Asrs adhd
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Understanding the ASRS for ADHD Screening
Introduction to ASRS ADHD Screening
The World Health Organization Adult ADHD Self-Report Scale (ASRS) is a widely used tool for screening attention-deficit/hyperactivity disorder (ADHD) in adults. Developed in conjunction with the WHO Composite International Diagnostic Interview (CIDI), the ASRS aims to provide a reliable and efficient method for identifying ADHD symptoms based on DSM-IV criteria .
Structure and Versions of ASRS
Full ASRS (18-Item)
The full ASRS consists of 18 questions that assess the frequency of recent ADHD symptoms. Each question corresponds to a DSM-IV Criterion A symptom of adult ADHD. The responses are then compared to clinical ratings to determine the presence of ADHD .
ASRS Screener (6-Item)
A shorter version, the ASRS Screener, includes six questions selected through logistic regression to optimize concordance with clinical diagnoses. This screener has shown higher sensitivity (68.7% vs. 56.3%), specificity (99.5% vs. 98.3%), and overall classification accuracy (97.9% vs. 96.2%) compared to the full ASRS .
Validity and Reliability of ASRS
General Population
The ASRS Screener has demonstrated strong validity and reliability in various populations. In a study involving health plan members, the ASRS Screener showed high internal consistency (0.63-0.72) and test-retest reliability (0.58-0.77). It also had a strong concordance with clinician diagnoses, with an area under the receiver operating characteristic curve (AUC) of 0.90 .
Substance Use Disorder Patients
In treatment-seeking substance use disorder (SUD) patients, the ASRS showed a sensitivity of 0.84 and specificity of 0.66 at admission, with similar results two weeks later. The ASRS was particularly effective in identifying ADHD in patients with alcohol as the primary substance of abuse .
Adolescents and College Students
The ASRS has also been validated in younger populations. The Italian translation of the ASRS-18 effectively differentiated adolescents with ADHD from those without, showing an AUC of 0.80 . Among college students, the ASRS demonstrated moderate to good congruency between different administration methods and was related to measures of executive functioning and cognitive failure .
Practical Applications
Primary Care Settings
The ASRS is particularly useful in primary care settings due to its brevity and ease of administration. It takes less than a minute to complete and has high sensitivity and moderate specificity, making it an effective tool for guiding further evaluations .
Community and Clinical Outreach
The ASRS Screener is valuable for large-scale surveys and clinical outreach initiatives. Its ability to discriminate between ADHD cases and non-cases makes it an attractive option for both community epidemiological surveys and targeted clinical assessments 28.
Conclusion
The ASRS, both in its full and screener forms, is a reliable and valid tool for screening ADHD in various populations. Its ease of use, strong psychometric properties, and applicability across different settings make it an essential instrument for identifying ADHD and guiding further diagnostic evaluations.
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