Impact of the impairment criterion in the diagnosis of adult ADHD: 33-year follow-up study of boys with ADHD

Objective: To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood (ages 6-12). Method: Clinicians blindly interviewed 121 White males; the mean age was 41 years across the sample. DSM-IV adult ADHD behaviors were systematically rated, and impairment resulting from symptoms was scored on a 5-point Likert-type scale. Results: Correlations between degree of impairment and number of behaviors were high (r’s =.83 to.85, p <.001). The impairment criterion had no effect on classifying any participants as having, or not having, adult ADHD. All participants who reported experiencing 5 or more inattention or hyperactive-impulsive behaviors as “often ” or “very often ” in adulthood were significantly impaired by their symptoms. Conclusions: Contrary to results reported in children, there was a strong relationship between number of ADHD symptoms and degree of impairment. However, for several reasons (discussed in the article), it should not be concluded that the impairment criterion is superfluous. (J. of Att. Dis. 2010; XX(X) 1-XX