Date of Award
Doctor of Philosophy (PhD)
Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder characterized by a persistent pattern of developmentally inappropriate levels of inattention, hyperactivity, and impulsivity (American Psychiatric Association, 2000). Currently, clinicians typically utilize a multi-method assessment battery focusing on identifying the core symptoms of ADHD. Further, current recommendations for a comprehensive assessment of ADHD require a lengthy and costly evaluation protocol despite a lack of evidence supporting the incremental utility of each method. Assessment strategies exhibiting the strongest evidence of reliability and validity include symptom-based rating scales, empirically-derived rating scales, and structured diagnostic interviews (Pelham, Fabiano, & Massetti, 2005), yet, their review provided limited empirical support for this conclusion. Nonetheless, other reviews have noted the lack of research examining whether each procedure and/or method adds unique information to a diagnosis of ADHD (Johnston & Murray, 2003). In order to fill this gap in the literature, the current study examined the independent and incremental utility of multiple methods and informants in a comprehensive, “gold standard” assessment of ADHD. The sample include 185 children with ADHD (Mage =9.22, SD=.95) and 82 children without ADHD (Mage =9.24, SD=.88). Logistic regressions were used to examine the incremental contribution of each method in the prediction of consensus diagnoses derived by two Ph.D. level experts in the field of ADHD following a review of comprehensive assessment data. This study also examined the clinical utility and efficiency of diagnostic algorithms using the methods demonstrating the greatest statistical association with a diagnosis of ADHD. Finding provided an empirical support for arguments espousing the redundancy of information in a comprehensive assessment. Namely, information collected from a structured diagnostic interview was unable to significantly improve a prediction model including parent and teacher ratings (Block X2-= .91 = .64). Importantly, parent and teacher ratings on a symptom-based scale alone were able to correctly classify 265 of 267 participants. Based on these results, a diagnostic algorithm that was derived utilizing only behavioral rating scales was able to classify correctly all 267 participants. Clinical implications are highlighted and future research directions are discussed.
Vaughn, Aaron, "The Incremental Utility of Behavioral Rating Scales and a Structured Diagnostic Interview in the Assessment of ADHD" (2009). Graduate College Dissertations and Theses. 235.