD-specific quality-of-life measure has been an obstacle to understanding this impact. To address this gap, the Adult ADHD Quality-of-Life Scale (AAQoL) was developed based on well accepted methods for designing patient reported outcomes. The purpose of this study was to validate the AAQoL. Methods: Nine Hundred and Eighty Nine adults in a retrospective cohort study were administered the AAQoL and psychometric validation was conducted according to an a priori statistical analysis plan. Results: A 29-item AAQoL was found to have robust scale structure with four domains: Life Productivity, Psychological Health, Relationships and Life outlook. Internal consistency was adequate (0.93 for overall, 0.75–0.93 for subscales), and construct and known-groups validity were supported. Conclusion: The AAQoL appears to be a valid measure of quality of life for adults with ADHD and can be considered for incorporation into future studies. The ability to quantify the quality-of-life consequences of adult ADHD should facilitate future research, assist clinicians in identifying appropriate treatment targets and contribute to the ultimate goal of improving the well-being and functioning of adults with ADHD.


Adult attention-deficit/hyperactivity disorder Quality of life Validation 



Attention-deficit/hyperactivity disorder


Adult Attention-Deficit/Hyperactivity Disorder Quality-of-Life Scale


Quality of Life


Adult ADHD Self-Report Scale-V1.1


Short Form 36


Patient Health Questionnaire


randomized clinical trial


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  1. 1.
    American Psychiatric Association1994Diagnostic and Statistical Manual of Mental Disorders4the AssociationWashington, DCGoogle Scholar
  2. 2.
    Barkley, RA 1998Attention Deficit Hyperactivity Disorders: A Handbook for Diagnosis and TreatmentGuilford PressNew YorkGoogle Scholar
  3. 3.
    Wolraich, ML, Hannah, JN, Pinnock, TY, Baumgaertel, A, Brown, J 1996Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sampleJ Am Acad Child Adolesc Psychiatry35319324PubMedGoogle Scholar
  4. 4.
    Wilens, TE, Dodson, W 2004A clinical perspective of attention-deficit/hyperactivity disorder into adulthoodJ Clin Psychiatry6513011313PubMedCrossRefGoogle Scholar
  5. 5.
    Weiss, G, Hechtman, L, Milroy, T, Perlman, T 1985Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive childrenJ Am Acad Child Psychiatry24211220PubMedGoogle Scholar
  6. 6.
    Rapport, LJ, Friedman, SR, Voorthis, A, Voorhis, A, Friedman, SL 2002Experienced emotion and affect recognition in adult attention-deficit hyperactivity disorderNeuropsychology16102110CrossRefPubMedGoogle Scholar
  7. 7.
    Barkley, RA, Murphy, K, Kwasnik, D 1996Psychological adjustment and adaptive impairments in young adults with ADHDJ Atten Disord14154Google Scholar
  8. 8.
    Wilens, TE, Biederman, J, Mick, E, Faraone, SV, Spencer, T 1997Attention deficit hyperactivity disorder (ADHD) is associated with early onset substance use disordersJ Nerv Ment Dis185475482CrossRefPubMedGoogle Scholar
  9. 9.
    Schubiner, H, Tzelepis, A, Milberger, S,  et al. 2000Prevalence of attention-deficit/hyperactivity disorder and conduct disorder among substance abusersJ Clin Psychiatry61244251PubMedGoogle Scholar
  10. 10.
    Richards, T, Deffenbacher, J, Rosen, L 2002Driving anger and other driving-related behaviors in high and low ADHD symptom college studentsJ Atten Disord62538PubMedGoogle Scholar
  11. 11.
    Brod, M, Perwien, A, Adler, L, Spencer, T. 2005Conceptualization and Assessment of Quality of Life for Adults with Attention Deficit DisorderPrimary Psychiatry125864Google Scholar
  12. 12.
    Acquadro, C, Berzon, R, Dubois, D,  et al. 2003PRO Harmonization Group. Incorporating the patient’s perspective into drug development and communication: an ad hoc task force report of the Patient-Reported Outcomes (PRO) Harmonization Group meeting at the Food and Drug Administration, February 16, 2001Value Health652231CrossRefPubMedGoogle Scholar
  13. 13.
    Scientific Advisory Committee of the Medical Outcomes Trust2002Assessing health status and quality-of-life instruments: attributes and review criteriaQual Life Res11193205Google Scholar
  14. 14.
    Juniper, EF, Guyatt, GH, Jaeschke, R 1996How to develop and validate a new health-related quality of life instrumentSpiker, B eds. Quality of Life and Pharmacoeconomics in Clinical Trials2Lippincott-RavenPhiladelphiaGoogle Scholar
  15. 15.
    Kessler, RC, Adler, L, Ames, M,  et al. 2005The World Health Organization Adult ADHD Self-Report Scale (ASRS): A Short Screening Scale for Use in the General PopulationPsychol Med35245256PubMedGoogle Scholar
  16. 16.
    Ware, JE, Sherbourne, CD 1992The MOS 6-item short form health survey (SF-36): Conceptual frame work and item selectionMedical Care30473483PubMedGoogle Scholar
  17. 17.
    Kroenke, K, Spitzer, RL, Williams, JB 2003The Patient Health Questionnaire-2: validity of a two-item depression screenerMed Care4112841292PubMedGoogle Scholar
  18. 18.
    Leon, AC, Olfson, M, Portera, L, Farber, L, Sheehan, DV 1997Assessing psychiatric impairment in primary care with the Sheehan Disability ScaleInt J Psychiatry Med2793105PubMedGoogle Scholar
  19. 19.
    Swindle, RW,Jr, Cronkite, RC, Moos, RH 1989Life stressors, social resources, coping, and the 4-year course of unipolar depressionAbnorm Psychol98468477CrossRefGoogle Scholar
  20. 20.
    Finch, JF, Okun, MA, Barrera, M,Jr, Zautra, AJ, Reich, JW 1989Positive and negative social ties among older adults: measurement models and the prediction of psychological distress and well-beingAm J Community Psychol17585605CrossRefPubMedGoogle Scholar
  21. 21.
    Chassany, O, Sagnier, P, Marquis, P, Fullerton, S, Aaronson, N 2002Patient-reported outcomes: The example of health-related quality of life – A European guidance document for the improved integration of health-related quality of life assessment in the drug regulatory processDrug Inf J36209238Google Scholar
  22. 22.
    Landis, JR, Koch, GG 1977The measurement of observer agreement for categorical dataBiometrics33159174PubMedGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Meryl Brod
    • 1
  • Joseph Johnston
    • 2
  • Stephen Able
    • 2
  • Ralph Swindle
    • 2
  1. 1.The BROD GROUPMill ValleyUSA
  2. 2.Eli Lilly and CompanyIndianapolisUSA

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