Translation and validation of the Brown attention-deficit disorder scale for use in Brazil: identifying cases of attention-deficit/hyperactivity disorder among samples of substance users and non-users. Cross-cultural validation study

Abstract

INTRODUCTION Until recently, it was believed that attention deficit hyperactivity disorder (ADHD) was exclusively a pediatric condition. 1 However, current research indicates that 60% to 70% of children diagnosed with ADHD continue to manifest symptoms into adulthood. 2 Persistence of symptoms of ADHD can have a pressing impact on the safety and personal relationships of patients, as well as having secondary effects in adulthood such as lost days of productivity and continual negative feedback or social and educational disadvantages. 3 A recent study that used the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for ADHD, which was conducted in both developed and underdeveloped countries, estimated that the worldwide prevalence of ADHD was 3.4% and showed that it was higher among underdeveloped countries. 4 Currently, there are no biomarkers available for diagnosing ADHD. All diagnoses require careful assessments by clinicians through interviews and appropriate classification criteria. 5 Two diagnostic tools are used today to classify this disorder: DSM-5 and the International Statistical Classification of Diseases and Related Health Problems (ICD-10). These two diagnostic tools define ADHD as a hyperkinetic disorder, a disorder characterized by inattention, hyperactivity and impulsivity with onset in childhood or adolescence. It is believed that the current diagnostic criteria (both DSM-5 and the ICD-10) are inadequate for evaluation of adults because they focus on early childhood problems and they do not fully account for developmental and maturation changes. 6 The symptoms and functional impairments identified among adults for making a diagnosis of ADHD tend to be different from those observed among children.

Clinical Utility and Cut-Off Scores of the Korean Adult Attention-Deficit/Hyperactivity Disorder Rating Scale

“…Meanwhile, Kessler et al [12] have reported that the six-question ASRS had a sensitivity of 68.7% and specificity of 99.5%, and Heo et al [13] have revealed that the ASRS had a sensitivity of 0.627 and 1-specificity of 0.196 for diagnosing ADHD in the Korean adult population. In Brazilians, the Brown Attention-deficit Disorder Scale presented a fair sensitivity with 72% accuracy and fair specificity with 88% accuracy [14]. Ustun et al [15] have reported that the revised ASRS had a higher sensitivity at 91.4% and specificity at 96.0%.…”

Psychometric Properties of the Persian Version of Brown Attention Deficit Disorder Scale (BADDS)

“…Similarly, in a Portuguese version, BADDS had a good internal consistency (Cronbach's alpha of 0.95) and fair sensitivity (72%), and specificity (88% accuracy). Its discriminant validity for people with substance abuse was also demonstrated (29). Solanto et al evaluated BADDS in 93 adults who presented with ADHD.…”

“…Each cluster score is calculated by summing up the scores of the corresponding items. The clusters are: Activation (items: 2, 3, 10, 11, 13, 19, 21, 27, 39), attention (items: 1, 4, 5,6,8,23,26,32,36), effort (items:12, 14, 16,17,22,25,34,37,40), affect (items: 9,18,20,24,29,30,31), and memory (items: 7,15,28,33,35,38). A score higher than 55 is highly probable for ADHD; in a score between 40 and 54, ADHD is probable but not definite, and in scores lower than 40, ADHD diagnosis is unlikely (the translation process is explained further in detail).…”

Adult Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder: A Systematic Review of the Literature

“…Brazilian study validated the translated version of the adult self-report The Brown Attention-Deficit Disorder Scale (BADDS) using the ASRS as the gold standard [52], but ASRS appears to be more appropriate screener that BADDS in SUD patients [53]. Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID) proved to be a diagnostic tool that can also be used during active substance use [54].…”