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Personality traits among ADHD adults: implications of late-onset and subthreshold diagnoses

Published online by Cambridge University Press:  30 June 2008

S. V. Faraone ,
A. Kunwar ,
J. Adamson  and
J. Biederman
S. V. Faraone*
Affiliation:
Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
A. Kunwar
Affiliation:
Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
J. Adamson
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
J. Biederman
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
*
*Address for correspondence: Dr S. V. Faraone, Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, 750 East Adams St, Syracuse, NY13210, USA. (Email: faraones@upstate.edu)
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Abstract

Background

Diagnosing attention deficit hyperactivity disorder (ADHD) in adults is difficult when diagnosticians cannot establish onset prior to the DSM-IV criterion of age 7 or if the number of symptoms does not achieve the DSM threshold for diagnosis. Previous work has assessed the validity of such diagnoses based on psychiatric co-morbidity, family history and neuropsychological functions but none of these studies have used personality as a validation criterion.

Method

We compared four groups of adults: (1) full ADHD subjects who met all DSM-IV criteria for childhood-onset ADHD; (2) late-onset subjects who met all criteria except the age at onset criterion, (3) subthreshold subjects who did not meet full symptom criteria and (4) non-ADHD subjects who did not meet any of the above criteria. Diagnoses were made by using the Structured Clinical Interview for DSM-IV (SCID) and the Temperament and Character Inventory (TCI) was used to assess personality traits.

Results

We found that full ADHD and late-onset ADHD showed similar personality profiles with significant deviations on all TCI scales except reward dependence and self-transcendence. By contrast, subthreshold cases only showed deviations on novelty seeking and self-directiveness.

Conclusions

These data call into question the stringent age of onset of ADHD symptom criteria for adults when making retrospective diagnoses of ADHD. Subthreshold ADHD seems to be a milder form of the disorder that is consistent with dimensional views of the disorder.

Keywords

Attention deficit hyperactivity disorder (ADHD)diagnosispersonality
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 4 , April 2009 , pp. 685 - 693
Copyright
Copyright © 2008 Cambridge University Press

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