Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-17T12:48:03.517Z Has data issue: false hasContentIssue false
  • English
  • Français

German validation of the Conners Adult ADHD Rating Scales (CAARS) II: Reliability, validity, diagnostic sensitivity and specificity

Published online by Cambridge University Press:  15 April 2020

H. Christiansen ,
B. Kis ,
O. Hirsch ,
S. Matthies ,
J. Hebebrand ,
J. Uekermann ,
M. Abdel-Hamid ,
M. Kraemer ,
J. Wiltfang  and
E. Graf
...Show all authors
H. Christiansen*
Affiliation:
Philipps-University Marburg, Department of Clinical Psychology, Gutenbergstr. 18, 35037Marburg, Germany
B. Kis
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
O. Hirsch
Affiliation:
Philipps-University Marburg, Department of General Practice/Family Medicine, Marburg, Germany
S. Matthies
Affiliation:
University of Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany
J. Hebebrand
Affiliation:
University of Duisburg-Essen, Department of Child and Adolescent Psychiatry and Psychotherapy, Essen, Germany
J. Uekermann
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
M. Abdel-Hamid
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
M. Kraemer
Affiliation:
Alfried-Krupp Hospital, Department of Neurology and clinical Neurophysiology, Essen, Germany
J. Wiltfang
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
E. Graf
Affiliation:
University Medical Center Freiburg, Clinical Trials Unit, Freiburg, Germany
M. Colla
Affiliation:
Department of Psychiatry, Charite – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
E. Sobanski
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
B. Alm
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
M. Rösler
Affiliation:
Saarland University, Institute for Forensic Psychology and Psychiatry, Homburg, Germany
C. Jacob
Affiliation:
University of Wuerzburg, University Hospital, Department of Psychiatry and Psychotherapy, Wuerzburg, Germany
T. Jans
Affiliation:
University of Wuerzburg, University Hospital, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Wuerzburg, Germany
M. Huss
Affiliation:
University of Mainz, Department of Child and Adolescent Psychiatry and Psychotherapy, Mainz, Germany
B.G. Schimmelmann
Affiliation:
University Hospital of Child and Adolescent Psychiatry, Bern, Switzerland
A. Philipsen
Affiliation:
University of Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany
*
*Corresponding author. Tel.: +49 0 6421 282 3706; fax: +49 0 6421 282 4281. E-mail address: christih@staff.uni-marburg.de (H. Christiansen).
Get access

Abstract

Background

The German version of the Conners Adult ADHD Rating Scales (CAARS) has proven to show very high model fit in confirmative factor analyses with the established factors inattention/memory problems, hyperactivity/restlessness, impulsivity/emotional lability, and problems with self-concept in both large healthy control and ADHD patient samples. This study now presents data on the psychometric properties of the German CAARS-self-report (CAARS-S) and observer-report (CAARS-O) questionnaires.

Methods

CAARS-S/O and questions on sociodemographic variables were filled out by 466 patients with ADHD, 847 healthy control subjects that already participated in two prior studies, and a total of 896 observer data sets were available. Cronbach's-alpha was calculated to obtain internal reliability coefficients. Pearson correlations were performed to assess test-retest reliability, and concurrent, criterion, and discriminant validity. Receiver Operating Characteristics (ROC-analyses) were used to establish sensitivity and specificity for all subscales.

Results

Coefficient alphas ranged from .74 to .95, and test-retest reliability from .85 to .92 for the CAARS-S, and from .65 to .85 for the CAARS-O. All CAARS subscales, except problems with self-concept correlated significantly with the Barrett Impulsiveness Scale (BIS), but not with the Wender Utah Rating Scale (WURS). Criterion validity was established with ADHD subtype and diagnosis based on DSM-IV criteria. Sensitivity and specificity were high for all four subscales.

Conclusion

The reported results confirm our previous study and show that the German CAARS-S/O do indeed represent a reliable and cross-culturally valid measure of current ADHD symptoms in adults.

Keywords

Attention-deficit/hyperactivity disorderAdult ADHDAdult ADHD assessmentDiagnostic issuesConners Adult ADHD Rating Scales (CAARS)ADHD, Attention-deficit/hyperactivity disorderADHD-DC, German ADHD Observer-Rating ScaleADHD-SR, German ADHD Self-Rating ScaleASRS, Adult Self-Report ScaleCAARS, Conners Adult ADHD Rating ScalesCP/TRS, Conners Parent/Teacher Rating ScaleDSM-IV, Diagnostic and Statistical Manual of the American Psychiatric Association, 4th versionICD-10, International Classification of Diseases, 10th versionWHO, World Health OrganizationWURS/WURS-K, Wender Utah Rating Scale/German short version
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 5 , July 2012 , pp. 321 - 328
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Contributed equally to this paper.

References

Adler, L., Kessler, R., Spencer, T.Adult Self-Report Scale. ASRS-V1. 1 Screener. New York: World Health Organization; 2003.Google Scholar
Adler, L., Spencer, T., Biederman, J.Adult ADHD Investigator Symptom Rating Scale. New York: New York University School of Medicine; 2003.Google Scholar
Barkley, R.A., Fischer, M.The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. J Am Acad Child Adolesc Psychiatry. 2010; 49: 503–513.Google ScholarPubMed
Beck, A.T., Steer, R.A.Beck Depression Inventory - Manual. San Antonio: The Psychological Association; 1987.Google Scholar
Bell A. A critical review of ADHD diagnostic criteria: what to address in the DSM-V. J Atten Disord 2011;15:3–10.10.1177/1087054710365982CrossRefGoogle Scholar
Brickenkamp, R.Handbuch psychologischer und pädagogischer Tests. Göttingen: Hogrefe; 1997.Google Scholar
Brown, T.E.Brown Attention-Deficit Disorder Scales. San Antonio, TX: Psychological Corporation; 1996.Google Scholar
Christiansen H, Kis B, Hirsch O, Philipsen A, Henneck M, Panczuk A, et al. German validation of the Conners Adult ADHD Rating Scales-self-report (CAARS-S) I: factor structure and normative data. Eur Psychiatry 2010 [10.1016/j.europsy.2009.12.024].10.1016/j.eurpsy.2009.12.024CrossRefGoogle Scholar
Christiansen H, Hirsch, O, Philipsen A, Matthies S, Hebebrand J, Ueckermann J, et al. German validation of the Conners Adult ADHD Rating Scales–self-report (CAARS-S): replication of factor structure in a large patient sample (under review).Google Scholar
Conners, C.K., Erhardt, D., Epstein, J.N., Parker, J.D.A., Sitarenios, G., Sparrow, E.Self-ratings of ADHD symptoms in adults I: factor structure and normative data. J Atten Disord. 1999; 3: 141–151.10.1177/108705479900300303CrossRefGoogle Scholar
Conners, C.K., Erhardt, D., Sparrow, E.P.Conners’ Adult ADHD Rating Scales (CAARS). North Tonawanda: Multi-Health Systems; 1999.Google Scholar
DuPaul, G., Power, T.J., Anastopoulos, A.D., Reid, R.ADHD Rating Scale-IV: checklists, norms, and clinical interpretation. New York: Guilford; 1998.Google Scholar
Erhardt, D., Epstein, J.N., Conners, C.K., Parker, J.D.A., Sitarenios, G.Self-ratings of ADHD symptoms in adults II: reliability, validity, and diagnostic sensitivity. J Atten Disord. 1999; 3: 153–158.10.1177/108705479900300304CrossRefGoogle Scholar
Faraone, S.V., Biederman, J., Spencer, T., Mick, E., Murray, K., Petty, C.et al.Diagnosing adult attention-deficit hyperactivity disorder: are late onset and subthreshold diagnoses valid?. Am J Psychiatry. 2006; 163: 1720–1729.10.1176/ajp.2006.163.10.1720CrossRefGoogle ScholarPubMed
Friedrichs B, Igl W, Larsson H, Larsson JO. Coexisting psychiatric problems and stressful life events in adults with symptoms of ADHD–A large Swedish population-based study of twins. J Atten Disord 2010, Aug. 4. [Epub ahead of print].10.1177/1087054710376909CrossRefGoogle Scholar
Hautzinger, M., Bailer, M., Worall, H., Keller, F.Beck-Depressions-Inventar (BDI). Bearbeitung der deutschen Ausgabe. Testhandbuch. Bern, Göttingen, Toronto. Seattle: Huber; 1994.Google Scholar
Jans T, Philipsen A, Graf E, Ihorst G, Gerlach M, Warnke A. Does the treatment of maternal attention deficit and hyperactivity disorder (ADHD) enhance the efficacy of a behavioural parent training for the treatment of their children's ADHD? Study protocol of a randomized controlled multicentre trail. ADHD Attention Deficit and Hyperactivity Disorders 2009;1:33–45 [http://dx.doi.org/10.1007/s12402-009-0004-4].CrossRefGoogle Scholar
Kessler, R.C., Adler, L., Ames, M., Delmer, O., Faraone, S., Hiripi, E.et al.The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005; 35: 245–256.10.1017/S0033291704002892CrossRefGoogle Scholar
Laux, L., Glanzmann, P., Schaffner, P., Spielberger, C.D.Das State-Trait-Angstinventar. Theoretische Grundlagen und Handanweisung. Weinheim: Beltz Test GmbH; 1981.Google Scholar
Newcomer, P., Hammill, D.Test of language development. Austin, Tx: Pro-Ed; 1982.Google Scholar
Patton, J.H., Stanford, M.S., Barratt, E.S.Factor structure of the Barrattimpulsiveness scale. J Clin Psychol. 1995; 51: 768–774.10.1002/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-13.0.CO;2-1>CrossRefGoogle ScholarPubMed
Philipsen A, Graf E, van Elst LT, Jans T, Warnke A, Hesslinger B, et al. Evaluation of the efficacy and effectiveness of a structured disorder tailored psychotherapy in ADHD in adults: study protocol of a randomized controlled multicentre trial. Attention Deficit and Hyperactivity Disorders 2010;2:203–12 [http://dx.doi.org/10.1007/s12402-010-0046-7].CrossRefGoogle Scholar
Retz-Junginger, P., Retz, W., Blocher, D., Weijers, H.G., Trott, G.E., Wender, P.H.et al.Wender Utah Rating Scale (WURS-k) Die deutsche Kurzform zur retrospektiven Erfassung des hyperkinetischen Syndroms bei Erwachsenen. Nervenarzt. 2002; 73: 830–838.10.1007/s00115-001-1215-xCrossRefGoogle Scholar
Reuter, M., Kirsch, P., Hennig, J.Inferring candidate genes for Attention Deficit Hyperactivity Disorder (ADHD) assessed by the World Health Organization Adult ADHD Self-Report Scale (ASRS). J Neural Transm. 2006; 113: 929–938.10.1007/s00702-005-0366-5CrossRefGoogle ScholarPubMed
Roesler, M., Retz, W., Retz-Junginger, P., Thome, J., Supprian, T., Nissen, T.et al.Instrumente zur Diagnostik der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter Selbstbeurteilungsskala (ADHS-SB) und Diagnosecheckliste (ADHS-DC). Nervenarzt. 2004; 75: 888–895.Google Scholar
Safren, S.A., Sprich, S.E., Cooper-Vince, C., Knouse, L.E., Lerner, J.A.Life impairments in adults with medication-treated ADHD. J Atten Disord. 2010; 5: 524–531.CrossRefGoogle Scholar
Sobanski, E., Alm, B.Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) bei Erwachsenen. Ein Überblick. Nervenarzt. 2004; 75: 697–716.10.1007/s00115-004-1757-9CrossRefGoogle Scholar
Ward, M.F., Wender, P.H., Reimherr, F.W.The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry. 1993; 6: 885–890.Google Scholar
Weiner, E., Stewart, B.Assessing individuals. Boston: Little, Brown; 1984.Google Scholar
Weiss, M., Murray, C.Assessment and management of attention-deficit hyperactivity disorder in adults. CMAJ. 2003; 168: 715–722.Google ScholarPubMed
Weiss, M.D., Gibbins, C., Goodman, D.W., Hodgkins, P.S., Landgraf, J.M., Faraone, S.V.Moderators and mediators of symptoms and quality of life outcomes in an open-label study of adults treated for attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2010; 71: 381–390.CrossRefGoogle Scholar
Wender, P.Attention deficit hyperactivity disorder in adults. New York: Oxford University Press; 1995.Google Scholar
Wender, P.H., Reimherr, F.W., Wood, D.R.Attention deficit disorder (‘minimal brain dysfunction’) in adults. A replication study of diagnosis and drug treatment. Arch Gen Psychiatry. 1981; 38: 449–456.10.1001/archpsyc.1981.01780290083009CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.