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ASRS Assessment: A Comprehensive Overview
Introduction to ASRS (Adult ADHD Self-Report Scale)
The Adult ADHD Self-Report Scale (ASRS) is a widely used tool developed by the World Health Organization (WHO) to screen for Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. The ASRS includes 18 questions that align with the DSM-IV criteria for ADHD, and a shorter six-question screener derived from these 18 questions 1. This article synthesizes research findings on the ASRS, focusing on its validity, reliability, and utility in various populations.
Validity and Reliability of ASRS
General Population
The ASRS has demonstrated strong validity and reliability in the general population. Studies have shown that the six-question ASRS screener has high sensitivity (68.7%) and specificity (99.5%), outperforming the full 18-question ASRS in these metrics 1. The ASRS screener also showed strong concordance with clinical diagnoses, with an area under the receiver operating characteristic curve (AUC) of 0.90 2.
Substance Use Disorder Patients
In treatment-seeking substance use disorder (SUD) patients, the ASRS has proven to be a sensitive screener for ADHD, with a sensitivity of 0.84 and specificity of 0.66 at admission 9. The ASRS was not as effective in screening for other externalizing disorders, highlighting its specificity for ADHD 9.
College Students
Among college students with ADHD, the ASRS has shown moderate to good congruency between self-reports and collateral reports, with correlations ranging from 0.47 to 0.66 6. The ASRS was also related to measures of impairment, such as executive functioning and everyday cognitive failure, indicating its utility in documenting ADHD symptoms in this population 6.
Adolescents
Initial evidence suggests that the ASRS screener is a valid and reliable tool for assessing ADHD symptoms in adolescents, making it suitable for large-scale survey efforts 5.
Non-ADHD Controls
In adults without ADHD, the ASRS screener has shown high test-retest reliability, with significant correlations between initial and follow-up assessments (Spearman's rho = 0.78) 7. This reliability is crucial for ensuring the tool's accuracy in differentiating between ADHD and non-ADHD individuals.
Psychometric Properties and Cross-Cultural Validity
Czech Population
The ASRS has been validated in the Czech Republic, showing good psychometric properties. Confirmatory factor analysis indicated a good fit for the screening part of the ASRS, with acceptable results for the symptom list 4. This suggests that the ASRS is appropriate for use in different cultural contexts, although clinical judgment should accompany its use.
Addictive Behaviors
In individuals treated for addictive behaviors, the ASRS v.1.1. demonstrated good convergent validity, sensitivity, and specificity. However, some items did not discriminate well between different psychiatric disorders, indicating a need for careful interpretation in this population 3.
Conclusion
The ASRS is a robust and versatile tool for screening ADHD in various populations, including the general public, substance use disorder patients, college students, and adolescents. Its high sensitivity, specificity, and reliability make it a valuable instrument for both clinical and research settings. However, its use should be complemented by clinical judgment, especially in populations with comorbid conditions or in different cultural contexts. Further research may refine the ASRS to enhance its specificity and applicability across diverse groups.
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Most relevant research papers on this topic
The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population
The six-question ASRS screener is a more sensitive and specific screening tool for adult ADHD than the full 18-question ASRS, making it a preferred choice for community surveys and clinical outreach.
Observational Study
Highly CitedValidity of the World Health Organization Adult ADHD Self‐Report Scale (ASRS) Screener in a representative sample of health plan members
The six-question ASRS Screener is a reliable and valid tool for identifying adult ADHD cases in health plan members, with strong concordance with clinician diagnoses.
Observational StudyHighly Cited[ASRS v.1.1., a tool for attention-deficit/hyperactivity disorder screening in adults treated for addictive behaviors: psychometric properties and estimated prevalence].
The ASRS v.1.1. is a reliable and valid tool for screening ADHD in adults with substance-related disorders, but its specificity is limited by its non-specific nature and potential biases in the sample.
Observational StudyValidity of the Czech Translation of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS)
The Czech translation of the ASRS is appropriate and has acceptable psychometric properties, but its use should be combined with clinical judgment.
Observational StudyEvidence for the reliability and preliminary validity of the Adult ADHD Self‐Report Scale v1.1 (ASRS v1.1) Screener in an adolescent community sample
The ASRS Screener is a reliable and valid screening tool for ADHD in adolescents, providing a needed public-available assessment for large-scale survey efforts.
Observational Study
Rigorous JournalThe Adult ADHD Self-Report Scale (ASRS): utility in college students with attention-deficit/hyperactivity disorder
The Adult ADHD Self-Report Scale (ASRS) is an easy-to-use, reliable, and cost-effective method for assessing ADHD symptoms in college students.
Observational StudyRigorous JournalHighly CitedTest–retest reliability of the adult ADHD Self-Report Scale (ASRS) v1.1 Screener in non-ADHD controls from a primary care physician practice
The DSM-IV ASRS v1.1 Screener has high test-retest reliability in adults without ADHD.
Observational StudyValidation of the Augmentation Severity Rating Scale (ASRS): a multicentric, prospective study with levodopa on restless legs syndrome.
The ASRS is a reliable and valid scale to measure the severity of augmentation in restless legs syndrome patients treated with levodopa.
Observational StudyHighly CitedValidity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD in treatment seeking substance use disorder patients.
The ASRS is a sensitive and specific screening tool for adult ADHD in treatment seeking substance use disorder patients, with better specificity in those with alcohol as their primary substance of abuse.
Observational StudyHighly CitedIntra- and Interjudge Reliability of the Apraxia of Speech Rating Scale in Early Stroke Patients.
The ASRS has limited applicability in assessing severe apraxia of speech in early stroke patients, with poor intra- and interjudge reliability for clinicians with limited experience and training.
Observational Study