Behaviour ratings of executive functions in adolescents with ADHD: correlation with core symptoms and functional impairment measured by multiple informants

Abstract

Background: Executive functional deficits (EFDs) are very common in patients with Attention Deficit/Hyperactivity Disorder (ADHD). Behavioural ratings of executive functions have high ecological value but vary between informants and observational settings. Objectives of this study were to describe correlations between ratings on behavioural executive functions, ADHD symptoms and functional impairment between different informants. Materials and Methods: The study includes 100 adolescents aged 14–18 with ADHD still experiencing clinically impairing symptoms despite standard treatment. Ratings of EFDs were obtained from teachers, parents and self-reports. Parents and adolescents also rated core symptoms of ADHD and functional impairment. A clinician assessed overall global functioning. The relationship between measures and informants were analysed using Pearson correlations. Results: There was a significant, strong, positive correlation between all measures reported by the same informant. The overall correlation was small to medium between teacher reported EFDs and both core symptoms of ADHD and functional impairment as reported by parents and adolescents. There was a significant negative correlation between clinicians’ assessment of global functioning and ratings of EFDs by all informants. Conclusions: We found that EFDs were strongly correlated both with higher levels of core symptoms of ADHD, and higher level of functional impairment as reported by the same informant. We also found, in line with previous research, that ratings of symptoms and impairment differs between informants and settings. Our findings underline the importance of multiple informants in both assessment and treatment planning.