The effect of medication and question wording on self‐reported symptoms and their accuracy in young adults with attention‐deficit/hyperactivity disorder

Abstract

Objectives. This study examined the effect of whether participants were on or off their medications and the effect of questionnaire wording on self-reported symptoms in young adults with ADHD. Additionally, this research evaluated the relationships between these self-reported symptoms and objective performance on measures of working memory.Design. This experimental study utilized a mixed factorial design with one betweensubjects factor (whether participants were unmedicated or medicated at the time they completed their assessment) and one within-subjects factor (whether participants reported their on-medication or off-medication symptoms when describing their ADHD subjective symptomatology).Methods. Forty-five young adults with ADHD (ages 18-23) completed a brief neuropsychological evaluation and several self-report questionnaires.Results. Although being medicated or unmedicated while completing the questionnaires did not directly affect self-reported symptoms or their accuracy, questionnaire wording exerted a statistically significant effect on subjective symptomatology; participants described themselves as substantially more symptomatic at times when they are off than at times when they are on their medications. More importantly, their general selfperceptions (symptoms when medication state was not specified) of their Inattention/ Memory Problems and their Hyperactivity/Restlessness aligned with their descriptions of their off-medication symptoms, whereas their general self-perceptions of their Impulsivity/Emotional Lability and Problems with Self-Concept related to both their selfreported off-medication and on-medication symptoms.Conclusions. These results highlight the necessity of specifying medication state when asking patients to report their current symptomatology. Failing to do so risks an overreporting of symptoms from patients who are typically on medications as they may describe the extent of their unmedicated, rather than medicated, symptomatology.

Systematic literature review examining the mere-measurement effect of patient reported measures: the interaction of emotional valence and frequency of exposure as an independent factor in patient change

“…The researchers found that the subjects whom were asked about their habits were significantly more likely to donate blood than their control counter parts at the following blood-drive (Godin, Sheeran, Conner, & Germain, 2008). Other researchers found that when clinicians did not ask patients with Attention Deficit Hyperactivity Disorder (ADHD) to report whether they were currently medicated on a disease-related severity questionnaire, patients were more likely to report un-medicated symptomologies (Lineweaver et al, 2021). In other words, patients on ADHD medications responded more symptomatically similar to their un-medicated selves when their medication status was not included on the questionnaire.…”