Disruptive Behavior Disorders Rating Scale | |
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Purpose | identify ADHD |
Part of a series on |
Psychology |
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The Disruptive Behavior Disorders Rating Scale (DBDRS) is a 45-question screening measure, completed by either parents or teachers, designed to identify symptoms of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder in children and adolescents.
This questionnaire was developed by Pelham and colleagues in 1992 [1] and inspired other widely used questionnaires, including the SNAP-IV (Swanson, Nolan and Pelham Teacher and Parent Rating Scale) and the Vanderbilt ADHD Diagnostic Rating Scale (Wolraich et al., 2003). The DBDRS is freely available online.
For each question, the respondent is asked to indicate the degree to which a statement describes the child's behavior. Response options include “not at all", "just a little", "pretty much", and "very much". For any question they do not know the answer to, respondents are asked to write "DK" for "don't know". The behavioral rating scale takes 5–10 minutes to complete and is designed for use with children ages 5 and up. The scores of the scale have been shown to be reliable and valid across multiple different study samples. [2] [3]
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate.
Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior that includes theft, lies, physical violence that may lead to destruction, and reckless breaking of rules, in which the basic rights of others or major age-appropriate norms are violated. These behaviors are often referred to as "antisocial behaviors", and is often seen as the precursor to antisocial personality disorder; however, the latter, by definition, cannot be diagnosed until the individual is 18 years old. Conduct disorder may result from parental rejection and neglect and can be treated with family therapy, as well as behavioral modifications and pharmacotherapy. Conduct disorder is estimated to affect 51.1 million people globally as of 2013.
Cognitive disengagement syndrome (CDS) is an attention syndrome characterised by prominent dreaminess, mental fogginess, hypoactivity, sluggishness, slow reaction time, staring frequently, inconsistent alertness, and a slow working speed.
Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness". This behavior is usually targeted toward peers, parents, teachers, and other authority figures. Unlike conduct disorder (CD), those with ODD do not show patterns of aggression towards people or animals, destruction of property, theft, or deceit. One half of children with ODD also fulfill the diagnostic criteria for ADHD.
Despite the scientifically well-established nature of attention deficit hyperactivity disorder (ADHD), its diagnosis, and its treatment, each of these has been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2009, the National Institute for Health and Care Excellence, while acknowledging the controversy, stated that the current treatments and methods of diagnosis are based on the dominant view of the academic literature.
Attention deficit hyperactivity disorder management options are evidence-based practices with established treatment efficacy for ADHD.
The Young Mania Rating Scale (YMRS), developed by Vincent E Ziegler and popularised by Robert Young, is an eleven-item multiple choice diagnostic questionnaire which psychiatrists use to measure the presence and severity of mania and associated symptoms. The scale was originally developed for use in the evaluation of adult patients with bipolar disorder, but has since been adapted for use in pediatric patients. The scale is widely used by clinicians and researchers in the diagnosis, evaluation, and quantification of manic symptomology.
The Pediatric Attention Disorders Diagnostic Screener (PADDS), created by Dr. Thomas K. Pedigo and Kenneth L. Pedigo, is a suite of computer administered neuropsychological tests of attention and executive functioning. The PADDS is used in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children between the ages of 6 and 12 years. The PADDS software program represents a multi-dimensional, evidence-based approach to ADHD assessment, consisting of the Computer Administered Diagnostic Interview (CADI), the Swanson, Nolan, and Pelham—IV (SNAP-IV) Parent and Teacher rating scales, and the three computer-administered objective measures of the Target Tests of Executive Functioning (TTEF). It calculates a diagnostic likelihood ratio, where each data source is allowed to contribute to (or detract from) the prediction of the diagnosis, as well as normalized relative standard scores, t-scores, z-scores, and percentile ranks for comparison to the non-clinical reference group.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty focusing attention, hyperactivity, and impulsive behavior. Treatments generally involve behavioral therapy and/or medications. ADHD is estimated to affect about 6 to 7 percent of people aged 18 and under when diagnosed via the DSM-IV criteria. When diagnosed via the ICD-10 criteria, hyperkinetic disorder gives rates between 1 and 2 percent in this age group.
The Swanson, Nolan and Pelham Teacher and Parent Rating Scale (SNAP), developed by James Swanson, Edith Nolan and William Pelham, is a 90-question self-report inventory designed to measure attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in children and young adults.
The Vanderbilt ADHD Diagnostic Rating Scale (VADRS) is a psychological assessment tool for attention deficit hyperactivity disorder (ADHD) symptoms and their effects on behavior and academic performance in children ages 6–12. This measure was developed by Mark L Wolraich at the Oklahoma Health Sciences Center and includes items related to oppositional defiant disorder, conduct disorder, anxiety, and depression, disorders often comorbid with ADHD.
The ADHD Rating Scale (ADHD-RS) is a parent-report or teacher-report inventory created by George J. DuPaul, Thomas J. Power, Arthur D. Anastopoulos, and Robert Reid consisting of 18–90 questions regarding a child's behavior over the past 6 months. The ADHD Rating Scale is used to aid in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children ranging from ages 5–17.
The Yale Global Tic Severity Scale (YGTSS) is a psychological measure designed to assess the severity and frequency of symptoms of disorders such as tic disorder, Tourette syndrome, and obsessive-compulsive disorder, in children and adolescents between ages 6 and 17.
The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a self-report screening questionnaire for anxiety disorders developed in 1997. The SCARED is intended for youth, 9–18 years old, and their parents to complete in about 10 minutes. It can discriminate between depression and anxiety, as well as among distinct anxiety disorders. The SCARED is useful for generalized anxiety disorder, social anxiety disorder, phobic disorders, and school anxiety problems. Most available self-report instruments that measure anxiety in children look at general aspects of anxiety rather than Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizations. The SCARED was developed as an instrument for both children and their parents that would encompass several DSM-IV and DSM-5 categorizations of the anxiety disorders: somatic/panic, generalized anxiety, separation anxiety, social phobia, and school phobia.
The Mood Disorder Questionnaire (MDQ) is a self-report questionnaire designed to help detect bipolar disorder. It focuses on symptoms of hypomania and mania, which are the mood states that separate bipolar disorders from other types of depression and mood disorder. It has 5 main questions, and the first question has 13 parts, for a total of 17 questions. The MDQ was originally tested with adults, but it also has been studied in adolescents ages 11 years and above. It takes approximately 5–10 minutes to complete. In 2006, a parent-report version was created to allow for assessment of bipolar symptoms in children or adolescents from a caregiver perspective, with the research looking at youths as young as 5 years old. The MDQ has become one of the most widely studied and used questionnaires for bipolar disorder, and it has been translated into more than a dozen languages.
The Child Mania Rating Scales (CMRS) is a 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents aged 9–17 using diagnostic criteria from the DSM-IV, developed by Pavuluri and colleagues. There is also a 10-item short form. The measure assesses the child's mood and behavior symptoms, asking parents or teachers to rate how often the symptoms have caused a problem for the youth in the past month. Clinical studies have found the CMRS to be reliable and valid when completed by parents in the assessment of children's bipolar symptoms. The CMRS also can differentiate cases of pediatric bipolar disorder from those with ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses. The CMRS has also been found to provide a reliable and valid assessment of symptoms longitudinally over the course of treatment. The combination of showing good reliability and validity across multiple samples and clinical settings, along with being free and brief to score, make the CMRS a promising tool, especially since most other checklists available for youths do not assess manic symptoms.
The Mood and Feelings Questionnaire is a survey that measures depressive symptoms in children and young adults. It was developed by Adrian Angold and Elizabeth J. Costello in 1987, and validity data were gathered as part of the Great Smokey Mountain epidemiological study in Western North Carolina. The questionnaire consists of a variety of statements describing feelings or behaviors that may manifest as depressive symptoms in children between the ages of 6 and 17. The subject is asked to indicate how much each statement applies to their recent experiences. The Mood and Feelings Questionnaire has six versions, short and long forms of each of the following: a youth self-report, a version that a parent would complete, and a self-report version for adults. Several peer-reviewed studies have found the Mood and Feelings Questionnaire to be a reliable and valid measure of depression in children. Compared to many other depression scales for youth, it has more extensive coverage of symptoms and more age-appropriate wording and content.
The General Behavior Inventory (GBI) is a 73-question psychological self-report assessment tool designed by Richard Depue and colleagues to identify the presence and severity of manic and depressive moods in adults, as well as to assess for cyclothymia. It is one of the most widely used psychometric tests for measuring the severity of bipolar disorder and the fluctuation of symptoms over time. The GBI is intended to be administered for adult populations; however, it has been adapted into versions that allow for juvenile populations, as well as a short version that allows for it to be used as a screening test.
The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) is a semi-structured interview aimed at early diagnosis of affective disorders such as depression, bipolar disorder, and anxiety disorder. There are different versions of the test that have use different versions of diagnostic criteria, cover somewhat different diagnoses and use different rating scales for the items. All versions are structured to include interviews with both the child and the parents or guardians, and all use a combination of screening questions and more comprehensive modules to balance interview length and thoroughness.
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