Symptoms Versus Impairment in Adults With ADHD: Intercorrelations of the BRIEF-A, CAARS, and TOVA

Objective: The aim of this study is to explore the connections within and between three measures of adult ADHD: the Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A)–Self-Report, Conners’ Adult ADHD Rating Scale–Investigator-Rated (CAARS-Inv), and Test of Variables of Attention (TOVA). Method: Data of 89 adults with ADHD (ages = 18-54, 46% females) who were assessed using these measures during pretreatment visits of a randomized study of metadoxine XR were analyzed. Results: The CAARS-Inv and TOVA did not correlate. The BRIEF-A correlated extensively with both the CAARS-Inv and TOVA, primarily via its Behavioral Regulation Index (BRI). The BRIEF-A Metacognition Index correlated with the CAARS-Inv inattentive score, while the BRI correlated with the CAARS-Inv hyperactive-impulsive score. Within the CAARS and TOVA, inattention and hyperactivity-impulsivity correlated weakly. Conclusion: The measures seem to capture different aspects of adult ADHD. While the CAARS-Inv addresses mainly the domain of symptoms, and the TOVA that of impairment, the BRIEF-A captures aspects of both.