Cross-Cultural Adult ADHD Assessment in 42 Countries Using the Adult ADHD Self-Report Scale Screener

Lewczuk K 1 , Marcowski P 2 , Wizła M 1 , Gola M 2 , Nagy L 3 , Koós M 3 Show all authors , Kraus SW 4 , Demetrovics Z 3 , Potenza MN 5 , Ballester-Arnal R 6 , Batthyány D 7 , Bergeron S 8 , Billieux J 9 , Briken P 10 , Burkauskas J 11 , Cárdenas-López G 12 , Carvalho J 13 , Castro-Calvo J 14 , Chen L 15 , Ciocca G 16 , Corazza O 17 , Csako RI 18 , Fernandez DP 19 , Fujiwara H 20 , Fernandez EF 21 , Fuss J 22 , Gabrhelík R 23 , Gewirtz-Meydan A 24 , Gjoneska B 25 , Grubbs JB 26 , Hashim HT 27 , Islam MS 28 , Ismail M 27 , Jiménez-Martínez MC 29 , Jurin T 30 , Kalina O 31 , Klein V 32 , Költő A 33 , Lee SK 34 , Lin CY 35 , Lin YC 36 , Lochner C 37 , López-Alvarado S 38 , Lukavská K 23 , Mayta-Tristán P 39 , Miller DJ 40 , Orosová O 31 , Orosz G 41 , Sungkyunkwan University’s research team 42 , Ponce FP 43 , Quintana GR 44 , Quintero Garzola GC 45 , Ramos-Diaz J 46 , Rigaud K 41 , Rousseau A 47 , Tubino Scanavino M 48 , Schulmeyer MK 49 , Sharan P 50 , Shibata M 20 , Shoib S 51 , Sigre-Leirós V 9 , Sniewski L 18 , Spasovski O 52 , Steibliene V 11 , Stein DJ 53 , Ünsal BC 3 , Vaillancourt-Morel MP 54 , Claire Van Hout M 55 , Bőthe B 8

Affiliations 

  • 1 Cardinal Stefan Wyszynski University, Warsaw, Poland
  • 2 University of California, San Diego, USA
  • 3 ELTE Eötvös Loránd University, Budapest, Hungary
  • 4 University of Nevada, Las Vegas, USA
  • 5 Yale University School of Medicine, New Haven, CT, USA
  • 6 University Jaume I of Castellón, Spain
  • 7 Sigmund Freud University Vienna, Austria
  • 8 Université de Montréal, Canada
  • 9 University of Lausanne, Switzerland
  • 10 University Medical Centre Hamburg-Eppendorf, Germany
  • 11 Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
  • 12 National Autonomous University of Mexico, Mexico
  • 13 Universidade de Aveiro, Portugal
  • 14 University of Valencia, Spain
  • 15 Fuzhou University, China
  • 16 Sapienza University of Rome, Italy
  • 17 University of Hertfordshire, UK
  • 18 Auckland University of Technology, New Zealand
  • 19 Nottingham Trent University, UK
  • 20 Kyoto University, Kyoto, Japan
  • 21 HELP University, Kuala Lumpur, Malaysia
  • 22 University of Duisburg-Essen, Germany
  • 23 Charles University, Prague, Czech Republic
  • 24 University of Haifa, Israel
  • 25 Macedonian Academy of Sciences and Arts, Republic of North Macedonia
  • 26 University of New Mexico, Albuquerque, USA
  • 27 University of Baghdad, Iraq
  • 28 Jahangirnagar University, Savar, Dhaka, Bangladesh
  • 29 Universidad Pedagógica y Tecnológica de Colombia, Colombia
  • 30 University of Zagreb, Croatia
  • 31 Pavol Jozef Safarik University in Kosice, Slovakia
  • 32 University of Southampton, UK
  • 33 University of Galway, Ireland
  • 34 Hallym University Chuncheon Sacred Heart Hospital, South Korea
  • 35 National Cheng Kung University, Tainan
  • 36 National Taipei University of Education, Taipei
  • 37 Stellenbosch University, South Africa
  • 38 University of Cuenca, Azuay, Ecuador
  • 39 Universidad Científica del Sur, Lima, Perú
  • 40 James Cook University, Australia
  • 41 Artois University, Arras, France
  • 42 Sungkyunkwan University, South Korea
  • 43 Universidad de Talca, Chile
  • 44 Universidad de Tarapacá, Arica, Chile
  • 45 Florida State University, Republic of Panama
  • 46 Universidad Privada del Norte, Lima, Perú
  • 47 KU Leuven, Belgium
  • 48 Western University, St. Joseph's Health Care London and London Health Sciences Centre, London, Canada
  • 49 Universidad Privada de Santa Cruz de la Sierra, Bolivia
  • 50 All India Institute of Medical Sciences, New Delhi, India
  • 51 Department of Health Services, Srinagar, India
  • 52 University of Ss. Cyril and Methodius in Trnava, Slovakia
  • 53 University of Cape Town, Rondebosch, South Africa
  • 54 Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS), Canada
  • 55 Liverpool John Moores University, UK
J Atten Disord, 2024 Feb;28(4):512-530.
PMID: 38180045 DOI: 10.1177/10870547231215518

Abstract

OBJECTIVE: We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener.

METHOD: Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57).

RESULTS: The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed.

CONCLUSIONS: Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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