Validity of the age-of-onset criterion for ADHD: A report from the DSM- IV field trials

Brooks Applegate, Benjamin B. Lahey, Elizabeth L. Hart, Joseph Biederman, George W. Hynd, Russell A. Barkley, Thomas Ollendick, Paul J. Frick, Laurence Greenhill, Keith McBurnett, Jeffrey H. Newcorn, Lynn Kerdyk, Barry Garfinkel, Irwin Waldman, David Shaffer

Research output: Contribution to journalArticle

256 Scopus citations

Abstract

Objective: To examine the validity of the DSM-IV requirement of an age of onset of impairment due to symptoms before 7 years of age for the diagnosis of attention-deficit/hyperactivity disorder (ADHD). Method: The validity of this criterion was examined in a clinic sample of 380 youths aged 4 through 17 years by comparing youths who met symptom criteria for ADHD and either did or did not display impairment before age 7 years. Results: Nearly all youths who met symptom criteria for the predominantly hyperactive- impulsive subtype also met the age of onset of impairment criterion, but 18% of youths who met symptom criteria for the combined type, and 43% of youths who met symptom criteria for the predominantly inattentive type, did not manifest impairment before 7 years. For the latter two subtypes, requiring impairment before age 7 years reduced the accuracy of identification of currently impaired cases of ADHD and reduced agreement with clinicians' judgments. Conclusions: These findings raise questions about the validity of the DSM-IV definition of age of onset of ADHD. Marked differences in the ages of onset of both symptoms and impairment for the three subtypes of ADHD support the validity of distinguishing among these subtypes in DSM-IV.

Original languageEnglish (US)
Pages (from-to)1211-1221
Number of pages11
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume36
Issue number9
DOIs
StatePublished - Sep 1997

Keywords

  • Age of onset
  • Attention-deficit/hyperactivity disorder
  • Diagnosis
  • Structured diagnostic interviews

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

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    Applegate, B., Lahey, B. B., Hart, E. L., Biederman, J., Hynd, G. W., Barkley, R. A., Ollendick, T., Frick, P. J., Greenhill, L., McBurnett, K., Newcorn, J. H., Kerdyk, L., Garfinkel, B., Waldman, I., & Shaffer, D. (1997). Validity of the age-of-onset criterion for ADHD: A report from the DSM- IV field trials. Journal of the American Academy of Child and Adolescent Psychiatry, 36(9), 1211-1221. https://doi.org/10.1097/00004583-199709000-00013