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

• Published in: Psychological medicine Vol. 39; no. 4; pp. 685 - 693
• Main Authors: Faraone, S. V., Kunwar, A., Adamson, J., Biederman, J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.04.2009
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Adults; Age of Onset; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Attention deficit hyperactivity disorder (ADHD); Biological and medical sciences; Character; Child; Childhood; Clinical interviews; Deviation; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Medical diagnosis; Medical sciences; Middle Aged; Miscellaneous; Morbidity; Novelty seeking; Personality; Personality Assessment - statistics & numerical data; Personality tests; Personality traits; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Selftranscendence; Symptoms; Temperament; Transcendence; Young Adult; personality; diagnosis; Attention deficit hyperactivity disorder (ADHD); Human; Late; Age of onset; Criterion; Young adult; Classification; Adult; Nosology; Personality; Attention disorder with hyperactivity; Diagnosis
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291708003917

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. 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. 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. 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.