Validity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD in treatment seeking substance use disorder patients

Geurt van de Glind, Wim van den Brink, Maarten W.J. Koeter, Pieter-Jan Carpentier, Katelijne van Emmerik-van Oortmerssen, Sharlene Kaye, Arvid Skutle, Eli-Torild H. Bu, Johan Franck, Maija Konstenius, Franz Moggi, Geert Dom, Sofie Verspreet, Zsolt Demetrovics, Máté Kapitány-Fövény, Melina Fatséas, Marc Auriacombe, Arild Schillinger, Andrea Seitz, Brian Johnson, Stephen V. Faraone, J. Antoni Ramos-Quiroga, Miguel Casas, Steve Allsop, Susan Carruthers, Csaba Barta, Robert A. Schoevers, Frances R. Levin
Drug and Alcohol Dependence. 2013-10-01; 132(3): 587-596
DOI: 10.1016/j.drugalcdep.2013.04.010

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1. Drug Alcohol Depend. 2013 Oct 1;132(3):587-96. doi:
10.1016/j.drugalcdep.2013.04.010. Epub 2013 May 6.

Validity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD
in treatment seeking substance use disorder patients.

van de Glind G(1), van den Brink W, Koeter MW, Carpentier PJ, van Emmerik-van
Oortmerssen K, Kaye S, Skutle A, Bu ET, Franck J, Konstenius M, Moggi F, Dom G,
Verspreet S, Demetrovics Z, Kapitány-Fövény M, Fatséas M, Auriacombe M,
Schillinger A, Seitz A, Johnson B, Faraone SV, Ramos-Quiroga JA, Casas M, Allsop
S, Carruthers S, Barta C, Schoevers RA; IASP Research Group, Levin FR.

Author information:
(1)Trimbos-instituut and ICASA Foundation, Utrecht, The Netherlands; Amsterdam
Institute for Addiction Research, Amsterdam, The Netherlands. Electronic address:

BACKGROUND: To detect attention deficit hyperactivity disorder (ADHD) in
treatment seeking substance use disorders (SUD) patients, a valid screening
instrument is needed.
OBJECTIVES: To test the performance of the Adult ADHD Self-Report Scale V
1.1(ASRS) for adult ADHD in an international sample of treatment seeking SUD
patients for DSM-IV-TR; for the proposed DSM-5 criteria; in different
subpopulations, at intake and 1-2 weeks after intake; using different scoring
algorithms; and different externalizing disorders as external criterion
(including adult ADHD, bipolar disorder, antisocial and borderline personality
METHODS: In 1138 treatment seeking SUD subjects, ASRS performance was determined
using diagnoses based on Conner’s Adult ADHD Diagnostic Interview for DSM-IV
(CAADID) as gold standard.
RESULTS: The prevalence of adult ADHD was 13.0% (95% CI: 11.0-15.0%). The overall
positive predictive value (PPV) of the ASRS was 0.26 (95% CI: 0.22-0.30), the
negative predictive value (NPV) was 0.97 (95% CI: 0.96-0.98). The sensitivity
(0.84, 95% CI: 0.76-0.88) and specificity (0.66, 95% CI: 0.63-0.69) measured at
admission were similar to the sensitivity (0.88, 95% CI: 0.83-0.93) and
specificity (0.67, 95% CI: 0.64-0.70) measured 2 weeks after admission.
Sensitivity was similar, but specificity was significantly better in patients
with alcohol compared to (illicit) drugs as the primary substance of abuse (0.76
vs. 0.56). ASRS was not a good screener for externalizing disorders other than
CONCLUSIONS: The ASRS is a sensitive screener for identifying possible ADHD cases
with very few missed cases among those screening negative in this population.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.drugalcdep.2013.04.010
PMCID: PMC4083506
PMID: 23660242 [Indexed for MEDLINE]

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