The Validity of the World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in Adolescence.

Abstract

Objectives: Short, self-report screening measures for adolescent and adult attention-deficit/hyperactivity disorder (ADHD) would greatly enhance the likelihood of ADHD subjects to be correctly diagnosed and treated. This study aimed at testing the reliability, factor structure, convergent validity, external validity, and diagnostic accuracy of the official Italian translation of the ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) in a sample of community-dwelling adolescents, extending previous data on adult participants to adolescent participants. Methods: Five hundred sixty-four community-dwelling male adolescents (mean age ≅15) were administered the ASRS-5, the Adult ADHD Self-Report Scale 18-item and 6-item versions (ASRS-18 and ASRS-6), the Wender Utah Rating Scale (WURS), and the Structured Clinician Interview for DSM-5-Clinician Version ADHD Module (SCID-5-CV-ADHD). School performance variables were also collected. Results: The item response theory (IRT) reliability of ASRS-5 was adequate. Dimensionality analyses strongly supported the unidimensional structure of ASRS-5 items; confirmatory factor analysis fit indices supported the adequacy of the one-factor model of ASRS-5. In terms of convergent validity, the ASRS-5 total score was significantly and positively associated with self-report and interview-based ADHD dimensional scores, as well as with school performance variables. Roughly 8.0% of our male adolescents met SCID-5-CV-ADHD criteria for categorical ADHD diagnosis. Ten-fold cross-validated receiver operating curve value was 0.843; precision-recall curve analysis suggests that an ASRS-5 total score >12 may be preferred for screening purposes in adolescence. Conclusions: Our data showed that the ASRS-5 may represent a psychometrically sound self-report instrument to reliably screen for DSM-5 ADHD, extending the range of application of ASRS-5 from adulthood to adolescence, suggesting that the ASRS-5 could be safely used for screening purposes also in community-dwelling adolescents, at least in its official Italian translation.