Behavioral rating inventory and laboratory tests measure different aspects of executive functioning in boys: a validity study

Behavioral rating inventory and laboratory tests measure different aspects of executive functioning in boys: a validity study Objective: The aim of this study is to investigate the correspondence between an ecological test of everyday behavior and laboratory tests of executive functions (EF) and to analyze whether the prior can be used in the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). Method: Sample consisted of 61 unmedicated first referral males who were diagnosed only with ADHD and were classified into subtypes (predominantly inattentive subtype: n= 22; predominantly hyperactive/impulsive subtype: n= 17; combined subtype: n= 22). Healthy control group consisted of age-matched healthy males (n= 19). Rating of everyday behavior of EF was performed using both the teacher and parent forms (BRIEF-T and P. respectively) of Behavioral Rating Inventory of Executive Functions (BRIEF). Laboratory tests consisted of the Stroop Test, Wisconsin Card Sorting Test and Raven Standard Progressive Matrices. Results: In the ADHD group, factor structure of BRIEF consisted of behavioral regulation index and metacognition index (explained variances: 70.07% in BRIEF-T and 72.29% in BRIEF-P). In no case did the laboratory and ecological measures of EF took place under the factors that the BRIEF scores loaded. Multivariate analyses of variance showed a significant effect of group but not of subgroup on BRIEF scores. Logistic regression analyses showed a sensitivity of 90.20% and specificity of 63.20% of BRIEF scores. Discussion: A multi-trait and multi-method approach, covering both the laboratory tests and ecological rating scales and both the teacher and parent informants should be used in order to capture the specific cognitive processes of EF and their behavioral manifestations. The findings showing the dissimilarity between the EF that BRIEF and the laboratory tests measure and shed light on the validity of BRIEF on the Turkish culture.