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Gepubliceerd in: Research on Child and Adolescent Psychopathology 8/2020

22-05-2020

Clarifying ADHD and Sluggish Cognitive Tempo Item Relations with Impairment: A Network Analysis

Auteurs: Patrick K. Goh, Michelle M. Martel, Russell A. Barkley

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 8/2020

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Abstract

Despite the pervasive nature of various forms of impairment associated with attention-deficit/hyperactivity disorder (ADHD), the precise nature of their associations with ADHD and related sluggish cognitive tempo (SCT), particularly at the heterogeneous item level, remains ambiguous. Using innovative network analysis techniques, we sought to identify and examine the concurrent validity of ADHD and SCT bridge items (i.e., those demonstrating the most robust relations with various forms of impairment) with respect to Overall, Home-School, and Community-Leisure impairment domains. Parents of a nationally representative sample of 1742 children (50.17% male) aged 6–17 years completed rating scales of ADHD, SCT, and impairment. Assessment of Bridge Expected Influence suggested eight bridge items primarily from impulsive and Task Completion (i.e., overlapping SCT and inattentive) domains that demonstrated relations with impairment in school performance, completing chores at home, interacting with family members, following rules, and playing sports. Sum scores only including bridge items exhibited relations with Overall, Home-School, and Community-Leisure impairment domains comparable to that of sum scores including all items. Bridge impairment areas were generally consistent across “Childhood” (6–11 years) and “Adolescence” (12–17 years). Problems listening and slowness emerged as bridge items in Childhood, whereas difficulties following through on instructions, problems waiting one’s turn, and social withdrawal emerged in Adolescence. Given the comparable validity of ADHD- and SCT-related bridge items versus all items, bridge items, together, may be the most efficient indicators of impairment. Further clarification is needed across development to inform personalized assessment and intervention protocols that account for item-level heterogeneity in ADHD, SCT, and impairment phenotypes.
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1
Given the nonnormality of some items, we also created mixed graphical model networks and reassessed items’ BEI given that these networks do not assume normality in data (Haslbeck and Waldorp 2015). Results of these analyses were consistent with those of glasso networks and are available upon request.
 
2
As a preliminary assessment of whether findings could be applied to clinical samples, we reconducted overall analyses using data from 143 participants in the original sample who endorsed (i.e., “often” or “very often”) >5 inattentive items, >5 hyperactive/impulsive items, or >2 SCT or TC items. These cut-offs were consistent with DSM-5 criteria and past studies of SCT using this dataset, respectively (APA 2013; Barkley 2013). Although it should be noted that BEI was not found to be stable (CS = 0.13), likely due to small sample size, five (out of eight) bridge items consistent with the overall sample were replicated in the clinical sample. Six new bridge items were also identified. Detailed results are available upon request.
 
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Metagegevens
Titel
Clarifying ADHD and Sluggish Cognitive Tempo Item Relations with Impairment: A Network Analysis
Auteurs
Patrick K. Goh
Michelle M. Martel
Russell A. Barkley
Publicatiedatum
22-05-2020
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 8/2020
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-020-00655-2

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