Clinical Utility and Predictive Validity of Parent and College Student Symptom Ratings in Predicting an ADHD Diagnosis

Objective: This study examined several questions about the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in a young adult college student population. The primary goal was to examine the clinical utility and predictive validity of college student and parent ratings for predicting a diagnostic status of ADHD. Method: In the present study, 86 college students and their parents completed a comprehensive ADHD evaluation including structured diagnostic interviews to determine an ADHD diagnosis (n = 59 with ADHD diagnosis). We collected ratings of childhood and current ADHD symptoms and examined the clinical utility and predictive validity of both parent and student ratings for predicting the presence or absence of an ADHD diagnosis. Results: Regression analyses revealed that above and beyond student ratings, parent ratings of childhood ADHD symptoms of inattention were the strongest predictors of current diagnostic status of ADHD. In the clinical utility analyses, only parent ratings of ADHD symptoms met acceptable thresholds for confirming and ruling out a diagnosis of ADHD. Conclusions: These results fill an important gap in the literature. Overall, results suggest that rating scales can be used effectively to evaluate ADHD on college campuses as long as both parent and student ratings of childhood symptoms are collected. Importantly, collecting parent ratings protects against possible student malingering to obtain ADHD medications or accommodations. Additional research with larger samples and across multiple universities is needed to establish best practices in the diagnosis of ADHD.