Validity of Change in DSM-5 Attention-Deficit/Hyperactivity Disorder (ADHD) Age of Onset Criterion Confirmed
A recent study published in the July 2014 issue of the Journal of the American Academy of Child and Adolescent Psychiatry confirms the validity of the DSM-5 change to the age of onset criterion for diagnosis of attention-deficit/hyperactivity disorder (ADHD).
In DSM-5, age of onset criterion for ADHD, previously set at 7 in DSM-IV, has been raised to 12. As explained in DSM-5, age of onset is now set at 12, rather than an earlier age, to reflect the importance of clinical presentation during childhood for accurate diagnosis, while also acknowledging the difficulties in establishing precise childhood onset retrospectively.
Using data from a nationally representative sample of youth who participated in the National Health and Nutrition Examination Survey (NHANES), a group of researchers led by Dr. Kathleen Merikangas of the National Institute of Health Intramural Research Program, evaluated symptoms of ADHD and its subtypes in 1,894 participants aged 12-15 years based on parent reports of symptomatology.
Researchers found that levels of severity, functional impairment, and patterns of comorbidity among the additional 3.46% of children who met all of the ADHD criteria except age of onset under 7 were comparable with those of other mental and behavioral disorders. Although raising the age of onset criterion in DSM-5 from 7 to 12 generated an increase in the prevalence of all subtypes of ADHD, the greatest increase was found for inattention, which tends to have a later onset than symptoms of hyperactivity that emerge earlier in development. Dr. Merikangas noted that youth with the inattention subtype of ADHD are less likely to be recognized and treated because their problems may be less apparent at school and at home. These findings highlight the importance of systematic study of diagnostic criteria in representative samples of the general population.
The article “Impact of the DSM-5 ADHD Age of Onset Criterion in the U.S. Adolescent Population” by Jennifer L. Vande Voort, Jian-Ping He, Nicole D. Jameson, and Kathleen R. Merikangas, (http://dx.doi.org/10.1016/j.jaac.2014.03.005) appears in the Journal of the American Academy of Child and Adolescent Psychiatry, Volume 53, Issue 7 (July 2014), published by Elsevier.
A related editorial, “How Evidence on the Developmental Nature of Attention-Deficit/Hyperactivity Disorder Can Increase the Validity and Utility of Diagnostic Criteria,” by Drs. Guilherme Polanczyk, and Terrie E. Moffitt, is published in the same issue (http://dx.doi.org/10.1016/j.jaac.2014.04.012).
Funding for this study was supported by the Intramural Research Program of NIMH (Z01 MH002804). The views and opinions expressed in the article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. government.
Notes for editors
Full text of the article is available to credentialed journalists upon request; contact Mary Billingsley at +1 202 587 9672 or firstname.lastname@example.org. Journalists wishing to interview the authors may contact the NIMH Media Office at NIMHpress@mail.nih.gov.
All articles published in JAACAP are embargoed until the day they are published as in press corrected proofs online at http://jaacap.org/inpress. Articles cannot be publicized as in press accepted manuscripts. Contents of the publication should not be released to or by the media or government agencies prior to the embargo date.
Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.
The journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.
Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com
JAACAP Editorial Office
+1 202 587 9672