Wender Utah Rating Scale Handbook

The Wender Utah Rating Scale Handbook succinctly summarizes research, describes different WURS forms, explains scoring, and helps with interpretation. 

The official name of this manual is: 

Handbook of Utah Scales for the Assessment and Treatment of ADHD in Adults.


Wender Utah Rating Scale Handbook - Download

→ Click here to download the Wender Utah Rating Scale Handbook

This WURS Handbook is licensed under CC BY- 4.0 which means you are free to copy and redistribute this Handbook in any medium or format, provided you give appropriate credit, provide a link to the license, and do not charge for its use for commercial purposes.


Citation 

Reimherr, Frederick W., Barrie K. Marchant, Thomas E. Gift, Tammy A. Steans, Melissa Wilson, and Camille Pommerville. Handbook of Utah Scales for the Assessment and Treatment of ADHD in Adults. Version 1, 2022.


WURS Manual - Wender Utah Rating Scale Handbook



→ Click here to download the Wender Utah Rating Scale Handbook

This WURS Handbook is licensed under CC BY- 4.0 which means you are free to copy and redistribute this Handbook in any medium or format, provided you give appropriate credit, provide a link to the license, and do not charge for its use for commercial purposes.


WURS Manual Excerpt

Wender Utah Rating Scale Handbook - excerpt

A - Introduction Background

In 1972 researchers at Washington University in St Louis published the Research Diagnostic Criteria in the Archives of General Psychiatry (Feighner et al. 1972) and then in 1974 the seminal monograph, Psychiatric Diagnosis (Woodruff, Goodwin & Gauze 1974). They argued for explicit criteria for the diagnosis of psychiatric patients which represented a turning point for psychiatry and laid the groundwork for the development of DSM-III.

In Utah in the 1970’s, we pursued a similar course by identifying a group of patients in a community mental health clinic who presented with a variety of social problems and emotional symptoms along with a childhood history consistent with ADHD. The prevailing wisdom at the time was that ADHD was a childhood disorder which mysteriously disappeared with entrance into adulthood. Following in the spirit of Washington University research, we started to validate the childhood diagnosis of ADHD in these now adult patients. In a first step, we attempted to show that our suspected adult ADHD patients did in fact have a childhood history of ADHD based on their report of childhood problems and using the Connors’ Brief Parent Rating Scale completed by their parents.

B – Wender Utah Rating Scale (WURS)
Among ADHD assessment instruments the WURS has had a unique position documenting childhood signs and symptoms which suggest a now adult patient had a childhood history of ADHD.

Two aspects of the scale deserve special attention. First, we published the scale without restrictions, which encouraged use of the scale. This was highly successful as indicated by over 5,000 citations in Google Scholar. Second, the scale allowed an examination of the adult conditions more generally associated with a childhood history of ADHD.

Collectively, these papers have reported on clinical use of the scale and its psychometric properties. Most papers have been highly supportive of the use of the scale, although some papers have raised concerns about the lack of diagnostic specificity of both high and low scores on the WURS.

In arriving at a psychiatric diagnosis, a score provided by a standardized instrument cannot be regarded as definitive, and this is true of the WURS in determining the presence or absence of ADHD.

In an effort to avoid confusion, we will refer to the original version of the Wender Utah Rating Scale as the “WURS-61” or the WURS. In presenting alternative versions of the scale, we will always refer to them with a number attached as either the Wender Utah Rating Scale-25 or the Wender Utah Rating Scale-45; both can also be abbreviated as the WURS-25 or the WURS-45.
Turning to the utility of the various versions, for typical clinical practice the WURS-25 categorized version is quick and convenient for both the patient and clinician. In this version similar symptoms are grouped under a heading or category name. This allows easy scoring of the WURS-25 and its 3 factors. Scoring the WURS-25 using its 3 factors improves the scale’s sensitivity relative to the simple item total and also provides a more complete clinical picture of the patient’s childhood.

For research purposes or more demanding clinical situations, the WURS-45 categorized version, improves the scale’s psychometric performance with little additional effort. In addition, its five factor scores provide a more comprehensive understanding of the patient.

The original WURS-61 items allows scoring to produce scores for all versions of the instrument. It is more time consuming for patients and those doing the scoring. Also the factors are less convincing since the item loadings tend to be lower than with the WURS-45. Further, efficacy as manifested by the AUC statistics for the two versions is virtually identical. In a sample of 137 ADHD patients and 228 MDD/GAD patients the WURS-61 correctly identified only 7 more subjects than the WURS-45.

For scoring convenience we have provided versions categorized into factors for all three versions. The convenience of using forms with the items categorized must be balanced against the possibility that patients are responding more to category headings rather than to the individual items.


→ Click here to download the Wender Utah Rating Scale Handbook

This WURS Handbook is licensed under CC BY- 4.0 which means you are free to copy and redistribute this Handbook in any medium or format, provided you give appropriate credit, provide a link to the license, and do not charge for its use for commercial purposes.



WURS Classification AccuracyWURS-61 Classification Accuracy using Factor Scores


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