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Reliability of DSM-IV Symptom Ratings of ADHD: implications for DSM-V. | LitMetric
Objective : The objective of this study was to examine the intrarater reliability of DSM-IV ADHD symptoms.Method : Two-hundred-two children referred for attention problems and 49 comparison children (all 7-12 years) were rated by parents and teachers on the identical DSM-IV items presented in two different formats, the SNAP-IV and Conners' Revised Questionnaires, at two closely spaced points in time.Results : For the combined sample, weighted kappa scores for intrarater agreement ranged from .30 ("fair") to .77 ("good") across symptoms. Kappa scores were good with respect to agreement on the DSM-IV criterion of endorsement of at least six symptoms in a given cluster for Inattention (.60 and .76, for parents and teachers, respectively) and Hyperactivity-Impulsivity (.72 and .75, respectively). Kappas for identification of cases as AD/HD or not AD/HD were good to excellent (.67 and .79 for parents and teachers, respectively). Classification as AD/HD or not AD/HD changed from the first to the second rating in 12% and 10% of cases rated parents and teachers, respectively.Conclusion : Reliability of individual ADHD symptoms appears to be suboptimal for clinical and research use and is improved, although less than ideal, at the levels of cluster endorsement and case classification.
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