If you’re being evaluated for possible ADHD, symptom questionnaires often feature prominently in the process.
Many of these questionnaires contain lists of statements such as “I often make careless mistakes.” You go through the statements, rate how much you agree with each one, and then get a score at the end which is meant to suggest how good of a candidate you are for the title of “ADHDer.”
There are a lot of advantages to these questionnaires. They’re simple to use, and they quickly summarize different aspects of what it means to have ADHD. A lot of people with ADHD can probably remember the first time they first laid eyes on an ADHD questionnaire and, reading through the symptoms, got a feeling of eery familiarity.
There are imperfections in questionnaires, too. The questions are open to interpretation, so they’re a somewhat subject measure. Some types of ADHD symptoms might not be captured in a given questionnaire. And not all questions that do appear necessarily correlate equally well with having ADHD.
It’s this last issue that was the subject of a recent study by researchers in the US.
Basically, of the different questions that can be asked as indications of possible ADHD symptoms, some questions might separate out people with and without ADHD more accurately than others. So the researchers analyzed a commonly used questionnaire, the Barkley Adult ADHD Rating Scale, to see which questions best discriminated between ADHDers and non-ADHDers.
The BAARS contains nine questions related to inattentive symptoms and nine related to hyperactive symptoms. The researchers confirmed that, to varying extents, all of the questions were helpful in discriminating between people with and without ADHD – which is good news because a lot of people have probably been diagnosed based partly on this questionnaire!
But not all ADHD symptoms are created equal, it appears. In other words, some of the symptoms more strongly separated out people with clinical levels of inattention or hyperactivity.
Out of the nine questions related to hyperactivity, the researchers found that the characteristic that best discriminated people with and without hyperactive symptoms was:
- Difficulty awaiting turn
To me, that sounds reasonable. As I’ve written about before, the experience of hyperactivity seems to come with a sense of impatience. You are seeking out immediate rewards, you want the stimulation of things happening as quickly as possible, and you don’t like waiting.
In the case of inattention, the question that best discriminated inattentive symptoms was:
- Does not follow instructions, finish work
One reason this question seems to separate out ADHDers and non-ADHDers especially well could be that it actually involves several possible ADHD symptoms rolled into one question.
Not following instructions could come from not listening when instructions are given or from not paying attention when carrying out the instructions. Not finishing work could come from getting distracted, the motivation deficits that come with ADHD, or some combination of both.
Although it’s interesting to see which questions best sort out ADHDers and non-ADHDers, these two questions shouldn’t be hyped up too much.
A single question is nowhere near enough information to make a diagnosis (even though some researchers have experimented with 2-question screening questionnaires). Besides, just because these questions were the best for separating out ADHDers and non-ADHDers among participants in this study doesn’t necessarily mean the same pattern would hold for other groups of people.
What I like about this research finding is that it highlights core experiences of hyperactivity and inattention that are somewhat different than these symptoms’ textbook definitions: trouble waiting, and issues turning instructions into completed tasks.
Image: Flickr/Jurgen Appelo