Skip to main content

Is it possible to determine the level of functional impairment that distinguishes the patients with ADHD from those without ADHD?

Quality of Life Research volume 28, pages 1097–1103 (2019)Cite this article

Abstract

Introduction

Functional impairment in attention deficit hyperactivity disorder (ADHD) can occur in many areas such as in family, social activities, and problems related to school and may also persist during adulthood. The Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P) is designed to measure the functional impairment related to ADHD symptoms. The aim of this study was to determine the level of functional impairment that distinguishes the patients with ADHD who were diagnosed through semi-structured interviews from those without ADHD.

Method

This study consists of ADHD patients who were diagnosed through semi-structured interview aged 5–18 years (n = 250) and same age gender-matched healthy controls (n = 250). A receiver operating characteristic (ROC) curve was constructed by calculating the sensitivity and specificity of the scale cut-off values.

Results

An area under the curve (AUC) of 0.974 (95% CI 0.956–0.986) was found in this study. For WFIRS-P subdomains, AUC curves, which range from 0.76 to 0.95, were also having strong power for differentiation between groups. The optimal cut-off value for WFIRS-P using Youden’s J Index is 0.32. There is no significant gender and age group differences in AUC for either the total or subdomain scores.

Conclusion

Our findings provide that Turkish version of WFIRS-P could be a reliable way of distinguishing the level of functional impairment in ADHD from controls.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Haack, L. M., & Gerdes, A. C. (2011). Functional impairment in Latino children with ADHD: implications for culturally appropriate conceptualization and measurement. Clinical Child and Family Psychology Review, 14(3), 318–328.

    Article  PubMed  Google Scholar 

  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th edn.). Washington: American Psychiatric Association.

    Book  Google Scholar 

  3. Barkley, R. A., Fischer, M., Fletcher, K., et al. (2002). Persistence of attention deficit hyperactivity disorder into adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology, 111, 279–289.

    Article  PubMed  Google Scholar 

  4. Pelham, W. E. Jr., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 34, 449–476.

    Article  Google Scholar 

  5. Sasser, T., Schoenfelder, E. N., & Stein, M. A. (2017 Feb). Targeting functional impairments in the treatment of children and adolescents with ADHD. CNS Drugs, 31(2), 97–107. https://doi.org/10.1007/s40263-016-0400-1.

    Article  PubMed  Google Scholar 

  6. Becker, K. D., Chorpita, B. F., & Daleiden, E. L. (2011). Improvement in symptoms versus functioning: How do our best treatments measure up? Administration and Policy in Mental Health and Mental Health, 38, 440–458.

    Article  Google Scholar 

  7. Biederman, J., Mick, E., & Faraone, S. V. (2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: Impact of remission definition and symptom type. American Journal of Psychiatry, 157(5), 816–818.

    Article  CAS  PubMed  Google Scholar 

  8. Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). (2011). Canadian ADHD practice guide-lines (3rd edn.). Toronto: CADDRA.

    Google Scholar 

  9. Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., et al. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry, 163(4), 716–723.

    Article  PubMed  Google Scholar 

  10. Faraone, S. V., & Buitelaar, J. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. European Child & Adolescent Psychiatry, 19, 353–364.

    Article  Google Scholar 

  11. Thompson, T., Lloyd, A., Joseph, A., & Weiss, M. (2017). The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis. Quality of Life Research, 26(7), 1879–1885.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gathje, R. A., Lewandowski, L. J., & Gordon, M. (2008). The role of impairment in the diagnosis of ADHD. Journal of Attention Disorder, 11, 529–537.

    Article  Google Scholar 

  13. Gordon, M., Antshel, K., Faraone, S., Barkley, R., Lewandowski, L., Hudziak, J. J., & Cunningham, C. (2006). Symptoms versus impairment the case for respecting DSM-IV’s criterion D. Journal of Attention Disorder, 9, 465–475.

    Article  Google Scholar 

  14. Lewandowski, L. J., Lovett, B. J., Gordon, M. (2009). Measurement of symptom severity and impairment. In S. Goldstein, J. Naglieri (Eds). Assessing impairment: from theory to practice (pp. 5–14). New York: Springer.

    Google Scholar 

  15. Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R., Loo, S. K., Carlson, C. L., McBurnett, K., & Lahey, B. B. (2012). Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991–1010.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Maziade, M., Rouleau, N., Lee, B., Rogers, A., Davis, L., & Dickson, R. (2009). Atomoxetine and neuropsychological function in children with attention-deficit/hyperactivity disorder: Results of a pilot study. Journal of Child and Adolescent Psychopharmacology, 19(6), 709–718.

    Article  PubMed  Google Scholar 

  17. De Bruyckere, K., Bushe, C., Bartel, C., Berggren, L., Kan, C. C., & Dittmann, R. W. (2016). Relationships between functional outcomes and symptomatic improvement in atomoxetine-treated adult patients with attention-deficit/hyperactivity disorder: Post hoc analysis of an integrated database. CNS Drugs, 30(6), 541–558.

    Article  CAS  PubMed  Google Scholar 

  18. Willcutt, E. G. (2012). The prevalence of DSM-IV attention deficit/hy-peractivity disorder: A meta-analytic review. Neurotherapeutics, 9, 490–499.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Pliszka, S., AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 894–921.

    Article  Google Scholar 

  20. Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Altaye, M. B.,, House, K., & Stark, L. J., Brink-man, W. M. (2010). Attention-deficit/hyperactivity disorder outcomes for children treated in community-based pediatric settings. Pediatrics, 164, 160–165.

    Google Scholar 

  21. Karpenko, V., Owens, J. S., Evangelista, N. M., & Dodds, C. (2009). Clinically significant symptom change in children with attention-deficit/hyperactivity disorder: Does it correspond with reliable improvement in functioning? Journal of Clinical Psychology, 65, 76–93.

    Article  PubMed  Google Scholar 

  22. O’Connor, B. C., Garner, A. A., Peugh, J. L., Simon, J., & Epstein, J. N. (2015). Improved but still impaired: Symptom-impairment correspondence among youth with attention-deficit hyperactivity disorder receiving community-based care. Journal of Developmental and Behavioral Pediatrics, 36, 106–114.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Owens, J. S., Johannes, L. M., & Karpenko, V. (2009). The relation between change in symptoms and functioning in children with ADHD receiving school-based mental health services. School Mental Health, 1, 183–195.

    Article  Google Scholar 

  24. European Medicines Agency. Guideline on the clinical investiga- tion of medicinal products for the treatment of attention deficit hyperactivity disorder (ADHD). Retrieved September 13, 2016, from http://www.ema.europa.eu/ docs/en_GB/document_library/Scientific_guideline/2009/09/ WC500003474.pdf.

  25. Canu, W. H., Hartung, C. M., Stevens, A. E., & Lefler, E. K. (2016). Psychometric properties of the Weiss Functional Impairment Rating Scale: Evidence for utility in research, assessment, and treatment of ADHD in emerging adults. Journal of Attention Disorders. https://doi.org/10.1177/1087054716661421.

    Article  PubMed  Google Scholar 

  26. Tarakçıoğlu, M., Memik, N., Olgun, N. N., Aydemir, Ö, & Weiss, M. D. (2015). Turkish validity and reliability study of the Weiss Functional Impairment Rating Scale-Parent Report. Attention Deficit Hyperactivity Disorders, 7(2), 129–139.

    Article  PubMed  Google Scholar 

  27. Gajria, K., Kosinski, M., Sikirica, V., Huss, M., Livote, E., Reilly, K., Dittmann, R. W., & Erder, M. H. (2015). Psychometric validation of the Weiss Functional Impairment Rating Scale-Parent Report Form in children and adolescents with attention-deficit/hyperactivity disorder. Health Quality of Life Outcomes, 13, 184.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Weiss, M. D., Brooks, B. L., Iverson, G. L., et al. (2007) Reliability and validity of the Weiss functional impairment rating scale. In World Psychiatry Association Conference, Shanghai.

  29. Hodgkins, P., Lloyd, A., Erder, M. H., Setyawan, J., Weiss, M. D., Sasané, R., & Nafees, B. (2017). Estimating minimal important differences for several scales assessing function and quality of life in patients with attention-deficit/hyperactivity disorder. CNS Spectrums, 22(1), 31–40.

    Article  PubMed  Google Scholar 

  30. Goyette, C. H., Conners, C. K., & Ulrich, R. F. (1978). Normative data on revised Conners Parent and Teacher Rating Scales. Journal of Abnormal Child Psychology, 6(2), 221–236.

    Article  CAS  PubMed  Google Scholar 

  31. Dereboy, C., Şenol, S., Şener, Ş, & Dereboy, F. (2007). Validation of the Turkish versions of the short-form Conners Teacher and Parent Rating Scales. Turk Psikiyatri Dergisi, 18(1), 48–58.

    PubMed  Google Scholar 

  32. Kaufman, J., Birmaher, B., Brent, D., et al. (1996). Kiddie-SADS-present and lifetime version (K-SADS-PL), version 1.0 of October 1996 edn. Pittsburgh: Department of Psychiatry, University of Pittsburgh School of Medicine.

    Google Scholar 

  33. Gökler, B., Ünal, F., & Pehlivantürk, B. (2004). Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADSPL-T). Turkish Journal of Child and Adolescent Mental Health, 11, 109–116.

    Google Scholar 

  34. Turgay, A. (1997). Turgay’s DSM-IV based ADHD and disruptive behaviour disorders screening scale. Toronto: Integrative Therapy Institute Publication.

    Google Scholar 

  35. Ercan, E. S., Amado, S., Somer, O., et al. (2001). Development of a test battery for the assessment of attention deficit hyperactivity disorder. Turkish Journal of Child and Adolescent Mental Health, 8, 132–144.

    Google Scholar 

  36. Kummar, R., & Indrayan, A. (2011). Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatrics, 48, 277–289.

    Article  Google Scholar 

  37. Youden, W. J. (1950). Index for rating diagnostic tests. Cancer, 3, 32–35.

    Article  CAS  PubMed  Google Scholar 

  38. Bewick, V., Cheek, L., & Ball, J. (2004). Statistics review 13: Receiver operating characteristic curves. Critical Care, 8(6), 508–512.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, SBU Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey

    Mahmut Cem Tarakçıoğlu

  2. Department of Public Health, Yıldırım Beyazıt University, Ankara, Turkey

    Mehmet Enes Gökler

  3. Department of Child and Adolescent Psychiatry, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Muhammed Tayyib Kadak

  4. Department of Child and Adolescent Psychiatry, Kocaeli University, Kocaeli, Turkey

    Nursu Çakın Memik

  5. Department of Psychiatry, SBU Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey

    Umut Mert Aksoy

Authors
  1. Mahmut Cem Tarakçıoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Enes Gökler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Muhammed Tayyib Kadak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nursu Çakın Memik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Umut Mert Aksoy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mahmut Cem Tarakçıoğlu.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tarakçıoğlu, M.C., Gökler, M.E., Kadak, M.T. et al. Is it possible to determine the level of functional impairment that distinguishes the patients with ADHD from those without ADHD?. Qual Life Res 28, 1097–1103 (2019). https://doi.org/10.1007/s11136-018-2086-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-018-2086-y

Keywords

  • Functional impairment
  • Receiver operating characteristics
  • Attention deficit hyperactivity disorder
  • Youden’s J Index