Assessing ADHD in college students: Integrating multiple evidence sources with symptom and performance validity data

Area of Science:

• Clinical Psychology
• Neurodevelopmental Disorders
• Psychological Assessment

Background:

• Adult ADHD diagnosis relies on multiple data sources.
• Integrating diverse assessment data for ADHD remains challenging.
• Client overreporting and low effort can complicate ADHD assessments.

Purpose of the Study:

• To investigate the integration of self-ratings, observer ratings, and performance data in adult ADHD assessment.
• To evaluate the impact of noncredible data on ADHD diagnoses.
• To determine optimal strategies for diagnostic decision-making in adult ADHD.

Main Methods:

• Examined data from 514 postsecondary students assessed for ADHD.
• Compared self-ratings, observer ratings, and performance task data.
• Analyzed reliability, correlations, and agreement between data types.

Main Results:

• Observer ratings were more reliable and corroborated more than self-ratings.
• Moderate to large correlations existed between continuous rating variables, but slight agreement at symptom cutoffs.
• Performance tests showed small relationships with both rating types.
• Half of cases had noncredible data; multiple informant requirements reduced this impact and diagnoses.

Conclusions:

• Observer ratings are valuable in adult ADHD assessment.
• Relying on multiple informants for clinically significant symptoms enhances diagnostic validity.
• Diagnostic criteria should account for potential noncredible data in adult ADHD evaluations.