Skip to main content
PMC home page
International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2006 Mar 24;14(4):186–201. doi: 10.1002/mpr.7

ADHD rating scale IV: psychometric properties from a multinational study as clinician‐administered instrument

S Zhang 1,✉, DE Faries 1, M Vowles 2, D Michelson 1,3
PMCID: PMC6878282  PMID: 16395872

Abstract

The development of rating scales for attention‐deficit/hyperactivity disorder (ADHD) has traditionally focused on parent‐ or teacher‐rated scales. However, clinician‐based instruments are valuable tools for assessing ADHD symptom severity The ADHD Rating Scale IV (ADHD RS), clinician administered and scored, has been validated as a useful instrument to assess ADHD symptoms among American children and adolescents. In this study, we assessed the psychometric properties of the scale in a recent clinical trial conducted mainly in Europe with over 600 children and adolescents diagnosed with ADHD. The trial was conducted in 11 European countries plus Australia, Israel, and South Africa.

Results based on data in the study indicate that this version of the scale has acceptable psychometric properties including inter‐rater reliability, test‐retest reliability, internal consistency, factor structure, convergent and divergent validity, discriminant validity, and responsiveness. There were low‐to‐moderate ceiling and floor effects. The psychometric properties were comparable with other validated scales for assessing ADHD symptom severity. These results were consistent across the 14 countries participating in this trial. Overall, the data from this study support the use of the ADHD RS as a clinician‐rated instrument for assessing the severity of ADHD symptoms in children and adolescents in Europe. Copyright © 2005 John Wiley & Sons, Ltd.

Keywords: Attention Deficit Hyperactivity Disorder, Rating Scale‐IV‐Parent, psychometric properties

Full Text

The Full Text of this article is available as a PDF (973.0 KB).

References

  1. Allen AJ, Spencer TJ, Heiligenstein JH, Faries DE, Kelsey DK, Laws HF, Wernicke J, Kendrick KL, Michelson D. Safety and efficacy of atomoxetine for ADHD in two double‐blind, placebo‐controlled trials. Biological Psychiatry, Society of Biological Psychiatry 56th Annual Convention and Scientific Program, 3–5 May 2001; New Orleans LA. Dallas, TX: Elsevier; [Google Scholar]
  2. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders: DSM‐IV‐TR. Washington DC: American Psychiatric Press, 2000. [Google Scholar]
  3. Anderson TW. An Introduction to Multivariate Statistical Analysis. 2 edn Beijing People's Republic of.China: John Wiley & Sons, 1990, pp. 120–5. [Google Scholar]
  4. Barkley RA. Attention Deficit Hyperactivity Disorder: Handbook for Diagnosis and Treatment. New York: Guilford, 1990. [Google Scholar]
  5. Baumgaertel A, Wolraich ML, Dietrich M. Comparison of diagnostic criteria for attention deficit disorders in German elementary school sample. J Am Acad Child Adolesc Psychiatry 1995; 34: 629–38. [DOI] [PubMed] [Google Scholar]
  6. Biederman J, Faraone SV, Monuteaux MC, Grossbard JR. How informative are parent reports of attention‐deficit/hyperactivity disorder symptoms for assessing outcome in clinical trials of long‐acting treatments? pooled analysis of parents' and teachers' reports. Pediatrics 2004; 113: 1667–71. [DOI] [PubMed] [Google Scholar]
  7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; I: 307–10. [PubMed] [Google Scholar]
  8. Brown, RT , Freeman WS, Perrin JM, Stein MT, Amler RW, Feldman HM, Pierce K, Buitelaar JK, Danckaerts M, Gillberg C, Zuddas A, Becker K, Bouvard M, Fagan J, Gadoros J, Harpin V, Hazell P, Johnsson M, Lerman‐Sagie T, Soutullo C, Wolanczyk T, Zeiner P, Fouche DS, Krikke‐Workel J, Zhang S, Michelson. A prospective, multicenter, open‐label assessment of atomoxetine in non‐North American children and adolescents with ADHD. Eur Child Adolesc Psychiatry 2004; 13(4): 249–57. [DOI] [PubMed] [Google Scholar]
  9. Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait‐multimethod matrix. Psychological Bulletin. 1959; 56: 81–105. [PubMed] [Google Scholar]
  10. Channon E, Butler A. Comparing investigators' use of rating scales such as PANSS in muti‐investigator studies of schizophrenia. Poster presentation at the Eleventh European College of Neuropsychopharmacology (ECNP) Congress, 1998.
  11. Cohen M, Becker MG, Campbell R. Relationships among four methods of assessment of children with attention deficit‐hyperactivity disorder. J School Psychol 1990; 28: 189–202. [Google Scholar]
  12. Conger AJ, Conger JC, Wallander J, Wark D, Dygdon J. A generalizability study of the Conners' Teacher Rating Scale‐Revised. Educ Psychol Meas 1983; 43: 1019–31. [Google Scholar]
  13. Conners CK. Conners' Rating Scales: Revised Technical Manual. North Towanda (New York): Multi‐Health Systems, 1997. [Google Scholar]
  14. Cronbach LF. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297–334. [Google Scholar]
  15. Deyo RA, Diehr P, Patrick KL. Reproducibility and responsiveness of health status measures: Statistics and stratifies for evaluation. Control Clin Trials 1991; 12: 142S–158S. [DOI] [PubMed] [Google Scholar]
  16. DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV: checklists, norms, and clinical inter‐pretation. New York: Guilford, 1998. [Google Scholar]
  17. Faraone SV, Biederman J. Neurobiology of attention‐deficit hyperactivity disorder. Biol Psychiatry 1998; 10: 951–8. [DOI] [PubMed] [Google Scholar]
  18. Faries DE, Yalcin I, Harder D, Heiligenstein JH. Validation of the ADHD Rating Scale as a clinician administered and scored instrument. J Atten Disord 2001; 5(2): 107–15. [Google Scholar]
  19. Fleiss JL. Measuring nominal scale agreement among many raters. Psychol Bull 1971; 76(5): 378–82. [Google Scholar]
  20. Graetz BW, Sawyer MG, Hazell PL, Arney F, Baghurst P. Validity of DSM‐IV ADHD subtypes in a nationally representative sample of Australian children and adolescents. J Am Acad Child Adolesc Psychiatry 2001; 40: 1410–17. [DOI] [PubMed] [Google Scholar]
  21. Guy W. ECDEU assessment manual for psychopharmacology, revised. Bethesda (MD): US Department of Health, Education, and Welfare, 1976. [Google Scholar]
  22. Health Council of the Netherlands . Diagnosis and treatment of ADHD. Publication no. 2000/24. The Hague: Health Council of the Netherlands, 2000. [Google Scholar]
  23. Herrmann C. International experiences with the Hospital Anxiety and Depression Scale–a review of validation data and clinical results. J Psychosom Res 1997; 42: 17–41. [DOI] [PubMed] [Google Scholar]
  24. Kaufman J, Birmaher B, Brent D, Rao U, Ryan N. Kiddie‐Sads‐Present and Lifetime Version (K‐SADS‐PL). Version 1.0. Pittsburgh: Department of Psychiatry University of Pittsburgh School of Medicine, 1996. [Google Scholar]
  25. Kazdin AE, Esveldt‐Dawson K, Loar LL. Correspondence of teacher ratings and direct observations of classroom behaviour of psychiatric inpatient children. J Abnorm Psychol 1983; 10; 483–95. [DOI] [PubMed] [Google Scholar]
  26. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–74. [PubMed] [Google Scholar]
  27. Lessing E, Oberlander MI, Barbera L. Convergent validity of the IPAT Children's Personality Questionnaire and teachers' ratings of the adjustment of elementary school children. Soc Behav Pers 1974; 2: 222–9. [Google Scholar]
  28. Magnusson P, Smart J, Gretarsdottir H, Prandardottir H. Attention‐Deficit/Hyperactivitity symptoms in Icelandic schoolchildren: assessment with the Attention Deficit/Hyperactivity Rating Scale‐IV. Scand J Psychol 1999; 40: 301–6. [DOI] [PubMed] [Google Scholar]
  29. Livingston R. Cultural issues in Diagnosis and treatment of ADHD. J Am Acad Child Adolesc Psychiatry 1999; 38(12): 1591–4. [DOI] [PubMed] [Google Scholar]
  30. Michelson D, Faries DE, Wernicke J, Kelsey DK, Kendrick KL, Sallee FR, Spencer T, and the Atomoxetine ADHD Study Group . Atomoxetine in the treatment of children and adolescents with ADHD: A randomized, placebo‐controlled dose‐response study. Pediatrics 2001; 108(5): 1–9. [DOI] [PubMed] [Google Scholar]
  31. Michelson D, Buitelaar JK, Danckaerts MJ, Gillberg C, Spencer T, Zuddas A, Faries D, Zhang S, Biederman J. Relapse prevention in Patients with Attention‐Deficit/Hyperactivity disorder treated with atomoxetine: a randomized, double‐blind, placebo‐controlled study. J Am Acad Child Adolesc Psychiatry 2004; 43(7): 896–904. [DOI] [PubMed] [Google Scholar]
  32. Mueller CW, Mann EM, Thanapum S, Humris E, Ikeda Y, Takahashi A, Tao KT, Li BL. Teachers' ratings of disruptive behaviour in five countries. J Clin Child Psychol 1995; 24(4): 434–42. [Google Scholar]
  33. National Institute of Clinical Excellence . Guidance on the Use of Methylphenidate (Ritalin, Equasym) for Attention Deficit/Hyperactivity Disorder (ADHD) in Childhood. Technology Appraisal Guidance no. 13. London: NICE, 2000. [Google Scholar]
  34. Nunnally, JC . Psychometric Theory. 3 edn New York: McGraw‐Hill, 1994. [Google Scholar]
  35. Perrin ES, Aaronson NK, Alonso J, Burnam A, Lohr K, Patrick KL. Instrument Review Criteria. Medical Outcomes Trust 1997: 1–5. [Google Scholar]
  36. Pliszka SR, McCracken JT, Maas JW. Catecholamines in attention‐deficit hyperactivity disorder: current perspectives. J Am Acad Child Adolesc Psychiatry 1996; 35(3): 264–72. [DOI] [PubMed] [Google Scholar]
  37. Prendergast M, Taylor E, Rapoport JL, Bartko J, Donnelly M, Zametkin A, Ahearn MB, Dunn G, Wieselberg HM. The diagnosis of childhood hyperactivity. A US‐UK cross‐national study of DSM‐III and ICD‐9. J Child Psychol Psychiatry 1988; 29(3): 289–300. [DOI] [PubMed] [Google Scholar]
  38. Reid, R . Assessment of ADHD with culturally different groups: the use of behaviour rating scales. School Psychology Review 1995; 24: 537–60. [Google Scholar]
  39. Reid R, DuPaul GJ, Power TJ, Anastopoulos AD, Rogers‐Adkinson D, Noll M, Riccio C. Assessing culturally different students for attention deficit hyperactivity disorder using behaviour rating scales. J Abnorm Child Psychol 1998; 26(3): 187–98. [DOI] [PubMed] [Google Scholar]
  40. Spencer F, Biederman J, Heiligenstein J, Wilens T, Faries D, Prince J. An open‐label, dose ranging study of tomoxetine in children with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2001; 11(3): 251–65. [DOI] [PubMed] [Google Scholar]
  41. Stratford PW, Binkley JM, Riddle DL. Health status measures: strategies and analytic methods for assessing change scores. Phys Ther 1996; 76(10): 109–23. [DOI] [PubMed] [Google Scholar]
  42. Stucki G, Michel BA. How to measure improvement: rules and fallacies. Rheumatol Eur Supp 1995; 2: 107–11. [Google Scholar]

Articles from International Journal of Methods in Psychiatric Research are provided here courtesy of Wiley

RESOURCES