ADHD symptoms, the current symptom scale, and exploratory structural equation modeling: A psychometric study.

Rapson and team looked at the Current Symptoms Scale in adults. They wanted to know if the items group into clean factors like inattention, impulsivity, and hyperactivity.

They used a fancy stats model called ESEM. It lets items load on more than one factor, just like real life.

Only two clear factors showed up: inattention and impulsivity. The hyperactivity items scattered everywhere and did not stick together.

Bottom line: when you score the CSS with adults, trust the inattention and impulsivity totals. Ignore the hyperactivity sub-score.

Arildskov et al. (2022) studied school kids and found one big general ADHD factor plus tiny specific factors. They tell you to use the total score, not sub-scales. Rapson’s adult two-factor result is simpler than that, but both warn that hyperactivity items are weak.

Alexandre et al. (2018) tested preschoolers with a different scale and got three shaky, overlapping factors. Again, hyperactivity did not stand alone. The pattern is the same across ages: hyperactivity is the hardest factor to pin down.

Groen et al. (2020) and Ozel-Kizil et al. (2016) seem to clash on hyperfocus in adults. The first found no overall difference between adults with ADHD and controls; the second found large hyperfocus in ADHD. The gap comes from different scales and samples, not a true contradiction. Rapson’s paper stays quiet on hyperfocus, so it does not pick sides.

If you use the Current Symptoms Scale during intake, add the inattention and impulsivity items for a reliable score. Do not report a separate hyperactivity score—it is noisy and could mislead treatment decisions. When you write reports, quote the two solid factors and note that hyperactivity behaves differently in adults.