ETD

• ADHD
• Adults
• attention-deficit/hyperactivity disorder
• emotional dysregulation
• validation
• WRAADDS

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that only rarely remits in adulthood, affecting approximately 2.5% of adults. Identifying this condition within the adult population is a significant challenge, as it is often associated with other disorders and exhibits symptoms beyond the classic presentation observed in childhood and described by official criteria.

Aim: In this study we developed and validated the Italian version of the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS; Wender, 1995), a clinician-rated scale based on the Utah Criteria for ADHD in adults. These criteria provide an alternative framework for the diagnosis, that includes both observable behavior and subjective experiences, specifically tailored to address clinical features more directly relevant to adults with the disorder.

Methods: 50 participants were recruited, including 32 referring to the Outpatient Service of Psychiatry Unit 2 at Pisa University Hospital, and 18 recruited through snowball sampling. 25 were diagnosed with ADHD, 15 with other psychiatric conditions, and 10 were considered healthy controls. All patients were evaluated using the WRAADDS and a set of clinician-rated, informant-rated and self-rated instruments to investigate ADHD symptoms. Psychometric characteristics of the WRAADDS were assessed, including inter-rater reliability (N = 17), internal consistency, structure, concurrent and diagnostic validity (N = 50).

Results: The WRAADDS total and composite domains score showed excellent inter-rater validity (Spearman’s r ≥ 0.815) and internal consistency (Cronbach’s α ≥ 0.88). A monodimensional structure of WRAADDS domains was supported by Principal Component Analysis, which showed a single component explaining 63% of variance. Concurrent validity was supported by correlations with measures of inattention, hyperactivity/impulsivity, and emotional dysregulation (r ≥ 0.6). Patients with ADHD scored significantly higher than the other participants on several WRAADDS scores and a combined ADHD composite score ≥ 8 was found to distinguish patients with ADHD with accuracy = 88%, sensitivity = 0.92, and specificity = 0.84.

Conclusions: The Italian version of WRAADDS could be considered a valid assessment tool for adult ADHD, allowing the consideration of aspects that would not be assessed through other available instruments and providing a more comprehensive understanding of the disorder within the adult population.