DSM-5 and Other Symptom Thresholds for ADHD: Which Is the Best Predictor of Impairment in College Students?

Abstract

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) threshold of five symptoms for ages 17 years and older is not necessarily predictive of ADHD-related impairment in college students and may not be preferable to other thresholds. Options for resolving this diagnostic dilemma are discussed.

Validation of the French Version of the Weiss Functional Impairment Rating Scale–Self-Report in a Large Cohort of Adult Patients With ADHD

“…Only the Japanese study included a small sample of adults with ADHD ( N = 46), but there were also healthy adults ( N = 104) and university students ( N = 889; Takeda et al, 2016). Note that the WFIRS-S scores of the present study are consistent with those obtained in previous studies that included patients with an established diagnosis of ADHD, suggesting a similar level of ADHD-related functional impairment across cultural contexts (Hartung et al, 2016; LaCount, Hartung, Shelton, Clapp, & Clapp, 2015).…”

Invariance of ADHD Symptoms Across Sex and Age: a Latent Analysis of ADHD and Impairment Ratings from Early Childhood into Adolescence

“…As an alternative, the current results, as well as those from recent bi-factor analyses of ADHD symptoms in childhood and a recent study of the dimensionality of ADHD in adulthood (Hartung et al, 2016), provide additional empirical support for a model that would incorporate dimensional modifiers that reflect the number of IN and HI symptoms at the time of assessment (e.g., mild, moderate, and severe for 0–2, 3–5, and 6 or more current symptoms; see Willcutt et al, 2012). Such a model might also encourage research on the developmental course and biobehavioral underpinnings of these presentations.…”

Psychometric Properties of the Weiss Functional Impairment Rating Scale: Evidence for Utility in Research, Assessment, and Treatment of ADHD in Emerging Adults

“…However, measures such as the CSS impairment scale, BFIS, modified IRS, and AAQol have empirical support and were all specifically developed to fulfill this purpose. Such measures that are specifically tailored to assess adult ADHD-related impairment seem to be the most appropriate options for researchers and clinicians to meet recent calls for additional focus on the functional impairment criterion (Hartung et al, 2019; Sibley, Pelham, Molina, Gnagy, Waxmonsky, et al, 2012). Unfortunately, each also has its shortcomings that, individually and collectively, signal that the establishment of new, viable alternatives is still a worthy endeavor.…”