Wolfgang Retz

[Gender differences in self-descriptions of child psychopathology in attention deficit hyperactivity disorder].

Diagnosing attention deficit hyperactivity disorder (ADHD) in adults requires retrospective assessment of ADHD symptoms in childhood. The Wender Utah Rating Scale (WURS) and its German validated version (WURS-k) may offer a helpful tool to acertain relevant childhood problems associated with ADHD. Up to now validating data of the WURS-k were limited to male population. In a population of 69 female adult ADHD patients and 97 controls, ROC analysis indicated a sensitivity of 93% and specificity of 92% at a cut-off of 30 points in the WURS-k. This cut-off value is equivalent to those of males. Symptom report varies significantly by gender and females describe more internalizing problems while males report more externalizing behaviour. Regarding different subtypes according to DSM-IV males and females did not differ in the items of the WURS-k.

Alters- und geschlechtsspezifische Besonderheiten der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung

ZusammenfassungDie Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) ist eine Erkrankung, die sich im Kindesalter manifestiert und sich nur bei einem Teil der Betroffenen bis zum Erwachsenenalter zurückbildet. Bei etwa 60% der Betroffenen persistiert die ADHS im Erwachsenenalter vollständig oder als Teilsyndrom. Im Erwachsenenalter treten zur ADHS-Kernsymptomatik noch weitere psychopathologische Phänomene im Sinne von desorganisiertem Verhalten und affektiver Dysregulation hinzu. Daneben sind zusätzliche psychiatrische Erkrankungen häufig zu beobachten. Hieraus entstehen oftmals beträchtliche Auswirkungen auf die Alltagsfunktionen und die Lebensqualität der Betroffenen. Die entwicklungspsychopathologischen und Verlaufsaspekte der Erkrankung müssen bei der Diagnostik und Therapie im Erwachsenenalter berücksichtigt werden. Darüber hinaus sind hinsichtlich der verschiedenen klinischen Subtypen der ADHS Besonderheiten in Bezug auf die Psychopathologie, Komorbidität und die funktionellen Auswirkungen der Erkrankung in den verschiedenen Lebensabschnitten zu bedenken. Gleiches gilt für Unterschiede bei beiden Geschlechtern, die vor allem im Erwachsenenalter bislang jedoch noch wenig untersucht sind.SummaryAttention-deficit hyperactivity disorder (ADHD) is a syndrome with onset in childhood which persists at least partially in about 60% of afflicted individuals. Core symptoms include inattention, hyperactivity, and impulsivity. Additional psychopathology with disorganized behavior and emotional dysregulation is common in adulthood. The vast majority of adults affected also present psychiatric comorbidities. There is severe impairment of everyday life and quality of life. Developmental psychopathologic changes, age-related comorbidity, and functional and psychosocial problems associated with ADHD must be taken into account during the diagnostic process. Regarding clinical subtypes of ADHD according to DSM-IV and particularly gender differences, knowledge about these factors in adults with ADHD is limited.Attention-deficit hyperactivity disorder (ADHD) is a syndrome with onset in childhood which persists at least partially in about 60% of afflicted individuals. Core symptoms include inattention, hyperactivity, and impulsivity. Additional psychopathology with disorganized behavior and emotional dysregulation is common in adulthood. The vast majority of adults affected also present psychiatric comorbidities. There is severe impairment of everyday life and quality of life. Developmental psychopathologic changes, age-related comorbidity, and functional and psychosocial problems associated with ADHD must be taken into account during the diagnostic process. Regarding clinical subtypes of ADHD according to DSM-IV and particularly gender differences, knowledge about these factors in adults with ADHD is limited.

[Age and gender aspects of attention-deficit hyperactivity disorder].

ZusammenfassungDie Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) ist eine Erkrankung, die sich im Kindesalter manifestiert und sich nur bei einem Teil der Betroffenen bis zum Erwachsenenalter zurückbildet. Bei etwa 60% der Betroffenen persistiert die ADHS im Erwachsenenalter vollständig oder als Teilsyndrom. Im Erwachsenenalter treten zur ADHS-Kernsymptomatik noch weitere psychopathologische Phänomene im Sinne von desorganisiertem Verhalten und affektiver Dysregulation hinzu. Daneben sind zusätzliche psychiatrische Erkrankungen häufig zu beobachten. Hieraus entstehen oftmals beträchtliche Auswirkungen auf die Alltagsfunktionen und die Lebensqualität der Betroffenen. Die entwicklungspsychopathologischen und Verlaufsaspekte der Erkrankung müssen bei der Diagnostik und Therapie im Erwachsenenalter berücksichtigt werden. Darüber hinaus sind hinsichtlich der verschiedenen klinischen Subtypen der ADHS Besonderheiten in Bezug auf die Psychopathologie, Komorbidität und die funktionellen Auswirkungen der Erkrankung in den verschiedenen Lebensabschnitten zu bedenken. Gleiches gilt für Unterschiede bei beiden Geschlechtern, die vor allem im Erwachsenenalter bislang jedoch noch wenig untersucht sind.SummaryAttention-deficit hyperactivity disorder (ADHD) is a syndrome with onset in childhood which persists at least partially in about 60% of afflicted individuals. Core symptoms include inattention, hyperactivity, and impulsivity. Additional psychopathology with disorganized behavior and emotional dysregulation is common in adulthood. The vast majority of adults affected also present psychiatric comorbidities. There is severe impairment of everyday life and quality of life. Developmental psychopathologic changes, age-related comorbidity, and functional and psychosocial problems associated with ADHD must be taken into account during the diagnostic process. Regarding clinical subtypes of ADHD according to DSM-IV and particularly gender differences, knowledge about these factors in adults with ADHD is limited.Attention-deficit hyperactivity disorder (ADHD) is a syndrome with onset in childhood which persists at least partially in about 60% of afflicted individuals. Core symptoms include inattention, hyperactivity, and impulsivity. Additional psychopathology with disorganized behavior and emotional dysregulation is common in adulthood. The vast majority of adults affected also present psychiatric comorbidities. There is severe impairment of everyday life and quality of life. Developmental psychopathologic changes, age-related comorbidity, and functional and psychosocial problems associated with ADHD must be taken into account during the diagnostic process. Regarding clinical subtypes of ADHD according to DSM-IV and particularly gender differences, knowledge about these factors in adults with ADHD is limited.

Psychometrische Güte der Selbst- und Fremdbeurteilungsinstrumente ADHS-SB und Wender-Reimherr-Interview bei Senioren mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung

Objective and Methods The aim of the study was to explore the psychometric properties of the ADHD self-rating ADHD-SR and the observer-rating Wender-Reimherr-Interview WRI for the assessment of ADHD symptoms in old age by using a sample of 324 subjects between 60 and 99 years. Results In the sample of older people the psychometric properties of the ADHD-SR and the WRI were adequate. Evidence for construct validity is provided through the WRI. Results of logistic analysiss showed a good discrimination of ADHD for both, the ADHD-SR (89.5 % correct classification; OR = 25.91) and the WRI (86.1 % correct classification; OR = 4.7); specificity ranged between 81 % and 94 %. Conclusion The study shows that both, the ADHD-SR and the WRI, are reliable and valid as tools for the assessment of ADHD in older adults.

[Wender-Reimherr self-report questionnaire on adult ADHD : German version].

ZusammenfassungHintergrundZur Erfassung der Psychopathologie der adulten Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) unter Berücksichtigung der Utah-Kriterien steht bislang im deutschsprachigen Raum lediglich das Wender-Reimherr-Interview (WRI) zur Verfügung. Mit dem Ziel der Ökonomisierung des diagnostischen Prozesses wurde die englische Originalversion des Wender-Reimherr-Selbstbeurteilungsfragebogens ins Deutsche übersetzt (WR-SB) und auf ihre Anwendbarkeit geprüft.Ziel der ArbeitTesttheoretische Analyse der deutschen Version des WR-SB.Material und MethodenDie psychometrischen Kennwerte des WR-SB wurden in einer Stichprobe von 122 adulten ADHS-Patienten und 79 gesunden Kontrollpersonen erhoben.ErgebnisseFür die einzelnen Subskalen des WR-SB wurden zufriedenstellende Trennschärfen und hohe Werte für die innere Konsistenz ermittelt. Es zeigte sich eine signifikante Korrelation zwischen dem WRI und der WR-SB wie auch eine hohe Retestreliabilität.DiskussionDer WR-SB stellt eine ökonomische Alternative zur Erfassung der sog. Utah-Kriterien dar. Der Fragebogen erweist sich in der Evaluierung als valides und reliables diagnostisches Instrument.AbstractBackgroundThe Wender-Reimherr adult attention deficit disorder scale (WRAADDS) is an internationally accepted attention-deficit hyperactivity disorder (ADHD) interview with an authorized German translation. The WRAADS not only assesses the symptoms of ADHD but also the severity of the symptoms using the Utah criteria. With the aim of economizing the diagnostic process the original English version of the Wender-Reimherr self-report questionnaire was translated into German (WR-SB) in order to evaluate the test psychometric properties.ObjectivesTo explore the psychometric properties of the WR-SB within a classical test theory framework.Material and methodsThe psychometric properties of the WR-SB were determined in a population of 122 adult ADHD patients and 79 healthy controls.ResultsFor the individual WR-SB subscales the results showed an adequate discriminatory power and a high internal consistency. The correlation between the WRAADS and the WR-SB was significant and the retest reliability was high.ConclusionThe WR-SB is a brief, self-report instrument and an economical alternative to assess adult ADHD symptomatology using the Utah criteria. The results of this evaluation study showed the WR-SB to be a valid and reliable measurement for both clinical and research purposes.BACKGROUND The Wender-Reimherr adult attention deficit disorder scale (WRAADDS) is an internationally accepted attention-deficit hyperactivity disorder (ADHD) interview with an authorized German translation. The WRAADS not only assesses the symptoms of ADHD but also the severity of the symptoms using the Utah criteria. With the aim of economizing the diagnostic process the original English version of the Wender-Reimherr self-report questionnaire was translated into German (WR-SB) in order to evaluate the test psychometric properties. OBJECTIVES To explore the psychometric properties of the WR-SB within a classical test theory framework. MATERIAL AND METHODS The psychometric properties of the WR-SB were determined in a population of 122 adult ADHD patients and 79 healthy controls. RESULTS For the individual WR-SB subscales the results showed an adequate discriminatory power and a high internal consistency. The correlation between the WRAADS and the WR-SB was significant and the retest reliability was high. CONCLUSION The WR-SB is a brief, self-report instrument and an economical alternative to assess adult ADHD symptomatology using the Utah criteria. The results of this evaluation study showed the WR-SB to be a valid and reliable measurement for both clinical and research purposes.

Emotional facial recognition in proactive and reactive violent offenders

The purpose of this study is to analyse individual differences in the ability of emotional facial recognition in violent offenders, who were characterised as either reactive or proactive in relation to their offending. In accordance with findings of our previous study, we expected higher impairments in facial recognition in reactive than proactive violent offenders. To assess the ability to recognize facial expressions, the computer-based Facial Emotional Expression Labeling Test (FEEL) was performed. Group allocation of reactive und proactive violent offenders and assessment of psychopathic traits were performed by an independent forensic expert using rating scales (PROREA, PCL-SV). Compared to proactive violent offenders and controls, the performance of emotion recognition in the reactive offender group was significantly lower, both in total and especially in recognition of negative emotions such as anxiety (d = −1.29), sadness (d = −1.54), and disgust (d = −1.11). Furthermore, reactive violent offenders showed a tendency to interpret non-anger emotions as anger. In contrast, proactive violent offenders performed as well as controls. General and specific deficits in reactive violent offenders are in line with the results of our previous study and correspond to predictions of the Integrated Emotion System (IES, 7) and the hostile attribution processes (21). Due to the different error pattern in the FEEL test, the theoretical distinction between proactive and reactive aggression can be supported based on emotion recognition, even though aggression itself is always a heterogeneous act rather than a distinct one-dimensional concept.

Der Wender-Reimherr-Selbstbeurteilungsfragebogen zur adulten ADHS

ZusammenfassungHintergrundZur Erfassung der Psychopathologie der adulten Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) unter Berücksichtigung der Utah-Kriterien steht bislang im deutschsprachigen Raum lediglich das Wender-Reimherr-Interview (WRI) zur Verfügung. Mit dem Ziel der Ökonomisierung des diagnostischen Prozesses wurde die englische Originalversion des Wender-Reimherr-Selbstbeurteilungsfragebogens ins Deutsche übersetzt (WR-SB) und auf ihre Anwendbarkeit geprüft.Ziel der ArbeitTesttheoretische Analyse der deutschen Version des WR-SB.Material und MethodenDie psychometrischen Kennwerte des WR-SB wurden in einer Stichprobe von 122 adulten ADHS-Patienten und 79 gesunden Kontrollpersonen erhoben.ErgebnisseFür die einzelnen Subskalen des WR-SB wurden zufriedenstellende Trennschärfen und hohe Werte für die innere Konsistenz ermittelt. Es zeigte sich eine signifikante Korrelation zwischen dem WRI und der WR-SB wie auch eine hohe Retestreliabilität.DiskussionDer WR-SB stellt eine ökonomische Alternative zur Erfassung der sog. Utah-Kriterien dar. Der Fragebogen erweist sich in der Evaluierung als valides und reliables diagnostisches Instrument.AbstractBackgroundThe Wender-Reimherr adult attention deficit disorder scale (WRAADDS) is an internationally accepted attention-deficit hyperactivity disorder (ADHD) interview with an authorized German translation. The WRAADS not only assesses the symptoms of ADHD but also the severity of the symptoms using the Utah criteria. With the aim of economizing the diagnostic process the original English version of the Wender-Reimherr self-report questionnaire was translated into German (WR-SB) in order to evaluate the test psychometric properties.ObjectivesTo explore the psychometric properties of the WR-SB within a classical test theory framework.Material and methodsThe psychometric properties of the WR-SB were determined in a population of 122 adult ADHD patients and 79 healthy controls.ResultsFor the individual WR-SB subscales the results showed an adequate discriminatory power and a high internal consistency. The correlation between the WRAADS and the WR-SB was significant and the retest reliability was high.ConclusionThe WR-SB is a brief, self-report instrument and an economical alternative to assess adult ADHD symptomatology using the Utah criteria. The results of this evaluation study showed the WR-SB to be a valid and reliable measurement for both clinical and research purposes.BACKGROUND The Wender-Reimherr adult attention deficit disorder scale (WRAADDS) is an internationally accepted attention-deficit hyperactivity disorder (ADHD) interview with an authorized German translation. The WRAADS not only assesses the symptoms of ADHD but also the severity of the symptoms using the Utah criteria. With the aim of economizing the diagnostic process the original English version of the Wender-Reimherr self-report questionnaire was translated into German (WR-SB) in order to evaluate the test psychometric properties. OBJECTIVES To explore the psychometric properties of the WR-SB within a classical test theory framework. MATERIAL AND METHODS The psychometric properties of the WR-SB were determined in a population of 122 adult ADHD patients and 79 healthy controls. RESULTS For the individual WR-SB subscales the results showed an adequate discriminatory power and a high internal consistency. The correlation between the WRAADS and the WR-SB was significant and the retest reliability was high. CONCLUSION The WR-SB is a brief, self-report instrument and an economical alternative to assess adult ADHD symptomatology using the Utah criteria. The results of this evaluation study showed the WR-SB to be a valid and reliable measurement for both clinical and research purposes.

Alters- und geschlechtsspezifische Besonderheiten der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung@@@Age and gender aspects of attention-deficit hyperactivity disorder

ZusammenfassungDie Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) ist eine Erkrankung, die sich im Kindesalter manifestiert und sich nur bei einem Teil der Betroffenen bis zum Erwachsenenalter zurückbildet. Bei etwa 60% der Betroffenen persistiert die ADHS im Erwachsenenalter vollständig oder als Teilsyndrom. Im Erwachsenenalter treten zur ADHS-Kernsymptomatik noch weitere psychopathologische Phänomene im Sinne von desorganisiertem Verhalten und affektiver Dysregulation hinzu. Daneben sind zusätzliche psychiatrische Erkrankungen häufig zu beobachten. Hieraus entstehen oftmals beträchtliche Auswirkungen auf die Alltagsfunktionen und die Lebensqualität der Betroffenen. Die entwicklungspsychopathologischen und Verlaufsaspekte der Erkrankung müssen bei der Diagnostik und Therapie im Erwachsenenalter berücksichtigt werden. Darüber hinaus sind hinsichtlich der verschiedenen klinischen Subtypen der ADHS Besonderheiten in Bezug auf die Psychopathologie, Komorbidität und die funktionellen Auswirkungen der Erkrankung in den verschiedenen Lebensabschnitten zu bedenken. Gleiches gilt für Unterschiede bei beiden Geschlechtern, die vor allem im Erwachsenenalter bislang jedoch noch wenig untersucht sind.SummaryAttention-deficit hyperactivity disorder (ADHD) is a syndrome with onset in childhood which persists at least partially in about 60% of afflicted individuals. Core symptoms include inattention, hyperactivity, and impulsivity. Additional psychopathology with disorganized behavior and emotional dysregulation is common in adulthood. The vast majority of adults affected also present psychiatric comorbidities. There is severe impairment of everyday life and quality of life. Developmental psychopathologic changes, age-related comorbidity, and functional and psychosocial problems associated with ADHD must be taken into account during the diagnostic process. Regarding clinical subtypes of ADHD according to DSM-IV and particularly gender differences, knowledge about these factors in adults with ADHD is limited.Attention-deficit hyperactivity disorder (ADHD) is a syndrome with onset in childhood which persists at least partially in about 60% of afflicted individuals. Core symptoms include inattention, hyperactivity, and impulsivity. Additional psychopathology with disorganized behavior and emotional dysregulation is common in adulthood. The vast majority of adults affected also present psychiatric comorbidities. There is severe impairment of everyday life and quality of life. Developmental psychopathologic changes, age-related comorbidity, and functional and psychosocial problems associated with ADHD must be taken into account during the diagnostic process. Regarding clinical subtypes of ADHD according to DSM-IV and particularly gender differences, knowledge about these factors in adults with ADHD is limited.

Der Einfluss des Geschlechts auf die Selbstbeschreibung kindlicher ADHS-Symptome@@@Gender differences in self-descriptions of child psychopathology in attention deficit hyperactivity disorder

Diagnosing attention deficit hyperactivity disorder (ADHD) in adults requires retrospective assessment of ADHD symptoms in childhood. The Wender Utah Rating Scale (WURS) and its German validated version (WURS-k) may offer a helpful tool to acertain relevant childhood problems associated with ADHD. Up to now validating data of the WURS-k were limited to male population. In a population of 69 female adult ADHD patients and 97 controls, ROC analysis indicated a sensitivity of 93% and specificity of 92% at a cut-off of 30 points in the WURS-k. This cut-off value is equivalent to those of males. Symptom report varies significantly by gender and females describe more internalizing problems while males report more externalizing behaviour. Regarding different subtypes according to DSM-IV males and females did not differ in the items of the WURS-k.