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Attention deficit hyperactivity disorder (ADHD) is often associated with psychosocial functioning difficulties and valid measures of disability are needed for this population. The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is widely used to measure disability but has not been validated in the adult ADHD population.
Aims
This study aims to assess the psychometric properties of the WHODAS 2.0 in adults with ADHD, and to examine differences in disability levels between ADHD subtypes and gender.
Method
A cross-sectional study was conducted with 577 adults with ADHD (mean age: 38.24, s.d = 12.23; 52.3% male). ADHD severity was assessed using the ADHD Rating Scale (ADHD-RS) and Clinical Global Impression-Severity (CGI-S) Scale, while functionality was measured with the WHODAS 2.0 and the Functioning Assessment Short Test (FAST). Analyses included: (a) Cronbach’s α for internal consistency, (b) Pearson’s correlation for convergent validity, (c) Confirmatory Factor Analysis (CFA) for factor structure and (d) t-tests to compare disability levels across ADHD subtypes and gender.
Results
The WHODAS 2.0 demonstrated good internal consistency (Cronbach’s α = 0.89). Scores were significantly correlated with psychosocial functioning (FAST, r = 0.476, p < 0.001) and clinical measures. CFA supported the original six-factor structure (root mean square error of approximation 0.039, Comparative Fit Index 0.998, Tucker–Lewis Index 0.996). When comparing ADHD subtypes, participants with the combined subtype had higher WHODAS 2.0 total scores than those with the inattentive subtype (p = 0.006). Additionally, gender differences were identified, with females displaying higher disability levels (p = 0.005).
Conclusions
The WHODAS 2.0 demonstrates psychometric properties that suggest it is a valid and reliable tool for assessing disability in adults with ADHD.
Psychosis are complex disorders due to their symptomatic and evolutionary heterogeneity. The genetic-environmental interaction model is the most accepted etiopathogenic model, in which neurobiological processes (genetic factors, connectivity and brain structure) and environmental factors (for example: childhood trauma) are studied. The association between suffering traumatic events in childhood and the subsequent development of a Mental Disorder is of increasing interest.
Objectives
Analyze if a childhood trauma is a modulating factor of psychotic symptoms in patients with Mental Disorder. Analyze the implication of childhood trauma in long-term functionality.
Methods
The sample is made up of 37 patients with psychosis and their healthy brothers. Different sociodemographic, clinical and evolutionary variables were collected in all groups. The sample was evaluated using the semi-structured interview CASH, the WHODAS scale and the self-applied questionnaire CTQ.
Results
We did not find significant differences between the scores of CTQ between patients with psychosis and their healthy brothers. Sexual abuse is significantly correlated with the presence of hallucinations, inappropriate affect, formal thought disorders and catatonic symptoms. Emotional neglect is significantly correlated with the presence of hallucinations, inappropriate affect, affective blunting, and anhedonia. Physical neglect is significantly correlated with flattery and blunt affection. Sexual abuse is correlated with poorer personal care. Emotional neglect is correlated with poorer personal care, poorer family functioning, and worse overall functioning in the last year.
Conclusions
The intensity of traumatic experiences throughout childhood could be considered a modulating factor of psychotic symptoms (positive, negative, disorganized and catatonic) and overall functioning (occupational, family, social and personal care).
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