Self-report of symptoms in adolescents with ADHD

There is much debate regarding who are the best or appropriate informants regarding an individual's mental health symptoms and functioning (Achenbach, 2011; De Los Reyes, 2011). In childhood disorders such as ADHD, parents and teachers have typically been relied upon as the primary informants with respect to reporting ADHD symptoms (Smith, Barkley, & Shapiro, 2007); however, ADHD is now conceptualized as a lifespan disorder (Barkley, 2006; Vaughan, Wetzel, & Kratochvil, 2008; Whalen, Jamner, Henker, Delfino, & Lozano, 2002). This raises questions regarding who are the best informants in assessing ADHD during the transitional period of adolescence. The current study identifies a gap in the literature and practice guidelines and supports a developmental perspective in the diagnosis and care for adolescents with ADHD. Participants were 122 adolescents (27% female) diagnosed with ADHD with a mean age of 15.41years. Adolescents, their parents, and their teachers completed clinical interviews and questionnaires assessing symptoms, impairment, and behaviour. Parents reported significantly more symptoms than adolescents; however, teachers were similar to adolescents in their reports of ADHD symptoms and impairment. Despite reporting fewer symptoms than parents, adolescents reported ADHD symptoms at levels warranting clinical concern. Adolescents diagnosed with ADHD were also internally consistent and valid in their ADHD reports, at levels similar to parents and teachers. Those who reported high versus low levels of ADHD symptoms did not differ by age or gender; however, adolescents who reported high levels of symptoms also reported more impairment. Preliminary findings in line with the upcoming DSM-5 change in symptom threshold for older adolescents are also explored. Overall, findings indicate that, in general, adolescents with ADHD possess the ability to recognize and report on their symptoms and impairment. Limitations and implications for clinical practice are discussed.