Wender Utah Rating Scale
– 25 item version (WURS-25)
The Wender Utah Rating
Scale – 25 item version (WURS-25) is a self-report instrument that is designed
to retrospectively evaluate the presence and severity of childhood symptoms of
ADHD in adults (18+; Ward et al., 1993).
Most of the items in the
WURS-25 are not directly tapping into core ADHD symptoms, instead, the items
were chosen for their discriminative ability in distinguishing between adults
with and without an ADHD diagnosis (Brevik et al., 2020). The WURS-25 has three
subscales that provide an indication of the problems experienced by the adult
in childhood:
1.Impulsivity & Behavioural
problems
2.Inattentiveness
& School problems
3.Self
Esteem & Negative mood
The WURS-25 is an
important adjunct for diagnosis of ADHD in adults given the requirement for
childhood onset (American Psychiatric Association, 2013). This scale is useful
for screening and diagnosis of ADHD among adults 18+ and can be particularly
useful when used in conjunction with the ASRS to provide additional clinical
information (Brevik et al., 2020).
It is important to
diagnose adults with ADHD given that adult ADHD is associated with negative
outcomes, including lower educational achievement, increased rates of
incarcerations, unemployment and illicit drug use (Faraone et al., 2015).
Validity and Reliability
The scale originally
consisted of 61 items but the long form was reduced to the 25 items that showed
the greatest mean difference between patients with ADHD and controls (Ward et
al., 1993). The WURS-25 has a high level of internal consistency of 0.94 (Cronbach’s
alpha; Kouros et al., 2018) and a higher score on the WURS-25 is associated
with poorer performance on objective measures of attention (Mackin et al.,
2005).
Brevik et al. (2020)
performed a principal component analysis and confirmed a three-factor structure
of the WURS as described in previous studies (Caci et al., 2010; Kouros et al.,
2018; McCann et al., 2000; Stanton & Watson, 2016):
Impulsivity & Behavioral
problems (items 5, 6, 8, 10, 12, 13, 14, 15, 16, 19, 20, 21, 22)
Inattentiveness &
School problems (items 1, 4, 7, 17, 23, 24, 25)
Self Esteem &
Negative mood (items 2, 3, 9, 11, 18)
The WURS was administered
to clinically diagnosed adult ADHD patients (n = 646) and to population
controls (n = 908) to calculate percentiles using means and standard deviations
(Brevik et al., 2020). The means (and standard deviations) were:
ADHD diagnosis: Mean =
58.2 (17.9)
Normative control: Mean =
17.3 (13.9)
Scoring and
Interpretation
For the total score of
the WURS-25, there is a cut score of 36 (sensitivity and specificity of 96%;
Ward et al., 1993) and clients with scores of 36 or above have childhood
symptoms that are consistent with adults who have an ADHD diagnosis. Normative
and clinical percentiles are presented for the WURS-25 total score based upon
administration to clinically diagnosed adult ADHD patients (n = 646) and to
population controls (n = 908; Brevik et al., 2020). The means (and standard
deviations) were:
ADHD diagnosis: Mean =
58.2 (17.9)
Normative control: Mean =
17.3 (13.9)
Raw and average scores
are presented for the three subscales of the WURS-25:
Impulsivity & Behavioral
problems (items 5, 6, 8, 10, 12, 13, 14, 15, 16, 19, 20, 21, 22): a measure of
problems with temper, outbursts, anger, and defiance issues as a child.
Inattentiveness &
School problems (items 1, 4, 7, 17, 23, 24, 25): a measure of learning problems
as a student and prominent issues with inattention as a child.
Self Esteem &
Negative mood (items 2, 3, 9, 11, 18): a measure of excessive anxious,
worrying, or unhappy moods as a child.
The average scores for
these subscales allow for a comparison between the childhood problem areas
given they have differing numbers of questions within each subscale.
Developer
Ward, M. F., Wender, P.
H., & Reimherr, F. W. (1993). The Wender Utah Rating Scale: an aid in the
retrospective diagnosis of childhood attention deficit hyperactivity disorder.
The American Journal of Psychiatry, 150(6), 885–890. https://doi.org/10.1176/ajp.150.6.885
Reference
Brevik, E. J.,
Lundervold, A. J., Haavik, J., & Posserud, M.-B. (2020). Validity and
accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD)
Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom
checklists in discriminating between adults with and without ADHD. Brain and
Behavior, 10(6), e01605. https://doi.org/10.1002/brb3.1605
Caci, H. M., Bouchez, J.,
& Baylé, F. J. (2010). An aid for diagnosing
attention-deficit/hyperactivity disorder at adulthood: Psychometric properties
of the French versions of two Wender Utah Rating Scales (WURS-25 and WURS-K).
Comprehensive Psychiatry, 51, 325–331.
Faraone, S. V., Asherson,
P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., …
Franke, B. (2015). Attention-deficit/hyperactivity disorder. Nature Reviews
Disease Primers, 1, 15020.
Kouros, I., Horberg, N.,
Ekselius, L., & Ramklint, M. (2018). Wender Utah Rating Scale-25 (WURS-25):
Psychometric properties and diagnostic accuracy of the Swedish translation.
Upsala Journal of Medical Sciences, 123, 230–236.
McCann, B. S., Scheele,
L., Ward, N., & Roy-Byrne, P. (2000). Discriminant validity of the Wender
Utah Rating Scale for attention-deficit/hyper-activity disorder in adults. The
Journal of Neuropsychiatry and Clinical Neurosciences, 12(2), 240–24
Stanton, K., &
Watson, D. (2016). An examination of the structure and construct validity of
the Wender Utah Rating Scale. Journal of Personality Assessment, 98(5),
545–552.
Mackin, R. S., &
Horner, M. D. (2005). Relationship of the Wender Utah Rating Scale to objective
measures of attention. Comprehensive Psychiatry, 46(6), 468–471.
https://doi.org/10.1016/j.comppsych.2005.03.004
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