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In search for objective measures of hyperactivity, impulsivity and inattention in adult attention deficit hyperactivity disorder using the Quantified Behaviour Test Plus
Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
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2011 (English)In: Europe's Journal of Psychology, ISSN 1841-0413, E-ISSN 1841-0413, Vol. 7, no 3, p. 443-457Article in journal (Refereed) Published
Abstract [en]

Clinical assessment tools for adult ADHD such as rating scales, interviews and behavior observations are often based on subjective judgments which enhance the risk of overlooking or misinterpreting symptoms. In search for objective measures of adult ADHD, the present study investigated levels of sensitivity and specificity for the Quantified Behavior Test Plus, QbTest-Plus, in adult patients (N = 19) awaiting clinical assessment for ADHD. QbTest-Plus report objective measures of ADHD core symptoms using an infrared motion tracking system and a continuous performance test. The measures were collected and evaluated previous to clinical assessment and compared regarding the diagnosis of ADHD. Sensitivity for detecting ADHD with QbTest-Plus was 83 % and specificity was 57 %. The results, possibly affected by confounding factors, suggest further examination of calibrated and objective measure for the QbTest-Plus with regard to ADHD in adults.

 

Place, publisher, year, edition, pages
Trier, 2011. Vol. 7, no 3, p. 443-457
Keywords [en]
attention deficit hyperactivity disorder, objective measures, clinical assessment, adults, the quantified behavior test plus.
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-8147OAI: oai:DiVA.org:kau-8147DiVA, id: diva2:438315
Available from: 2011-09-02 Created: 2011-09-02 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Measuring Cardinal Symptoms of Attention Deficit Hyperactivity Disorder in Adults: Examining objective measures of hyperactivity, impulsivity, and inattention
Open this publication in new window or tab >>Measuring Cardinal Symptoms of Attention Deficit Hyperactivity Disorder in Adults: Examining objective measures of hyperactivity, impulsivity, and inattention
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The purpose of this licentiate thesis is to examine measures of ADHD in adult persons. An instrument that reports objective measures of cardinal symptoms of ADHD in adult persons is used for this purpose. The instrument is called the Quantified Behavior Test Plus and records motor activity by means of an infrared motion tracking system and cognitive deficits with a continuous performance test. Paper I investigates sensitivity and specificity for the test with regard to ADHD in a clinic-referred sample. When the test was compared to clinical assessments, results yielded 83 % sensitivity and 57 % specificity. The high level of comorbid psychiatric disorders motivates continuous search for a composite measure of ADHD cardinal symptoms and better understanding of normative behavior in healthy participants. In Paper II, a composite measure of ADHD called the Weighed Core Symptom scale (WCS) is developed. WCS integrates measures of ADHD cardinal symptoms on a ten point scale. A majority of participants with ADHD has low points on the scale (indicating high levels of symptoms) and a majority of healthy normative participants has high points on the scale (indicating low levels of symptoms). Levels of sensitivity and specificity for the test were examined with a measure called Prediction of ADHD (PADHD), and results yielded 86 % sensitivity and 83 % specificity. The measures developed in Paper II are tentative and needs to be tested in further studies in order to better understand behavior manifestations of ADHD in adult persons.

Place, publisher, year, edition, pages
Karlstad: Karlstad University, 2011. p. 93
Series
Karlstad University Studies, ISSN 1403-8099 ; 2011:39
Keywords
Attention Deficit Hyperactivity Disorder, Objective measures, Adults, the Quantified Behavior Test Plus, Psychometrics
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-8004 (URN)978-91-7063-374-4 (ISBN)
Presentation
2011-10-28, Undénsalen, 11C 413, Karlstads universitet,, Karlstad, 00:00 (Swedish)
Opponent
Supervisors
Available from: 2011-09-02 Created: 2011-08-08 Last updated: 2011-10-24Bibliographically approved
2. Global Assessment of Attention Deficit Hyperactivity Disorder: Examining Objective Measures of Hyperactivity, Impulsivity and Inattention in Adults
Open this publication in new window or tab >>Global Assessment of Attention Deficit Hyperactivity Disorder: Examining Objective Measures of Hyperactivity, Impulsivity and Inattention in Adults
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Global bedöming av aktivitets- och uppmärksamhetsstörning : objektiva mätningar av hyperaktivitet, impulsivitet och ouppmärksamhet hos vuxna personer
Abstract [en]

The aim of this thesis is to examine objective laboratory measures of Attention Deficit Hyperactivity Disorder (ADHD) in adult persons and to develop measures for diagnosis and treatment using a psychometric instrument called the Quantified Behavior Test Plus. The instrument objectively quantifies cardinal symptom manifestations in adult ADHD using motion tracking devices and continuous performance testing. Paper I-IV suggest that ADHD predisposes adult persons to perform poorer on continuous performance tasks and to have higher levels of motor activity while performing these tasks as compared to other clinical as well as non-clinical groups. Performance by adults with ADHD is normalized following stimulant treatment which implicates therapeutic effects and measures of response to treatment and remission for ADHD is suggested.

Paper I concludes that the psychometric instrument needs to be calibrated with regard to adult ADHD and emphasizes the importance of a composite measure for the disorder. Paper II generates two new measures, the Weighed Core Symptom scale (WCS) - a composite measure of adult ADHD ranging from 0 to 100, and Prediction of ADHD (PADHD) - a categorical variable of the diagnostic status with good predictive power. A majority of participants with ADHD has low points on WCS (indicating high levels of symptoms) and a majority of non-ADHD normative participants has high points on WCS (indicating low levels of symptoms). Paper III examines WCS and PADHD among complex clinical groups with shared symptoms vis-à-vis ADHD. Here, findings from Paper II are replicated since participants with ADHD present the highest level of global symptoms, followed by participants with bipolar II disorder and borderline personality disorder, participant with diconfirmed ADHD and finally, non-clinical participants has the lowest level of global symptoms. In Paper IV, the measures are proposed as indications of response to treatment and remission after titration with stimulant treatment and WCS indicates response to small changes in dose level.

The major findings of the present thesis may be summarized as the construction of two new objective measures for ADHD in adult persons with practical implications for diagnosis and treatment. Hyperactivity is the most specific marker of ADHD in both men and women, followed by the cognitive markers of inattention and impulsivity. The composite measure, WCS, quantifies the global amount of ADHD symptoms and provides the most sensitive measure for the disorder. PADHD and WCS may not replace a thorough neuropsychiatric assessment and further studies promoting diagnostic subtype stratification is suggested. Future studies may want to consider these measures in outcome-based investigations of treatment efficacy as well as in the study of neuropsychological endophenotypes. Practical implications include clinical strategies to enhance objectivity during assessment as well as optimizing beneficial effects of treatment and attaining remission.

 

 

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2012. p. 192
Series
Karlstad University Studies, ISSN 1403-8099 ; 2012:49
Keywords
Attention Deficit Hyperactivity Disorder, Objective measures, Adults, Psychometrics, Diagnosis, Treatment
National Category
Other Medical Sciences not elsewhere specified Psychiatry Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-15186 (URN)978-91-7063-460-4 (ISBN)
Public defence
2012-12-14, Sjöströmsalen, 1B 309, Karlstads Universitet, Karlstad, 10:00 (English)
Opponent
Supervisors
Available from: 2012-11-21 Created: 2012-10-17 Last updated: 2018-07-16Bibliographically approved

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http://www.ejop.org/images/2011/08/4.-Adult-attention-deficit-hyperactivity-disorder.pdfhttp://www.ejop.org

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Edebol, HannaNorlander, Torsten

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