The ADHD Concomitant Difficulties Scale (ADHD-CDS), a Brief Scale to Measure Comorbidity Associated to ADHD

Abstract

Introduction: Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians.Methods: The total sample included 399 parents of children with ADHD aged 6–18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process.Results: Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]).Discussion: The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and health professionals in dealing with ADHD.

Arousal and Executive Alterations in Attention Deficit Hyperactivity Disorder (ADHD)

“…Following this approach, impairments observed in individuals with ADHD are expected at the three levels of the CEM. For instance, motor difficulties have been reported in children with ADHD ( Goulardins et al, 2013 ; Kaiser et al, 2015 ; Rosa Neto et al, 2015 ; Fenollar-Cortés and Fuentes, 2016 ; Fenollar-Cortés et al, 2017 ), which might reflect dysfunction at the lower level. Moreover, children with ADHD generally exhibit a dysfunction in their response inhibition (upper level), as we mentioned previously.…”

“…Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders (Polanczyk et al, 2014). ADHD is mainly characterized by varying degrees of inattention, hyperactivity, and impulsivity (American Psychiatric Association, 2013) as critical features of the disorder, which are usually accompanied by other concomitant deficits, such as lower emotional/motivational management, impaired fine motor coordination, low management of time, more frequent disruptive behavior, unstable sleep habits, academic achievement lower than their possible intellectual abilities, and impaired quality of life (Fenollar-Cortés and Fuentes, 2016). These symptoms appear at early stages of children's development before the age of 12 (American Psychiatric Association, 2013) and may change over time (American Psychiatric Association, 2013), such as decrease in hyperactivity-impulsivity symptoms with age (Döpfner et al, 2015).…”

Implicación de la memoria visoespacial y fonológica en la heterogeneidad clínica del Trastorno por Déficit de Atención con Hiperactividad (TDAH)

“…-ADHD Concomitant Difficulties Scale (ADHD-CDS) (Fenollar-Cortés & Fuentes, 2016). It is a brief scale of 13 items with 4 answer options of veracity, ranging from 0 ("Not true") to 3 ("Completely true"), which measures the difficulties concomitant to ADHD, and includes areas such as emotional management, fine psychomotricity, executive functions, reading and math performance, quality of life and sleeping habits.…”

Sensibilidade e especificidade de instrumentos psicológicos na avaliação do transtorno de déficit de atenção e hiperatividade: um estudo de revisão sistemática

“…Seus principais objetivos foram discriminar as dificuldades funcionais no TDAH e estabelecer um instrumento breve para avaliação médica e serviços de saúde. Para tanto, fez-se a verificação da sensibilidade de tal instrumento via curva de ROC, a partir de uma amostra composta por crianças diagnosticadas com TDAH e um grupo controle sem diagnóstico (FENNOLAR-CORTÉS;FUEN-TES, 2016).…”

“…O instrumento, nomeado TDAH-Concomitant Difficulties Scale (TDAH--CDS), mostrou evidências psicométricas adequadas, além de boa sensibilidade para discriminação das crianças com diagnóstico de TDAH. Tais dados demonstram que esse instrumento pode ser apropriado para o uso de profissionais da saúde que lidem com tal demanda (FENNOLAR-CORTÉS;FUENTES, 2016).…”