Blinded, multi-center validation of EEG and rating scales in identifying ADHD within a clinical sample

Steven M. Snyder, Humberto Quintana, Sandra Griffin Bishop Sexson, Peter Knott, A. F M Haque, Donald A. Reynolds

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Previous validation studies of attention deficit/hyperactivity disorder (ADHD) assessment by rating scales or EEG have provided Class-IV evidence per standards of the American Academy of Neurology. To investigate clinical applications, we collected Class-I evidence, namely from a blinded, prospective, multi-center study of a representative clinical sample categorized with a clinical standard. Participating males (101) and females (58) aged 6 to 18 had presented to one of four psychiatric and pediatric clinics because of the suspected presence of attention and behavior problems. DSM-IV diagnosis was performed by clinicians assisted with a semi-structured clinical interview. EEG (theta/beta ratio) and ratings scales (Conners Rating Scales-Revised and ADHD Rating Scales-IV) were collected separately in a blinded protocol. ADHD prevalence in the clinical sample was 61%, whereas the remainder had other childhood/adolescent disorders or no diagnosis. Comorbidities were observed in 66% of ADHD patients and included mood, anxiety, disruptive, and learning disorders at rates similar to previous findings. EEG identified ADHD with 87% sensitivity and 94% specificity. Rating scales provided sensitivity of 38-79% and specificity of 13-61%. While parent or teacher identification of ADHD by rating scales was reduced in accuracy when applied to a diverse clinical sample, theta/beta ratio changes remained consistent with the clinician's ADHD diagnosis. Because theta/beta ratio changes do not identify comorbidities or alternative diagnoses, the results do not support the use of EEG as a stand-alone diagnostic and should be limited to the interpretation that EEG may complement a clinical evaluation for ADHD.

Original languageEnglish (US)
Pages (from-to)346-358
Number of pages13
JournalPsychiatry Research
Volume159
Issue number3
DOIs
StatePublished - Jun 30 2008

Fingerprint

Attention Deficit Disorder with Hyperactivity
Electroencephalography
Comorbidity
Validation Studies
Learning Disorders
Anxiety Disorders
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
Interviews
Pediatrics
Sensitivity and Specificity

Keywords

  • Adolescent
  • Attention deficit/hyperactivity disorder
  • Child
  • EEG
  • Rating scales
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Psychology(all)

Cite this

Blinded, multi-center validation of EEG and rating scales in identifying ADHD within a clinical sample. / Snyder, Steven M.; Quintana, Humberto; Sexson, Sandra Griffin Bishop; Knott, Peter; Haque, A. F M; Reynolds, Donald A.

In: Psychiatry Research, Vol. 159, No. 3, 30.06.2008, p. 346-358.

Research output: Contribution to journalArticle

Snyder, Steven M. ; Quintana, Humberto ; Sexson, Sandra Griffin Bishop ; Knott, Peter ; Haque, A. F M ; Reynolds, Donald A. / Blinded, multi-center validation of EEG and rating scales in identifying ADHD within a clinical sample. In: Psychiatry Research. 2008 ; Vol. 159, No. 3. pp. 346-358.
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