Development and Validation of the ADHD Clinical and Secondary Symptoms Scale for Adults (ADHD-CS)

Abstract

Recently, adult ADHD patients in South Korea have rapidly increased, but existing scales limitedly evaluate their cumulative internal distress and secondary problems. Accordingly, this study developed and validated the ‘ADHD-Clinical and Secondary Symptoms Scale (ADHD-CS)’ to multi-dimensionally assess secondary complaint issues along with core symptoms. Based on a literature review, 62 preliminary items were constructed. Using data from 494 participants, item analysis and exploratory factor analysis were conducted. Correlation analyses with objective behavioral data (ADHD-CRT) and concurrent scales (CAARS, BDI, BAI, STAXI) utilized data from 350 and 352 participants, respectively. Consequently, a 7-subfactor structure was established: three primary factors (inattention & disorganization, impulsivity, hyperactivity) and four secondary factors (self-concept, emotion regulation difficulty, interpersonal maladaptation, work difficulty). Confirmatory factor analysis verified structural clarity, convergent validity, and discriminant validity, with excellent internal consistency. This scale is expected to measure core symptoms and explore lifelong internal distress multi-dimensionally, helping establish appropriate psychosocial interventions in clinical and counseling settings.