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Florida State University Libraries
Electronic Theses, Treatises and Dissertations The Graduate School
2014
The Psychometric Properties of the BarkleyDeficits in Executive Functioning Scale(BDEFS) in a College Student PopulationTheodora Passinos Coffman
Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected]
LITERATURE REVIEW ............................................................................................................ 9
ADHD and How the College Student is Different ...................................................................... 9
The Relationship Between ADHD and EF: How Biology and Neuropsychology Inform Our Understanding ........................................................................................................................... 15
EF Deficits as Manifested in ADHD......................................................................................... 25
Assessing EF ............................................................................................................................. 29
Test Construction and Validation Principles ............................................................................. 48
Proposed Study and Research Questions .................................................................................. 53
1 Demographics ....................................................................................................................57 2 Suggested Ranges for Fit-Indices ......................................................................................71 3 Inter-Rater Correlations for College Student Sample, Comparing Self-Reports to Other-Reports .....................................................................................................................73 4 Inter-Rater Correlations for Barkley’s Sample, Comparing Self-Reports to Other-
Reports ...............................................................................................................................73 5 Means, t-Tests, and p-Value for Self vs. Other-Informant Forms, in the Current Sample................................................................................................................................74 6 Summary of Canonical Coefficients and Structure Loadings ............................................76 7 New 15-Item ADHD-EF Index ..........................................................................................80 8 Original 11-Item ADHD-EF Index ....................................................................................82 9 Summary of Canonical Discriminant Functions ................................................................82 10 ADHD-EF Index Description of Models ...........................................................................83 11 Functions at Group Centroids ............................................................................................83 12 Classification Rates ............................................................................................................83 13 CFA Models .......................................................................................................................85 14 Standardized Factor Loadings and Standardized Residual Variances ...............................85
vii
ABSTRACT
Approximately 4.4% of the adult population suffers from Attention-Deficit/Hyperactivity
Disorder (ADHD) (Keesler et al., 2010). The identification of adults with ADHD can be
difficult because the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM;
APA, 2013) were originally designed with children in mind. Identifying high achieving college
students with ADHD has proven even more challenging due to masked academic difficulties
until later in life.
The specific population of adults in the college setting (college students) with ADHD are
more likely to have protective factors such as higher cognitive abilities and previous academic
The analysis used in this study was the SRMR. Parsimonious indices are different from the
absolute fit indices because they have a consequence for poor model parsimony. The most
frequently used index of this type is root mean square error of approximation (REMSA) (Brown,
2002) and this is used in this analysis. In addition, the comparative fit index (CFI) and the
Tucker Lewis Index (TLI), also known as the non-normed fit index (NNFI) are used in this
study.
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CHAPTER 4
RESULTS
Demographic Variables and Statistics
Demographic statistics were reviewed for all data collected and are represented
previously in Table 1. There were statistically significant differences between the ADHD
group and the Non-ADHD group for the variable Age (t = -3.73, p=.00). On average, participants
in the ADHD group were one year older than participants in the non-ADHD group. Chi-Square
tests were conducted to compare the two groups (ADHD verses non-ADHD) with regard to gender
(X2=6.44, p=.01), year in school (X2=.66, p=.88), and ethnicity (X2=4.96, p=.29), of which only
gender was statistically significant. The non-ADHD group had significantly more women than the
ADHD group.
Research Question 1
What is the relationship between the BDEFS self-report and other-informant report in a
college student population of students with ADHD? What are these relationships on the
following factors: Self-Management to Time, Self-Organization and Problem Solving, Self-
Restraint, Self-Motivation, Self-Regulation, ADHD-EF Index, and Total Executive Functioning
Symptoms? How do these correlations compare to the correlations that Barkley found in his
original study? Are the means of the self-informant reports higher or lower than the means of
the other-informant reports within the college student population of students with ADHD?
To evaluate the relationship between the self-report form (BDEFS) and the other-
informant report form (BDEFS-other), Pearson Correlations were conducted for the following
variables: the five factors, total score, and ADHD-EF Indexes. Results can be found in Table 3.
The correlations between BDEFS-self and BDEFS-other from Barkley’s analyses are listed in
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Table 4 for comparison (Barkley, 2012b). A Fisher r to z transformation was conducted on four
of the factors to see if the results found in this study were significantly different from the results
found by Barkley. Recall that Barkley’s data did not have the Self-Regulation of Emotion, and
Barkley did not give inter-rater agreement correlation rates for the Total Score or the original 11-
item ADHD-EF Index, so these comparisons could not be made using the Fisher r to z
transformation. Results showed the following: Self-Management to Time z = -7.55, p =.00; Self-
Organization/Problem Solving z = -3.35, p=.00; Self-Restraint (z = -2.34, p =.019); and Self-
Motivation (z = -5.95, p = .00). These statistics indicate that all BDEFS-self/BDEFS-other
correlations in the current study are significantly different from the correlations reported by
Barkley. All of the comparable Barkley self/other correlations are higher than the current
self/other correlations.
Table 3 Inter-Rater Correlations for College Student Sample,
Comparing Self-Reports to Other-Reports
Factor r2 p
Self-Management to Time .22 .00 Self-Organization/Problem Solving .42 .00 Self-Restraint .39 .00 Self-Motivation .35 .00 Self-Regulation of Emotion .51 .00 Total Score .38 .00 Original 11-item ADHD-EF Index .80 .00 New 15-item ADHD-EF Index .24 .02
Table 4 Inter-Rater Correlations for Barkley’s Sample,
Comparing Self-Reports to Other-Reports
Factor r2 p
Self-Management to Time .79 < .00 Self-Organization/Problem Solving
Following these analyses, a series of t-tests were conducted to compare the means of the
BDEFS-self and the BDEFS-other, in the current sample. These results were significant and can
be found in Table 5.
Table 5 Means, t-Tests, and p-Value for Self vs. Other-Informant Forms, in the
Current Sample
Means Self Other t p
Self-Management to Time 57.78 50.22 49.09 .00 Self-Organization/Problem Solving 60.59 50.03 46.06 .00 Self-Restraint 39.54 38.01 34.78 .00 Self-Motivation 26.46 22.44 35.53 .00 Self-Regulation of Emotion* 26.45 29.97 30.01 .00 Total Score 217.59 205.60 - - ADHD-EF Index 28.66 26.62 - -
Research Question 2
In the college student ADHD sample, is there a correlation between intellectual
functioning (as measured by the BIA) and the BDEFS similar to the correlation between the
intellectual functioning and BDEFS in the norming sample?
To evaluate the relationship between the Brief Intellectual Functioning (BIA) and the five
BDEFS factors, the original 11-item ADHD-EF Index, the new 15-item ADHD-EF index, and
Total Score; Pearson correlations were conducted. Please refer back to pages 75-78 for more
details regarding this analysis. The average Brief Intellectual Index (BIA) was 101.9 with a
standard deviation of 10.9. The correlations between the BIA and each of the factors were as
follows: Self-Management to Time (r=.26, p=.00); Self-Organization/Problem Solving (r=.04,
p=.64); Self-Restraint (r=.09, p=.28); Self-Motivation (r=.12, p=.16); Self-Regulation of
Emotion (r=.13, p=.15); Total Score (r=.15, p=.07); original 11-item ADHD-EF Index (r=.20,
p=.02), and new 15-item ADHD-EF index (r=.16, p=.06). In sum, the BIA was significantly
75
correlated with only two factors: Self-Management to Time and the original 11-item ADHD-EF
Index.
Research Question 3
Are the same ADHD-EF Index questions the most predictive of a diagnosis of ADHD in a
college student population as they are in the original normative sample?
To evaluate whether the same items from the original 11-item ADHD-EF Index were
needed to discriminate between students with and without ADHD in the college student
population, a control sample was obtained to compare to the clinic sample of students (a
description of this sample can be found in the Preliminary Analyses section, and is represented in
Table 1).
Models
In order to determine which items on the BDEFS best discriminate between college
students with and without ADHD, a discriminant function analysis (DFA) was conducted. First,
a DFA was conducted on all 89 items on the BDEFS. The DFA was then rerun with only the
items with a Structure Matrix loading of .4 or higher, which was the preset cutoff. There were
14 items at or over a Structure Matrix loading of .4. In addition, five items approached the .4
mark (.394-.372). Table 6 is a review of the canonical coefficients and structure coefficients of
each item with the items in bold to denote highest coefficients.
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Table 6 Summary of Canonical Coefficients and Structure Loadings
Predictor (Scale Item) Canonical Coefficient
Structure Loadings
1 Procrastinate or put off doing things until the last minute -.145 .233
2 Poor sense of time -.009 .352
3 Waste or mismanage my time -.245 .315
4 Not prepared on time for work or assigned tasks -.223 .372
5 Fail to meet deadlines for assignments .094 .363
6 Have trouble planning ahead or preparing for upcoming
events. -.045 .375
7 Forget to do things I am supposed to do .149 .436
8 Can't seem to accomplish the goals I set for myself .083 .423
9 Late for work or scheduled appointments .233 .366 10 Can't seem to hold in mind things I need to remember to do .018 .426
11 Can't seem to get things done unless there is an immediate deadline
-.019 .357
12 Have difficulty judging how much time it will take to do something or get somewhere
.135 .417
13 Have trouble motivating myself to start work -.027 .298 14 Have difficulty motivating myself to stick with my work
and get it done .173 .402
15 Not motivated to prepare in advance for things I know I am supposed to do
-.122 .337
16 Have trouble completing one activity before starting into a new one
.020 .394
17 Have trouble doing what I tell myself to do -.042 18 Difficulties following through on promises or commitments
I may make to others .173 .364
19 Lack self-discipline .044 .299
20 Have difficulty arranging or doing my work by its priority or importance; can't "prioritize" well .318 .469
21 Find it hard to get started or get going on things I need to get done .223 .445
22 I do not seem to anticipate the future as much or as well as others
-.137 .291
23 Can't seem to remember what I previously heard or read about
-.124 .348
24 I have trouble organizing my thoughts .394 .527
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Table 6 continued Predictor (Scale Item) Canonical
Coefficient Structure Loadings
25 When I am shown something complicated to do, I cannot keep the information in mind so as to imitate or do it correctly
-.083 .347
26 I have trouble considering various options for doing things and weighing their consequences
-.132 .325
27 Have difficulties saying what I want to say -.068 .244
28 Unable to come up with or invent as many solutions to problems as others seem to do
-.150 .210
29 Find myself at a loss for words when I want to explain something to others
-.121 .269
30 Have trouble putting my thoughts down in writing as well or as quickly as others
.114 .291
31 Feel I am not as creative or inventive as others of my level of intelligence -.216 .110
32 In trying to accomplish goals or assignments, I find I am not able to think of as many ways of doing things as others
-.100 .258
33 Have trouble learning new or complex activities as well as others
-.179 .296
34 Have difficulty explaining things in their proper order or sequence
-.094 .360
35 Can't seem to get to the point of my explanations as quickly as others .205 .345
36 Have trouble doing things in their proper order or sequence -.117 .376 37 Unable to "think on my feet" or respond as effectively as
others to unexpected events .007 .235
38 I am slower than others at solving problems I encounter in my daily life
.090 .293
39 Easily distracted by irrelevant events or thoughts when I must concentrate on something
.091 .470
40 Not able to comprehend what I read as well as I should be able to do; have to reread material to get its meaning .241 .413
41 Cannot focus my attention on tasks or work as well as others
.164 .536
42 Easily confused .227 .420
43 Can't seem to sustain my concentration on reading,
paperwork, lectures, or work .287 .505
44 Find it hard to focus on what is important from what is not important when I do things
-.151 .381
45 I don't seem to process information as quickly or as accurately as others
-.013 .334
78
Table 6 continued Predictor (Scale Item) Canonical
Coefficient Structure Loadings
46 Find it difficult to tolerate waiting; impatient .140 .303 47 Make decisions impulsively -.242 .247 48 Unable to inhibit my reactions or responses to events or
others -.194 .269
49 Have difficulty stopping my activities or behavior when I should do so.
.126 .301
50 Have difficulty changing my behavior when I am given feedback about my mistakes.
.051 .349
51 Make impulsive comments to others. .162 .270 52 Likely to do things without considering the consequences
for doing them. .051 .276
53 Change my plans at the last minute on a whim or last minute impulse.
-.060 .292
54 Fail to consider past relevant events or past personal experiences before responding to situations (I act without thinking).
.065 .288
55 Not aware of things I say or do. .028 .285 56 Have difficulty being objective about things that affect me. -.199 .166 57 Find it hard to take other people's perspectives about a
problem or situation. -.249 .098
58 Don't think or talk things over with myself before doing something.
.147 .311
59 Trouble following the rules in a situation. .164 .293 60 More likely to drive a motor vehicle much faster than others
(Excessive speeding). -.120 .102
61 Have a low tolerance for frustrating situations .156 .284 62 Cannot inhibit my emotions as well as others. .027 .202 63 I don't look ahead and think about what the future outcomes
will be before I do something (I don't use my foresight). .206 .275
64 I engage in risk taking activities more than others are likely to do.
.014 .207
65 Likely to take short cuts in my work and not do all that I am supposed to do.
.091 .352
66 Likely to skip out on work early if my work is boring to do. -.059 .301 67 Do not put as much effort into my work as I should or than
others are able to do. -.006 .321
68 Others tell me that I am lazy or unmotivated. -.082 .235 69 Have to depend on others to help me get my work done. .195 .314 70 Things must have an immediate payoff for me or I do not
seem to get them done. -.123 .313
79
Table 6 continued Predictor (Scale Item) Canonical
Coefficient Structure Loadings
71 Have difficulty resisting the urge to do something fun or more interesting when I am supposed to be working.
.053 .309
72 Inconsistent in the quality or quantity of my work performance.
.000 .370
73 Unable to work as well as others without supervision or frequent instruction.
.027 .323
74 I do not have the willpower or determination that others seem to have.
-.193 .327
75 I am not able to work toward longer term or delayed rewards as well as others. .254 .366
76 I cannot resist doing things that produce immediate rewards, even if those things are not good for me in the long run.
-.034 .283
77 Quick to get angry or become upset. -.149 .153 78 Overreact emotionally. -.045 .124 79 Easily excitable. -.313 .076 80 Unable to inhibit showing strong negative or positive
emotions. -.043 .154
81 Have trouble calming myself down once I am emotionally upset.
-.089 .142
82 Cannot seem to regain emotional control and become more reasonable once I am emotional.
-.139 .130
83 Cannot seem to distract myself away from whatever is upsetting me emotionally to help calm me down. I can't refocus my mind to a more positive framework.
.286 .257
84 Unable to manage my emotions in order to accomplish my goals successfully or get along well with others. .200 .279
85 I remain emotional or upset longer than others. -.101 .155 86 I find it difficult to walk away from emotionally upsetting
encounters with others or leave situations in which I have become very emotional.
.013 .126
87 I cannot re-channel or redirect my emotions into more positive ways or outlets when I get upset.
-.093 .196
88 I am not able to evaluate an emotionally upsetting event more objectively.
-.103 .194
89 I cannot redefine negative events into more positive viewpoints when I feel strong emotions.
-.128 .191
Note: Canonical Coefficient items in boldface account for the highest importance for describing differentiation among groups. Structure loadings in boldface account for the highest amount of contribution to the significant discriminant function.
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The model was run with these five items and combinations thereof to see if they increased the
sensitivity and specificity of the model. Only one of these items (item number 16 with a matric
loading of .394) improved the model; therefore, item number 16 was included in the model.
These 15 items are listed in Table 7 with a description and the factor in which they belong.
Table 7 New 15-Item ADHD-EF Index
# Item description Factor r
7 Forget to do things I am supposed to do Time .149
8 Can’t seem to accomplish the goals I set out for myself Time .083
10 Can’t seem to hold in mind things I need to remember to do Time .018
12 Having difficulty judging how much time it will take to do something or get somewhere
Time .065
14 Having difficulty motivating myself to stick with my work
and get it done
Time -.084
16 Have trouble completing one activity before starting into a
new one
Time -.074
20 Having difficulty arranging or doing my work by its priority or importance; can’t “prioritize” well
Time .238
21 Find it hard to get started or get going on things I need to get done
Time .066
24 I have trouble organizing my thoughts Organization .292
39 Easily distracted by irrelevant events or thoughts when I must concentrate on something
Organization .120
40 Not able to comprehend what I read as well as I should be able to do; have to reread material to get its meaning
Organization .146
41 Cannot focus my attention on tasks or work as well as others Organization .189
42 Easily confused Organization .053
43 Can’t seem to sustain my concentration on reading, paperwork, lectures, or work
Organization .167
Note: Bolded items overlap with the items found on the original 11-item ADHD-EF Index
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The original 11-item ADHD-EF Index items are listed in Table 8 for comparison. Three of these
items overlap between the models and are identified in bold. The new 15-item ADHD-EF Index
had the ability to significantly discriminate between the ADHD group and the control group, and
this model represented the highest degree of specificity and sensitivity than the other models
attempted. The model is presented in Table 9 along with several other models run for
comparison (described below). The new 15-item ADHD-EF Index accounted for 44.8% of the
total relationship between the items and diagnosis. In addition to the new 15-item model
represented previously, several separate DFA’s were run using different sets of items. The
different models are described in Table 10.
Group Centroids
The group centroids for the four models are represented in Table 11. The group centroid
for the new 15-item ADHD-EF Index discriminates the most between the ADHD group and the
non-ADHD group.
Table 8
Original 11-Item ADHD-EF Index
# Item Description Factor
1 Procrastinates or puts things off until the last minute Time
6 Have trouble planning ahead or preparing for upcoming events Time
14 Having difficulty motivating myself to stick with my work and get it
done
Time
16 Having trouble completing one activity before starting into a new
one
Time
24 I have trouble organizing my thoughts Organization
49 Having difficulty stopping my activities or behavior when I should do so Restraint
82
Table 8 continued
Item Description Factor
50 Having difficulty changing my behaviors when I am given feedback about my mistakes
Restraint
55 Not aware of things I say or do Restraint
60 More likely to drive a motor vehicle much faster than others Restraint
65 Likely to take short cuts in my work and not do all that I am supposed to do
Motivation
69 Have to depend of others to help me get my work done Motivation
Note: Bolded items overlap with the items found on the new 15-item ADHD-EF Index
Table 9 Summary of Canonical Discriminant Functions
ADHD-EF Index Eigenvalue
% Variance
Canonical Correlation
R*
Canonical R2
Lambda Chi-
Square df Sig
New 15-item
.809 100.00 .669 .448 .553 330.65
1 14 .00
Original 11-item .660 100.00 .630 .397 .603
283.425
11 .00
5-item .602 100.00 .613 .376 .624
264.997
5 .00
2-item .636 100.00 .623 .388 .611
277.562
2 .00
Classification Rates
As far as overall classification rate, the highest rate was found with the new 15-item
ADHD-EF Index. The new 15-item ADHD-EF Index also had a higher sensitivity rate.
However, the specificity rate was relatively equal across all models. The classification data for
each model are represented in Table 12.
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Table 10 ADHD-EF Index Description of Models
Model Description
Original 11-item ADHD-EF Index Barkley’s 11-item model which is published in the BDEFS manual (Barkley, 2011b).
New 15-item ADHD-EF Index The 15 items with the best discrimination between the ADHD and Non ADHD groups determined in this study.
5-item community control ADHD-EF Index The five items that Barkley’s logistic regression yielded from comparing the community control sample with the ADHD sample in his study. These five items are included in the 11-item model.
2-item ADHD-EF Index (screening tool) The two-item screening model was derived by using the two items with the highest canonical correlations from this study.
Table 11 Functions at Group Centroids
Function
Group New 15-
item Original 11-item
Community Control 5-
item
2-item (screener)
Control Group -.436 -.393 -.376 -.386 ADHD Group 1.851 1.671 1.596 1.641
Table 12 Classification Rates
Model Overall Sensitivity Specificity
New 15-item ADHD-EF-Index
91 81.5 93.2
Original 11-item ADHD-EF Index
89.1 69.4 93.7
Community Control 5-item model
87.7 63 93.5
2-item (screener) 88.4 68.5 93
84
Research Question 4
Is the factor structure of the BDEFS the same for college students as it is for the
normative sample, based on a confirmatory factor analysis?
The CFA was conducted using the modeling software M-Plus 7 on the 89-items of the
BDEFS. The hypothesized model is the model presented by Barkley (2011b) in that items 1-21
belong to Factor 1 (Self-Management to Time), items 22-45 belong to Factor 2 (Self-
saying what he/she wants to say” (item 27), “or cannot focus on the task at hand as well as
others” (item 41) may be particularly difficult for someone else to rate. On the original study
published by Barkley (211b), correlations between self-informants and others-informants were
strong at .66-.79. The correlations found in this study were weak to moderate (.295-.534), and
statistically significantly smaller than those found by Barkley. The only information about the
other-informant given from Barkley’s analysis was that this should be a person who knows the
90
person well. In the present study, this was often a significant other, parent, or roommate. As was
just discussed, a reason that the college students’ self-ratings may have varied more from the
other-informant ratings versus the general adult population is perhaps due to the difference in
demands placed on the two different groups. The responsibilities in the college setting tend to be
a greater reliance on executive functions than in the adult in general. Given that the majority of
these are unseen by others, it is not improbable that these results were found.
In addition, it was found in the current study that the BDEFS self-ratings were higher, in
all but one case, than the BDEFS other-ratings. The BDEFS self-ratings were not higher than the
BDEFS other-ratings for the factor Self-Regulation of Emotion. In evaluating these results, the
researcher must consider several possibilities. Are differences in self-other ratings scores a
function of the scale itself or a function of the rater? Several possibilities can be speculated as to
why the self-ratings tended to be higher than the other-ratings. First, in the case of college
students the risk of malingering must be considered. As was discussed in the literature review,
stimulant medications such as used in the treatment of ADHD have been misused and abused at
alarming rates on college campuses. Students may try to look worse than they are in order to
obtain medication (Booksh, et al., 2010). Second, related to this issue, is that of “crisis”.
Students who are referred to this clinic for evaluation of their symptoms of ADHD are generally
doing so because they are in some kind of crisis situation, such as failing a class or academic
probation. Therefore, they are likely to rate themselves as more impaired than would their other-
informant.
Relationship between the BIA and BDEFS Factors
The second area of research was aimed at examining the relationship between the
intellectual ability of college students with ADHD and their responses on the BDEFS. This is an
91
important analysis, in that it addresses a major limitation of traditional EF tests. The traditional
EF tests were often contaminated by IQ, specifically indices of intelligence including measures
of motor and naming speed, which is not related to EF (Salthouse (1996, 2005). In addition,
there is a significant overlap between IQ and EF tests in relation to working memory (Antshel et
al., 2010). The current study found that intelligence was significantly correlated with one BDEFS
factor: Self-Management. This relationship was in the positive direction (meaning as IQ
increased, so did the level of impairment in Self-Management). Additionally, the correlation was
relatively weak (r = .26). There are several plausible explanations for the correlation between
intelligence and the factor Self-Management to Time. The first issue is that of selection bias. All
participants in this analysis were non-randomly selected, in that they were either self-referred or
referred by a doctor, counselor, or academic advisor for evaluation of ADHD. Furthermore, all
participants received a diagnosis of ADHD following their evaluation. As was discussed in the
literature review, college students with ADHD tend to have some protective factors to help them
succeed in their academic programs. Once such protective factor may be intelligence (DuPaul et
al., 2009; Glutting et al., 2005). High school students who have ADHD (whether known or
unknown) and continue on to college after graduation likely do so based on their intellectual
abilities, rather than organizational skills. More specifically, the skill of time management may
have never been developed. Put succinctly, students with intellectual capacity sufficient to
complete high-quality work at the last minute with minimal organization may never have been
forced to organize their workload in high school. Students with ADHD (i.e. poor time
management skills) who did not have the requisite intellectual functioning likely did not self-
select to attend college. Therefore, they are not represented in this sample. In essence, the
higher the intellectual ability, the less the need for developing time management skills to succeed
92
in high school. This may partially explain why, as intelligence increased, so did the impairment
of time management. In a student with both ADHD and high IQ, the degree of intellectual
ability might actually function to progressively reduce the consequences for failing to learn basic
time management strategies, resulting in an inverse correlation between these areas.
An alternative (and complementary) way to view this correlation is that a college student
who has high intelligence and also has good time management skills (whether diagnosed with
ADHD or not) would be unlikely to find themselves being evaluated for ADHD. Mostly
students in “crisis” situations or struggling in some way were included in this sample. On an
item level, the types of information gathered in the factor of Self-Management to Time relate
heavily to procrastination and self-discipline relative to school work, which is consistent with
research on salience and ADHD. It has been noted anecdotally and supported by research
(Zentall, 2005), that students with ADHD tend to become most productive when a deadline is
approaching. Again, students who procrastinate until the last minute and do not have the ability
to produce good work at the last minute (e.g. students with lower relative intellectual ability) are
less likely to find themselves in college. For higher ability individuals, college may represent the
first time that their intellectual abilities are overmatched by the need for time management,
leading to increased “crisis” situations and subsequent referrals for evaluation.
Barkley’s analysis utilizing an early version of the BDEFS found only the Self-
Organization/Problem Solving factor to be associated with IQ. The results of the current study
supported the researcher’s original hypothesis that Self-Organization/Problem Solving would not
be significantly correlated with IQ. While the prediction was borne out, it was predicated on the
assumption that the intellectual abilities in the college sample would be higher than the general
population. However, the Brief Intellectual Ability (BIA) in the current study was average
93
(X=101.9, SD=10.6). There are a few reasons why this may have been the case. First, Barkley
used a full scale IQ in his study, and the current study used the BIA. The BIA has only .60-.69
correlation with a full measure of IQ (McGrew & Woodcock, 2011), and clinical experience has
demonstrated that it is generally an underestimate of full scale IQ. Furthermore, the BIA is only
made up of three sub-tests. Two of these are heavily influenced by timed testing (Concept
Formation and Decision Speed) and one (Concept Formation) is consistent in design with tasks
recruiting working memory and attention to detail. Students with ADHD tend to struggle with
processing speed tasks (Weyandt, 2005), potentially demonstrating a lowered BIA than if a non-
timed or mixed measure were used. Given this, it remains unclear to what degree intelligence is
related to the Self-Management to Time factor. However, this would be consistent with the
hypothesis that utilizing the BIA yields suppressed IQ scores overall, while allowing for
reasonable comparison within the sample.
Reevaluation of ADHD-EF Index
The current 11-item ADHD-EF Index developed by Barkley was created to provide
clinicians with a brief tool to predict a diagnosis of ADHD in the adult population. Of the 89
items on the BDEFS, these 11 items were selected using two logistic regressions which is
discussed in detail in the literature review of this manuscript. While having such a brief index is
valuable in the clinical setting to identify individuals who are likely to have ADHD for the
purposes of referring them for a more extensive assessment, this index has not been validated on
a college student population. Therefore, the same items that predict ADHD in the adult
population may not be the best predictors of ADHD in a college student population. When
examining the ability of some items on the BDEFS to successfully discriminate between the
ADHD group and the non-ADHD group, results show that the best model was the new 15-item
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ADHD-EF-Index which successfully categorizes 91% of the participants and accounted for
44.8% (canonical R2 = .448) of the variance in a college student population. When the original
11-item ADHD-EF Index was used on the current college student sample, the 11 items were able
to discriminate between those students with and without ADHD, but to a slightly lesser extent
(89%, canonical R2= .397). Interestingly, only three of the items from the original 11-item index
overlap with the new 15-item ADHD-EF Index, thus indicating that, in a college population,
different items are needed to accurately discriminate between those with ADHD and those
without.
The three items that overlap are all from the factors Self-Management to Time and Self-
Organization/Problem Solving, and these items are: “Having difficulty motivating myself to stick
with my work and get it done” (item 14, Self-Management to Time), “Having trouble completing
one activity before starting into a new one” (item 16, Self-Management to Time), and “I have
trouble organizing my thoughts” (item 24, Self-Organization/Problem Solving).
The original ADHD-EF Index scale uses 11 items to discriminate individuals with
ADHD from those without. Of the items that overlapped between the two scales, one was from
Barkley’s comparison of the ADHD group to his clinical control group, and two were derived
from his comparison between his ADHD and the community control group. When using the five
items from the original 11-item ADHD-EF Index that were obtained from the sample most
closely related to the sample in this study, these five items (1, 16, 24, 50, and 65) discriminate
almost as well as the original 11-item ADHD-EF Index (at 87.7% vs. 89%). Therefore, when
looking at the college student population, the original 11-item ADHD-EF Index may not be the
most efficient model when attempting to discriminate students with and without ADHD. In fast-
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paced clinical settings, gaining approximately one percentage point of discriminant ability may
not justify a greater than 100% increase in the length of the screening instrument.
In looking at the difference between the items on the original 11-item ADHD-EF Index
and the new 15-item ADHD-EF Index, there are some general themes. On the original 11-item
ADHD-EF Index, there are four items from the factor Self-Management to Time, one from Self-
Organization/Problem Solving, four from Self-Restraint, and two from Self-Motivation. The
new scale pulled only from Self-Management to Time (eight items) and Self-
Organization/Problem Solving (six items) all of which are listed below.
Self-Management to Time
Forget to do things I am supposed to do (item 7)
Can’t seem to accomplish the goals I set out for myself (item 8)
Can’t seem to hold in mind things I need to remember to do (item 10)
Having difficulty judging how much time it will take to do something or get somewhere
(item 12)
Having difficulty motivating myself to stick with my work and get it done (item 14)
Have trouble completing one activity before starting into a new one (item 16)
Having difficulty arranging or doing my work by its priority or importance; can’t
“prioritize” well (item 20)
Find it hard to get started or get going on things I need to get done (item 21)
Self-Organization/Problem Solving
I have trouble organizing my thoughts (item 24)
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Easily distracted by irrelevant events or thoughts when I must concentrate on something
(item 39)
Not able to comprehend what I read as well as I should be able to do; have to reread
material to get its meaning (item 40)
Cannot focus my attention on tasks or work as well as others (item 41)
Easily confused (item 42)
Can’t seem to sustain my concentration on reading, paperwork, lectures, or work (item 43)
As discussed in the literature review, the population of college students with ADHD
tends to be either Combined Type ADHD or Inattentive Type ADHD (Barkley and Murphy,
2011). Far fewer of the Hyperactivity Type ADHD only is seen in the college population.
(DuPaul et al., 2009). In fact, none of the participants in the current sample were of the
Hyperactive subtype. There are several hypotheses of why this might be; however, it is widely
accepted that students either “grow-out” of these behaviors or the acts of being accepted into and
attending college self-selects for students with more self-control, successful academic histories,
advanced coping skills, and higher cognitive abilities (DuPaul et al., 2009; Glutting et al., 2005).
Thus, it is not surprising that a major difference between the original 11-item ADHD-EF Index
derived from an adult population has several items from the factor, Self-Restraint, and the model
derived from the college student population has no such items. Along the same lines, no items
from the factor Self-Motivation were noted to be derived from the college student population.
Again, college students are self-selected to be more motivated than the non-college student
(Reaser et al., 2007); therefore, items tapping these types of symptoms would not differentiate
between students with and without ADHD.
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The time demands facing a college student may be more than that of non-college student
adults. Given the increased pressure in college to have good time management and
organizational skills, it is not unlikely that the items needed to differentiate the ADHD group
from the non ADHD group would be different in the college student population verses the adult
population. For example, when surveying most college students about procrastination and skills
related to planning-ahead, one might expect to find most students struggling with the perception
of difficulties in these areas. Therefore, items tapping these symptoms may not necessarily
distinguish between college students with and without ADHD as it does in the general adult
population. The results here are similar to what was seen by Murphy (2005) and Proctor and
Prevatt (2009) when they asserted that college students with ADHD have more problems
focusing, making deadlines, task completion, and sustaining effort in presumed irrelevant tasks.
Overall, when comparing the specificity rate (percentage of students without ADHD
correctly identified in the non-ADHD group) there were no clinically relevant differences,
indicating all of the models were equally effective in accurately classifying participants as non-
ADHD. However, there were clinically relevant differences with regards to sensitivity (the
ability to correctly identify someone with ADHD). The new 15-item ADHD-EF Index had a
sensitivity rate of 81.5% versus the original 11-item ADHD-EF Index (69.54%), the 5-item
community control ADHD-EF Index (63%), or the 2-item ADHD-EF Index screener (68.5%)
which will be discussed below. This provided evidence in support of using a different model to
predict or screen for ADHD in the college student population. If given as a screening device, the
new 15-item ADHD-EF Index has a much better rate of correctly identifying college students
who likely have ADHD. The clinical utility of a quick screening tool is substantial in a
university or college campus setting. Given that college students with ADHD experience
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significantly more academic consequences than college students without ADHD (Reaser et al.,
2007), it is important to efficiently identify these students in order to offer treatment and
assistance. It is worth emphasizing that the ADHD-EF Index is meant to be a screening tool.
With this in mind, if error is present, it is desirable to err in the direction of over-identifying
students as belonging to the potential-ADHD group so that they can be referred for a full
diagnostic evaluation of their symptoms.
In addition to the new 15-item ADHD-EF Index and the 5-item Community Control
ADHD-EF Index, another interesting result came of these analyses. A very brief two-item model
identified items number 20 (having difficulty arranging or doing my work by its priority or
important; can’t prioritize well) and 24 (I have trouble organizing my thoughts) as generally
equal in specificity and sensitivity to the original 11-item ADHD-EF Index. Thus, these two
items alone may be quite beneficial as a quick screening tool. If a clinical or academic advisor
asks a student if they are having difficulty prioritizing their tasks and difficulty organizing their
thoughts, the likelihood of missing a student who has ADHD is only about 7%. Of course, this is
not diagnostic given that the sensitivity is in the high 60% range. However, this is a useful,
quick, and low cost screening method for determining which students to refer for more thorough
assessment.
Evidence of Factorial Validity
Only one researcher, the author of the BDEFS, has evaluated the factor structure of the
BDEFS to date. No study has yet been published looking at this factor structure for the BDEFS
on a college student population. The current study found moderate support for the published
factor structure of the BDEFS in the college student population. This support was found in both
samples analyzed in this study. While there was support for the factor structure, some of the fit
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indices were not as strong as had been hoped for. As mentioned in the planned analysis section,
there are multiple ways to determine goodness of fit, or evaluating the model, for a CFA. One of
the most common is the Chi Squared (X2). A goodness of fit is represented by a non-significant
X2 and in this analysis, the X2 was significant. However, one of the short-falls with relying on X2
is the influence of a large n on the statistic making most any differences statistically significant
(Tabachnick & Fidell, 2007). Given the problems with sample size and the underlying
assumptions that influence the results, other statistics have been proposed. Related to the X2, a
cursory measure to look at fit is to use the ratio of X2 to the degrees of freedom. Referring back
to Table 2, if this is less than two, this provides support for the model (Tabachnick & Fidell,
2007). In this analysis, the X2 is 2.2 indicating a level just slightly over the generally accepted
range. The CFI and TLI fit indices were at the moderate level showing near their respective
specified cut off points. However, the larger sample (more closely aligned with the normative
sample) had fit indices values that were slightly stronger. The REMSA and the SRMR are the
two fit indices which show the best support for Barkley’s factor model of the BDEFS. These
indexes are best suited for larger samples (like the current sample) and may explain the reason
these indices were more supportive than the preceding indices that are heavily influenced by the
larger sample size. Another potential explanation for the moderate results relates to the
assumption that a sample must be normally distributed. This is an impairment rating scale.
Therefore, the participants in the control sample and the participants in the ADHD sample likely
rated the items quite differently, and their responses were not normally distributed. There is also
the possibility of a floor effect for the control sample.
When looking at the items on an individual level, all 89 items has a statistically
significant factor loading, meaning each item contributed to its respective factor indicating
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evidence of validity to the factor structure of the BDEFS in a college student population. While
all items were significant, there were a few items that fell just under the .55 cut off score for
“good” fit. The two items were “I feel I am not as creative or inventive as others of my
intelligence level” (item 31) and “More likely to drive a motor vehicle faster than other” (item
60). While still statistically significant, these two items account for the least amount of variance
in the model. When looking at the item pertaining to creativity, the college student population
may differ on their perceptions of creativity as it relates to intelligence in a different way than the
general adult population does. Specifically, college students are generally higher in cognitive
abilities than the adult population and creativity may be more revered on college campuses as
well. As published, this item belongs to the factor Self-Organization/Problem Solving. This
question about creativity does not necessarily fit with the other type of items when referring to a
college student population. For instance, other items in this area focus on tasks of concentration
and organizing, with only one other questions discussing something similar to creatively (coming
up with a new way to solve a problem). The question pertaining to creativity may be viewed as a
difficult area in the college student population regardless of any impairment on that factor.
The item related to driving falls within the factor of self-restraint. Other items in this factor
pertain mostly to impatience and impulsivity. While driving fast is generally related to ADHD
and EF deficits, it is also common for this age group in general. Thus, endorsing this item may
not have much to do with the endorsement of other items included in this factor making it a less
than desirable fit.
Limitations
There are several issues that could affect the findings of the study. All participants in this
study were acquired from a large public university in the southeastern United States. The results
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of this study may not generalize to other college student populations such as private colleges or
universities, community colleges, or universities in northern or western areas. In addition, these
students were mostly traditional students under the age of 30. The results found may not
generalize to non-traditional (or second career) students or graduate students. Students in this
study were recruited in several different ways, which could have affected the results. The
control group was primarily from one college of the university and was heavily female in
composition. To remedy this, additional control participants were collected from the same
university in several undergraduate classes and in general areas on campus. Participants in the
one college received either extra credit for participating or participation fulfilled a course
requirement. The participants recruited in other parts of the university were offered monetary
incentives for participating. These different methods could have influenced the way the
participants responded to the survey.
In regards to the participants in the ADHD group, there are several issues which could
have affected the validity of the results as well. As reported, the participants in the ADHD group
were evaluated at an on-campus clinic to determine whether or not they qualified for a diagnosis
of ADHD. Students often presented for an evaluation when they were in a crisis situation such
as academic probation or losing a scholarship due to poor academic performance. In addition,
students may have been looking for a diagnosis of ADHD to acquire stimulant medications
(secondary gain). All of these factors could have influenced the way in which they completed
the survey which measured impairment.
As far as the evaluation and determination of ADHD is concerned, all students who were
given a diagnosis met criteria for ADHD using the DSM-IV-TR. Since that time, the DSM-5 has
been published, with a slightly less stringent criteria for diagnosing ADHD in adults and with
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more relevant criteria. Therefore, there were likely many students who did not receive a
diagnosis of ADHD and were excluded from this sample that would receive such a diagnosis if
currently evaluated It is possible that a sample with more moderate levels of ADHD could
influence the results. Finally, the students in the ADHD group were given the Brief Intellectual
Abilities Index (BIA) from the Woodcock Johnson Tests of Cognitive Abilities as a proxy for
IQ. Unfortunately, the BIA has only a .60-.69 correlation with IQ from other full measures of
intelligence (McGrew & Woodcock, 2011). This may explain why results from that research
question were moderate in nature.
Implications for Future Research
Given that the BDEFS is in its infancy, there are multiple avenues for continued research.
The Discriminant Function Analysis (DFA) in this study was conducted with sufficient sample
size; however, there were not enough participants in each group to run a split-half analysis. This
would entail conducting the DFA on half of the sample, then using the results from that analysis
to check the specificity and sensitivity on the other half of the data. This would increase the
validity of the results. In addition, given that the new 15-Item ADHD-EF Index has been
produced on this single sample, it is recommended that replication studies be conducted before
this is used in clinical practice as a standalone measure.
The control sample in the current study had a higher representation of females; therefore
a reduced sample was used for the CFA. It is advised that a sample of at least 500 participants,
with equal gender distribution, be collected to run the CFA again. In addition, a multi-sample
CFA should be conducted given the anticipated difference in these groups regarding impairment.
In continuing to investigate the psychometric properties of the BDEFS on a college student
population, several other analyses should be considered. This current study did not exclude
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participants in the ADHD group who had co-occurring disorders. During the course of the
ADHD evaluation, participants complete a DSM checklist of clinical symptoms. These
symptoms should be correlated with the five factors of the BDEFS to see if there is a
relationship. As well, Barkley (2012b) noted that when there were higher internalizing
symptoms, the participant was more likely to rate themselves more impaired on the BDEFS than
their other informant. This should be replicated in the college population. Finally, concurrent
validity should be evaluated by comparing responses on the BDEFS to the Behavior Rating
Inventory of Executive Functioning (BRIEF-A), which has evidence of validity.
Implications for Clinical Practice
One of the most notable implications resulting from this study is the identification of the
new 15-item ADHD-EF Index that better discriminates college students with ADHD from
students without ADHD. In addition to this new scale, the two brief screening questions
identified as highly identifying students that may have ADHD could be used by campus
professionals to quickly identify students who may need a more extensive evaluation. These
professionals may include mental health counselors, academic counselors, and medical
professionals. Another finding indicating that the 5-item ADHD-EF Index (from the original
ADHD-EF Index) was also quite useful in discriminating the college student with and without
ADHD and can also be used as a screening tool.
There are several other clinical implications that could be considered when using the
BDEFS with the college student population. First, there were statistically significant differences
between the self-report and the other-informant report form of the BDEFS in this sample. This
result highlights the need for clinicians to gain not only the students’ perception of their
impairments, but the perceptions of those who interacted with the student the most. In addition,
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results suggest that clinicians view the self-report rating with caution, taking into consideration
the student’s circumstances such as a crisis situation or the possibility of secondary gain.
Second, high cognitive ability students tend to have more impairment in the area of self-
management of time. Students in the category of high cognitive ability tend to be overlooked
because of their abilities; however, the results of this study highlight the need to provide a skills-
based intervention to improve skills for time-management. This may include setting alarms or
alerts for tasks and activities and encouraging the student with ADHD to have visual reminders
of time (countdown clocks on their desks).
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APPENDIX A
INFORMED CONSENT FOR ADHD GROUP
Consent Form
1. I consent to receiving a psycho-educational assessment from the Adult Learning Evaluation Center at Florida State University.
2. I understand that no information concerning my evaluation will be released from the Adult Learning Evaluation Center within the limits of confidentiality that have been specified (see Client Information). 3. I understand the information provided to me regarding supervision and observation of services. 4. I understand that the fee for a psycho-educational assessment is $500.00 and is payable on the first day of the evaluation unless other arrangements have been finalized through financial aid. 5. I understand that it is in my best interest to put forth my best effort during the psycho-educational evaluation. 6. The following section specifically applies to a research project that you are being asked to consider.
I freely and voluntarily and without element of force or coercion, consent to be a participant in the research project, Exploration of the Factors Underlying Academic Difficulty in College
Students.
I understand that this research is being conducted by Dr. Frances Prevatt at Florida State University. I understand the purpose of the research project is to create an archival data base that can be used to evaluate correlates of learning disability (LD) and Attention Deficit Hyperactivity Disorder (ADHD) in a college population. I am being asked to allow the results of my current evaluation to be utilized in this archival data base. I understand that all clients in ALEC, (approximately 200 per year) are asked to participate in this research. I am not being asked to do
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anything other than my standard evaluation; I am just allowing my data to be used later for research purposes. I understand that I must be at least 18 years of age in order to participate in this study. I understand that I will receive no direct benefits in return for participating in this research project. I understand that my participation is totally voluntary and I may withdraw my consent at any time in the research. I understand that if I do not agree for my data to be used, that will have no impact on my evaluation. I understand there is no risk involved if I agree to let my data be used. I understand that my identity will never be associated with the data (that is, my name and any identifying information will be removed.)The records will be kept private and confidential to the extent permitted by law. Data will be stored securely and only the researchers will have access to the data base. I understand that I may contact Dr. Frances Prevatt, Florida State University, Adult Learning Evaluation Center, at *********, for answers to questions about this research or my rights.
If you have any questions or concerns regarding this study and would like to talk to someone other than the researcher(s), you are encouraged to contact the FSU IRB at 2010 Levy Street, Research Building B, Suite 276, Tallahassee, FL 32306-2742, or 850-644-8633, or by email at [email protected]. I do [ ] do not [ ] consent to allow my data to be used in the manner described above. I do [ ] do not [ ] give ALEC my permission to contact me by email or telephone to describe future research projects and ask me if I would be interested in participating. If yes, this permission is granted for ____ years from today’s date. I do [ ] do not [ ] consent to participate in an additional research study that involves the comparison of my responses to those of a group of college students without ADHD. Should I agree, I will be given an additional thirty-three questions, which will add approximately ten minutes to my psycho-educational evaluation. I have read, understand, and agree to all Adult Learning Evaluation Center procedures outlined in this document. Signature ___________________________ Date__________________________
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APPENDIX B
BARKLEY DEFICITS IN EXECUTIVE FUNCTIONING SCALES
Instructions: How often do you experience each of these problems? Please circle the number next to each item that best describes your behavior DURING THE PAST 6 MONTHS. Note to committee- these items are in an on-line survey tool, so the formatting here is not the
same. This is for a reference on the actual questions that are contained within the survey
All items are on a Likert scale with 1= Never or Rarely, 2= Sometimes, 3= Often, and 4= Very Often 1) Procrastinate or put off doing things until the last minute
2) Poor sense of time
3) Waste or mismanage my time
4) Not prepared on time for work or assigned tasks
5) Fail to meet deadlines for assignments
6) Have trouble planning ahead or preparing for upcoming events.
7) Forget to do things I am supposed to do
8) Can't seem to accomplish the goals I set for myself
9) Late for work or scheduled appointments
10) Can't seem to hold in mind things I need to remember to do
11) Can't seem to get things done unless there is an immediate deadline
12) Have difficulty judging how much time it will take to do something or get somewhere
13) Have trouble motivating myself to start work
14) Have difficulty motivating myself to stick with my work and get it done
15) Not motivated to prepare in advance for things I know I am supposed to do
16) Have trouble completing one activity before starting into a new one
17) Have trouble doing what I tell myself to do
18) Difficulties following through on promises or commitments I may make to others
19) Lack self-discipline
20) Have difficulty arranging or doing my work by its priority or importance; can't "prioritize"
well
21) Find it hard to get started or get going on things I need to get done
22) I do not seem to anticipate the future as much or as well as others
23) Can't seem to remember what I previously heard or read about
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24) I have trouble organizing my thoughts
25) When I am shown something complicated to do, I cannot keep the information in mind so as
to imitate or do it correctly
26) I have trouble considering various options for doing things and weighing their consequences
27) Have difficulties saying what I want to say
28) Unable to come up with or invent as many solutions to problems as others seem to do
29) Find myself at a loss for words when I want to explain something to others
30) Have trouble putting my thoughts down in writing as well or as quickly as others
31) Feel I am not as creative or inventive as others of my level of intelligence
32) In trying to accomplish goals or assignments, I find I am not able to think of as many ways
of doing things as others
33) Have trouble learning new or complex activities as well as others
34) Have difficulty explaining things in their proper order or sequence
35) Can't seem to get to the point of my explanations as quickly as others
36) Have trouble doing things in their proper order or sequence
37) Unable to "think on my feet" or respond as effectively as others to unexpected events
38) I am slower than others at solving problems I encounter in my daily life
39) Easily distracted by irrelevant events or thoughts when I must concentrate on something
40) Not able to comprehend what I read as well as I should be able to do; have to reread material
to get its meaning
41) Cannot focus my attention on tasks or work as well as others
42) Easily confused
43) Can't seem to sustain my concentration on reading, paperwork, lectures, or work
44) Find it hard to focus on what is important from what is not important when I do things
45) I don't seem to process information as quickly or as accurately as others
46) Find it difficult to tolerate waiting; impatient
47) Make decisions impulsively
48) Unable to inhibit my reactions or responses to events or others
49) Have difficulty stopping my activities or behavior when I should do so.
50) Have difficulty changing my behavior when I am given feedback about my mistakes.
51) Make impulsive comments to others.
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52) Likely to do things without considering the consequences for doing them.
53) Change my plans at the last minute on a whim or last minute impulse.
54) Fail to consider past relevant events or past personal experiences before responding to
situations (I act without thinking).
55) Not aware of things I say or do.
56) Have difficulty being objective about things that affect me.
57) Find it hard to take other people's perspectives about a problem or situation.
58) Don't think or talk things over with myself before doing something.
59) Trouble following the rules in a situation.
60) More likely to drive a motor vehicle much faster than others (Excessive speeding).
61) Have a low tolerance for frustrating situations
62) Cannot inhibit my emotions as well as others.
63) I don't look ahead and think about what the future outcomes will be before I do something (I
don't use my foresight).
64) I engage in risk taking activities more than others are likely to do.
65) Likely to take short cuts in my work and not do all that I am supposed to do.
66) Likely to skip out on work early if my work is boring to do.
67) Do not put as much effort into my work as I should or than others are able to do.
68) Others tell me that I am lazy or unmotivated.
69) Have to depend on others to help me get my work done.
70) Things must have an immediate payoff for me or I do not seem to get them done.
71) Have difficulty resisting the urge to do something fun or more interesting when I
am supposed to be working.
72) Inconsistent in the quality or quantity of my work performance.
73) Unable to work as well as others without supervision or frequent instruction.
74) I do not have the willpower or determination that others seem to have.
75) I am not able to work toward longer term or delayed rewards as well as others.
76) I cannot resist doing things that produce immediate rewards, even if those things are not
good for me in the long run.
77) Quick to get angry or become upset.
78) Overreact emotionally.
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79) Easily excitable.
80) Unable to inhibit showing strong negative or positive emotions.
81) Have trouble calming myself down once I am emotionally upset.
82) Cannot seem to regain emotional control and become more reasonable once I am emotional.
83) Cannot seem to distract myself away from whatever is upsetting me emotionally to help
calm me down. I can't refocus my mind to a more positive framework.
84) Unable to manage my emotions in order to accomplish my goals successfully or get along
well with others.
85) I remain emotional or upset longer than others.
86) I find it difficult to walk away from emotionally upsetting encounters with others or leave
situations in which I have become very emotional.
87) I cannot re-channel or redirect my emotions into more positive ways or outlets when I get
upset.
88) I am not able to evaluate an emotionally upsetting event more objectively.
89) I cannot redefine negative events into more positive viewpoints when I feel strong emotions.
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APPENDIX C
INFORMED CONSENT FOR CONTROL GROUP
Measure of Attention Deficit Hyperactivity Disorder (ADHD) and Executive Functioning in
College students
I understand that I am not required to take this survey and that I have the option to decline participation. If I agree, my responses will be used in the research project described below. I understand that I will take this survey online at the above stated web address. I will keep this copy of the informed consent for my records, but I will sign a copy of this consent online prior to completing the survey. I understand that this survey is being collected to serve a research study, entitled “The Psychometric Properties of the Barkley Deficits in Executive Functioning” You will be part of the control group without ADHD. If you have a current diagnosis of ADHD and you report that on the survey, then your data will not be used as part of the control group. However, you may still participate in the study and still be eligible to participate in the lottery. This study is being conducted by Dr. Frances Prevatt at Florida State University. I understand the purpose of this research project is to evaluate an existing measure that currently has no normative data for college students. I will be given a questionnaire to complete, which will take approximately 15 minutes. About 300 college students will participate in this study, 150 with a diagnosis of ADHD and 150 without a diagnosis of ADHD. I understand that I must be at least 18 years of age in order to participate in this study. I understand that in return for participating in this research project, I will be entered in a drawing for a 1 in 25 chance of receiving a $15 gift certificate to the store of my choosing. I understand that my participation is totally voluntary and I may stop participation at any time in the research, and that there is no penalty for non-participation. I understand this consent may be withdrawn at any time, even after I have completed the survey. I understand that the responses I provide today are being collected with software that is designed to secure my data and provide me with confidentiality. Although every effort will be done to ensure confidentiality of my responses, all Internet-based communication is subject to the remote likelihood of tampering from an outside source. IP addresses will not be investigated and data will be removed from the server. My data and consent form will be kept electronically on secure servers at the FSU Learning Systems Institute (LSI) and will not be disclosed to third parties. LSI has physical and environmental controls in place to protect data. Data are backed up daily.
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I understand that I may contact the primary researcher, Dr. Frances Prevatt at *******. I can also contact the Chair of the Human Subjects Committee, Institutional Review Board, through the Office of the Vice President for Research, at ********. I freely and voluntarily and without element of force or coercion, consent to be a participant in the research project “The Psychometric Properties of the Barkley Deficits in Executive Functioning Scale.” It is possible that I may wonder about my responses to the questions. If after having answered the survey questions, I feel I may have some symptoms of ADHD, I can contact my local chapter for Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) at www.chadd.org for information for assistance with resources or I may contact the following resources: The FSU Student Counseling Center ****** (free) The FSU Psychology Department Clinic ********(sliding scale fee) The FSU Human Services Center ******* (free) If you have any questions or concerns regarding this study and would like to talk to someone other than the researcher(s), you are encouraged to contact the FSU IRB at 2010 Levy Street, Research Building B, Suite 276, Tallahassee, FL 32306-2742, or 850-644-8633, or by email at [email protected] You will be given a copy of this information to keep for your records. Statement of Consent:
I have read the above information. I have asked questions and have received answers. I consent to participate in the study. _____ YES. By checking yes, I consent to participate in this study. ________________ _________________ Signature Date ________________ _________________ Signature of Investigator Date
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APPENDIX D
INTERNAL REVIEW BOARD FOR HUMAN SUBJECTS APPROVAL
The Florida State University Office of the Vice President For Research Human Subjects Committee Tallahassee, Florida 32306-2742 (850) 644-8673, FAX (850) 644-4392 APPROVAL MEMORANDUM Date: 3/29/2013 To: Frances Prevatt Dept.: EDUCATIONAL PSYCHOLOGY AND LEARNING SYSTEMS From: Thomas L. Jacobson, Chair Re: Use of Human Subjects in Research The Psychometric Properties of the Barkley Deficits in Executive Functioning Scale (BDEFS) The application that you submitted to this office in regard to the use of human subjects in the proposal referenced above have been reviewed by the Secretary, the Chair, and one member of the Human Subjects Committee. Your project is determined to be Expedited per 45 CFR § 46.110(7) and has been approved by an expedited review process. The Human Subjects Committee has not evaluated your proposal for scientific merit, except to weigh the risk to the human participants and the aspects of the proposal related to potential risk and benefit. This approval does not replace any departmental or other approvals, which may be required. If you submitted a proposed consent form with your application, the approved stamped consent form is attached to this approval notice. Only the stamped version of the consent form may be used in recruiting research subjects. If the project has not been completed by 3/28/2014 you must request a renewal of approval for continuation of the project. As a courtesy, a renewal notice will be sent to you prior to your expiration date; however, it is your responsibility as the Principal Investigator to timely request renewal of your approval from the Committee. You are advised that any change in protocol for this project must be reviewed and approved by the Committee prior to implementation of the proposed change in the protocol. A protocol change/amendment form is required to be submitted for approval by the Committee. In addition, federal regulations require that the Principal Investigator promptly report, in writing any unanticipated problems or adverse events involving risks to research subjects or others.
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By copy of this memorandum, the Chair of your department and/or your major professor is reminded that he/she is responsible for being informed concerning research projects involving human subjects in the department, and should review protocols as often as needed to insure that the project is being conducted in compliance with our institution and with DHHS regulations. This institution has an Assurance on file with the Office for Human Research Protection. The Assurance Number is FWA00000168/IRB number IRB00000446. Cc: Betsy Becker, Chair HSC No. 2013.10087 Human Subjects Application For Full IRB and Expedited Exempt Review
1. Project Title and Identification
1.1 Project Title
The Psychometric Properties of the Barkley Deficits in Executive Functioning Scale (BDEFS)
Project is: Dissertation
1.2 Principal Investigator (PI)
Name(Last name, First name MI): Prevatt, Frances F
Highest Earned
Degree: Doctorate
University Department: EDUCATIONAL PSYCHOLOGY AND LEARNING SYSTEMS
Email:
The training and education completed in the protection of human
subjects or human subjects records: Other
Occupational
Position: Faculty
1.3 Co-Investigators/Research Staff
Name(Last name, First name MI): Coffman, Theodora Passinos; Co-Investigator
Highest Earned
Degree: Bachelor's
Degree
University Department: EDUCATIONAL PSYCHOLOGY AND LEARNING SYSTEMS
Email:
The training and education completed in the protection of human subjects
or human subjects records: FSU Training Module
Occupational
Position: Student
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APPENDIX E
DEMOGRAPHIC QUESTIONNAIRE
If you consent to taking this survey, please select yes with the knowledge that your information will be kept confidential and used for research purposes only.
Yes No
If No Is Selected, Then Skip To End of Survey
1) What is your gender?
Male Female
2) What is your age?
_________________ (in years) 3) What is your ethnicity?
Caucasian African American Asian Hispanic Other
4) What year in college are you in?
Freshmen Sophomore Junior Senior Graduate Student
5) Have you been previously diagnosed with a Learning Disability?
Yes No
6) Have you been previously diagnosed with ADHD?
Yes No
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APPENDIX F
BDEFS SCORING TEMPLATE
Scale Raw Score Percentile rank
Classification
Section 1, Q-1-21 Self-Management/ To Time
Section 2, Q-22-45 Self-Organization/ Problem Solving
Section 3, Q-46-64 Self-Restraint
Section 4, Q-65-76 Self-Motivation
Section 5, Q-77-89 Self-Regulation of Emotions
Total sections 1-5 Total EF
Count # of items answered 3 or 4
EF symptom count
Add items, 1,6,14,16,24,49,50,55,60 65, 69
ADHD-EF index score
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APPENDIX G
OTHER INFORMANT BDEFS
Note to committee members- the questions contained in the other-informant version of the
BDEFS are identical in content to the self-report version. The only change is in first/third
person reference.
1) Procrastinates or puts off doing things until the last minute
2) Poor sense of time
3) Waste or mismanage his/her time
4) Not prepared on time for work or assigned tasks
5) Fails to meet deadlines for assignments
6) Has trouble planning ahead or preparing for upcoming events.
7) Forgets to do things that he/she am supposed to do
8) Can't seem to accomplish the goals he/she set for self
9) Late for work or scheduled appointments
10) Can't seem to hold in mind things he/she need to remember to do
11) Can't seem to get things done unless there is an immediate deadline
12) Has difficulty judging how much time it will take to do something or get somewhere
13) Has trouble motivating self to start work
14) Has difficulty motivating self to stick with his/her work and get it done
15) Not motivated to prepare in advance for things he/she knows he/she is supposed to do
16) Has trouble completing one activity before starting into a new one
17) Has trouble doing what he/she tells self to do
18) Difficulties following through on promises or commitments he/she may make to others
19) Lack self-discipline
20) Has difficulty arranging or doing his/her work by its priority or importance; can't "prioritize"
well
21) Finds it hard to get started or get going on things he/she need to get done
22) Does not seem to anticipate the future as much or as well as others
23) Can't seem to remember what he/she previously heard or read about
24) Has trouble organizing his/her thoughts
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25) When he/she is shown something complicated to do, he/she cannot keep the information in
mind so as to imitate or do it correctly
26) Has trouble considering various options for doing things and weighing their consequences
27) Has difficulties saying what he/she wants to say
28) Unable to come up with or invent as many solutions to problems as others seem to do
29) Finds he/she is at a loss for words when he/she wants to explain something to others
30) Has trouble putting his/her thoughts down in writing as well or as quickly as others
31) Feels he/she is not as creative or inventive as others of his/her level of intelligence
32) In trying to accomplish goals or assignments, he/she finds that he/she is not able to think of
as many ways of doing things as others
33) Has trouble learning new or complex activities as well as others
34) Has difficulty explaining things in their proper order or sequence
35) Can't seem to get to the point of his/her explanations as quickly as others
36) Has trouble doing things in their proper order or sequence
37) Unable to "think on his/her feet" or respond as effectively as others to unexpected events
38) Is slower than others at solving problems he/she encounters in his/her daily life
39) Easily distracted by irrelevant events or thoughts when he/she must concentrate on
something
40) Not able to comprehend what he/she read as well as he/she should be able to do; has to
reread material to get its meaning
41) Cannot focus his/her attention on tasks or work as well as others
42) Easily confused
43) Can't seem to sustain his/her concentration on reading, paperwork, lectures, or work
44) Finds it hard to focus on what is important from what is not important when he/she does
things
45) Doesn’t seem to process information as quickly or as accurately as others
46) Finds it difficult to tolerate waiting; impatient
47) Makes decisions impulsively
48) Unable to inhibit his/her reactions or responses to events or others
49) Has difficulty stopping his/her activities or behavior when he/she should do so.
50) Has difficulty changing his/her behavior when he/she is given feedback about my mistakes.
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51) Makes impulsive comments to others.
52) Likely to do things without considering the consequences for doing them.
53) Changes his/her plans at the last minute on a whim or last minute impulse.
54) Fails to consider past relevant events or past personal experiences before responding to
situations (Acts without thinking).
55) Not aware of things he/she says or does.
56) Has difficulty being objective about things that affect him/her.
57) Finds it hard to take other people's perspectives about a problem or situation.
58) Doesn’t think or talk things over with self before doing something.
59) Trouble following the rules in a situation.
60) More likely to drive a motor vehicle much faster than others (Excessive speeding).
61) Has a low tolerance for frustrating situations
62) Cannot inhibit his/her emotions as well as others.
63) Doesn’t look ahead and think about what the future outcomes will be before he/she does
something (Doesn’t use his/her foresight).
64) Engages in risk taking activities more than others are likely to do.
65) Likely to take short cuts in his/her work and not do all that he/she is supposed to do.
66) Likely to skip out on work early if his/her work is boring to do.
67) Does not put as much effort into his/her work as he/she should or than others are able to do.
68) Others tell his/her that he/she is lazy or unmotivated.
69) Has to depend on others to help them get their work done.
70) Things must have an immediate payoff for his/her or he/she does not seem to get them done.
71) Has difficulty resisting the urge to do something fun or more interesting when he/she is
supposed to be working.
72) Inconsistent in the quality or quantity of his/her work performance.
73) Unable to work as well as others without supervision or frequent instruction.
74) Does not have the willpower or determination that others seem to have.
75) Is not able to work toward longer term or delayed rewards as well as others.
76) Cannot resist doing things that produce immediate rewards, even if those things are not good
for him/her in the long run.
77) Quick to get angry or become upset.
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78) Overreact emotionally.
79) Easily excitable.
80) Unable to inhibit showing strong negative or positive emotions.
81) Has trouble calming self down once he/she is emotionally upset.
82) Cannot seem to regain emotional control and become more reasonable once he/she is
emotional.
83) Cannot seem to distract self away from whatever is upsetting him/her emotionally to help
calm self down. Can't refocus his/her mind to a more positive framework.
84) Unable to manage his/her emotions in order to accomplish his/her goals successfully or get
along well with others.
85) Remains emotional or upset longer than others.
86) Find it difficult to walk away from emotionally upsetting encounters with others or leave
situations in which he/she has become very emotional.
87) Cannot re-channel or redirect his/her emotions into more positive ways or outlets when
he/she gets upset.
88) Is not able to evaluate an emotionally upsetting event more objectively.
89) Cannot redefine negative events into more positive viewpoints when he/she feels strong
emotions.
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BIOGRAPHICAL SKETCH
Theodora Passinos Coffman completed her Bachelors of Science degree in Psychology in
2000 at Clemson University in Clemson, South Carolina. She pursued her PhD at the Combined
Doctoral Program in Counseling Psychology and School Psychology at Florida State University
in Tallahassee, Florida. Currently, Theodora is completing an APA-accredited pre-doctoral
psychology internship at GeoCare LLC/South Florida State Hospital in Pembroke Pines, Florida.
She will remain at GeoCare LLC/South Florida State Hospital for her post-doctoral fellowship