The Impact of DSM-5 A-Criteria Changes on Parent Ratings of ADHD in Adolescents

J Atten Disord. 2018 Jan;22(1):83-91. doi: 10.1177/1087054714526040. Epub 2014 Mar 13.

Abstract

Objective: Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) A-criteria for ADHD were expanded to include new descriptors referencing adolescent and adult symptom manifestations. This study examines the effect of these changes on symptom endorsement in a sample of adolescents with ADHD (N = 259; age range = 10.72-16.70).

Method: Parent ratings were collected and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) and DSM-5 endorsement of ADHD symptoms were compared.

Results: Under the DSM-5, there were significant increases in reported inattention, but not hyperactivity/impulsivity (H/I) symptoms, with specific elevations for certain symptoms. The average adolescent met criteria for less than one additional symptom under the DSM-5, but the correlation between ADHD symptoms and impairment was attenuated when using the DSM-5 items. Impulsivity items appeared to represent adolescent deficits better than hyperactivity items. Results were not moderated by demographic factors.

Conclusion: In a sample of adolescents with well-diagnosed DSM-IV-TR ADHD, developmental symptom descriptors led parents to endorse slightly more symptoms of inattention, but this elevation is unlikely to be clinically meaningful.

Keywords: DSM-5; adolescents; diagnosis.

MeSH terms

  • Adolescent
  • Adult
  • Attention
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Child
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Female
  • Humans
  • Impulsive Behavior
  • Male
  • Parents / psychology*
  • Personal Satisfaction