Understanding And Improving Adhd Symptom Recall: An Investigation of Temperament And Childhood Symptom Recall Over Time

Background: ADHD is characterized by a high prevalence, functional impairment across the lifespan, negative long-term consequences, and a heterogeneous etiology, rendering it of significant public health import. Despite this, there is still a significant delay to treatment as well as low rate of lifetime treatment contact in the ADHD population, which may potentially increase the associated personal and public health burdens. Due to this delay to treatment and requirement of symptom onset before the age of 12, adults seeking ADHD assessments provide a challenge to clinicians to determine if symptoms were present in childhood. The current study investigated the consistency of retrospective parental and self-recall of childhood symptoms and explored potential avenues for improving assessment of symptoms of ADHD in childhood. Method: Participants were recruited from an outpatient mental health clinic and a developmental research program. Data were collected from 50 parents and 40 children (Time 2 age M=13.63; SD=3.09; range 6.87 - 20.50). who had previously completed a measure of ADHD symptoms (Time 1 age M=9.48; SD=2.65; range 5.44 - 14.92). Participants completed a retrospective recall of previous child ADHD symptoms using the same symptom measure they completed earlier. Participants also completed measures of child current ADHD symptoms and associated impairment, and a retrospective report of child temperament. Results: Repeated measures ANCOVAs were conducted to assess the difference between retrospective recall and past symptom reports. Results suggested that Time 1 childhood symptoms of ADHD were significantly higher than Time 2 retrospective reports. ADHD diagnostic status only affected self-report of childhood hyperactivity/impulsivity symptoms, such that youth with ADHD demonstrated more consistent report of hyperactivity/impulsivity over time. Multiple linear regressions suggested that Time 2 symptoms of ADHD were the most significant factor in predicting Time 1 childhood symptoms for parent report and child report of attention problems. Linear regressions assessed the relationship between retrospective recall of Time 1 temperament traits and past, current, and retrospective reports of ADHD symptoms. Parent reported child reward dependence, novelty-seeking, and self-directedness temperament traits were associated with parent report of childhood ADHD symptoms. Self-reported novelty-seeking, persistence, reward dependence, and self-directedness were the most significant temperament correlates with parent report of childhood ADHD symptoms. Discussion: Results were consistent with previous research and suggested that parents and youth tend to underreport previous symptom levels of inattention and hyperactivity/impulsivity. Higher parent reported reward dependence was associated with lower inattention and hyperactivity/impulsivity in childhood. Higher novelty-seeking was associated with both inattention and hyperactivity/impulsivity in childhood. Lower parent reported self-directedness was associated with higher parent reported hyperactivity/impulsivity. Regarding self-report, higher novelty-seeking was associated with childhood inattention and hyperactivity/impulsivity. Further, higher self-directedness and reward dependence were associated with childhood hyperactivity. Finally, higher self-reported persistence was associated with higher inattention in childhood. These results provide preliminary data suggesting that assessing child temperament, specifically related to motivational processes and reward seeking may aid ADHD diagnostic processes