ADHD Follow-Up in Adulthood among Subjects Treated for the Disorder in a Child and Adolescent Mental Health Service from 1995 to 2015

Validity of the Italian Version of DIVA-5: Semi-Structured Diagnostic Interview for Adult ADHD Based on the DSM-5 Criteria

Introduction: In 2019, an updated version of the Diagnostic Interview for ADHD in Adults (DIVA-5) was developed based on DSM-5 criteria, currently validated in Korean and Farsi. The aim of this study is to validate the DIVA-5 Italian version. Methods: 132 subjects in the Adult ADHD Screening Center of AUSL-Modena, who agreed to participate in this study, were selected. Socio-demographic and clinical variables were collected. DIVA-5, Barkley Adult ADHD Rating Scale (BAARS), and Adult ADHD Self Rating Scale (ASRS-v1.1) were administered. We assessed the internal consistency of the DIVA-5 Italian version and its concurrent validity with ASRS-v1.1 and BAARS-IV. An exploratory factor analysis (EFA) was conducted to evaluate the construct validity, and a multiple linear regression to evaluate the predictive validity. Results: Our analysis indicated good internal consistence of the DIVA-5 Italian version (Cronbach's alpha and Kuder coefficients ranged between 0.61 and 0.78). The EFA showed five factors representing specific variance. The correlation between the corresponding ADHD dimensions of DIVA-5 and BAARS was found to be statistically significant (Spearman's coefficient ranged between 0.61 and 0.47, p = 0.000), while the correlation between the DIVA-5 dimensions and ASRS-v1.1 was statistically significant for all the dimensions except child hyperactivity/impulsivity. The multiple linear regression showed a positive association of the DIVA-5 score with the "job" variable and a negative association with "drug therapy". DIVA-5 showed greater sensitivity for inattention in adulthood and greater specificity for hyperactivity/impulsivity in childhood. Conclusions: Our results confirm that the DIVA-5 Italian version represents a valid and reliable tool to diagnose adult ADHD.

Subclinical attention-deficit hyperactivity disorder symptoms and unhealthy lifestyle behaviours

BACKGROUND

Literature emphasises the importance of identifying and intervening in the adoption of unhealthy lifestyle behaviours (ULBs) during adolescence at an early stage, to mitigate their long-term detrimental effects. Among the possible associated factors contributing to ULBs, attention-deficit hyperactivity disorder (ADHD) has been shown to play an important role. However, little is known about ADHD subclinical manifestations.

AIMS

The present study aimed to bridge the gap in the literature and shed light on the relationship between subclinical ADHD and early adoption of ULBs during adolescence. Through a clinimetric approach, prevalence of ULBs, severity of ADHD symptoms and psychosocial factors (i.e. allostatic overload, abnormal illness behaviour, quality of life, psychological well-being) were investigated among adolescents. The associations between different degrees of ADHD, ULBs and psychosocial factors were also explored.

METHOD

This multicentre cross-sectional study involved 440 adolescents (54.5% females; mean age 14.21 years) from six upper secondary schools. Participants completed self-report questionnaires on sociodemographic characteristics, ULBs, ADHD symptoms and psychosocial factors.

RESULTS

The most common ULBs were energy drinks/alcohol consumption and problematic smartphone use. Of the sample, 22% showed subclinical ADHD and 20.2% showed clinical ADHD. The subclinical ADHD group showed several ULBs (i.e. altered mindful eating, impaired quality of sleep, problematic technology use) and psychosocial factors, akin to those of ADHD group and different from peers without ADHD symptoms.

CONCLUSIONS

Since subclinical ADHD manifestation is associated with ULBs, similarly to clinical ADHD, identifying subthreshold symptoms during adolescence is crucial, as it could improve health-related outcomes in adulthood across different domains.

ADHD Adults Show Lower Interindividual Similarity in Ex-Gaussian Reaction Time Vectors for Congruent Stimuli Compared to Control Peers

OBJECTIVE

Interindividual similarity refers to how similarly individuals respond when receiving the same stimulus or intervention. In this study, we aimed to examine interindividual similarity in adults with ADHD.

METHOD

We used the cosine similarity index of ex-Gaussian reaction time (RT) vectors of mu, sigma, and tau parameters during a Stroop task.

RESULTS

Our results demonstrate that the ADHD group exhibits a reduced interindividual similarity index in their ex-Gaussian RT vectors for congruent stimuli compared to the healthy control group. Importantly, we did not find significant differences in the interindividual similarity index to incongruent stimuli between both groups, thus suggesting that this reduced index was selective for congruent stimuli.

CONCLUSION

Our findings highlight that ADHD adults exhibit more significant interindividual differences in cognitive functioning when processing congruent stimuli than healthy controls. These results provide new insights into the selective mechanisms underlying ADHD and may contribute to developing new targeted interventions for this disorder.