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01-11-2009

The Unity and Diversity of Inattention and Hyperactivity/Impulsivity in ADHD: Evidence for a General Factor with Separable Dimensions

Auteurs: Maggie E. Toplak, Ashley Pitch, David B. Flora, Linda Iwenofu, Karen Ghelani, Umesh Jain, Rosemary Tannock

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 8/2009

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Abstract

To examine the unity and diversity of inattention and hyperactivity/impulsivity symptom domains of Attention-Deficit/Hyperactivity Disorder (ADHD) in a clinical sample of adolescents with ADHD. Parents and adolescents were administered a semi-structured diagnostic interview, the Schedule for Affective Disorders and Schizophrenia for School-Age Children — Present and Lifetime Version (K-SADS-PL), to assess adolescent ADHD. Data from 201 parent interviews and 189 adolescent interviews were examined. Four potential factor structures for the 18 ADHD symptoms were tested using confirmatory factor analysis: two models with correlated factors and two bifactor models. A bifactor model with two specific factors best accounted for adolescent symptoms, according to both parent and adolescents’ reports. Replication of these findings from behavioral rating scales completed for this sample by parents and teachers indicates that the findings are not method– or informant-specific. The results suggest that there is an important unitary component to ADHD symptoms and separable dimensional traits of Inattention and Hyperactivity/Impulsivity.
Voetnoten
1
The clinician’s summary on the K-SADS-PL integrated parent, adolescent, and teacher reported symptoms. Each symptom was scored when the informant provided evidence of an observed behavior for each symptom. In the case of any discrepancies between informants, evidence of observed behavior by one informant was scored as a symptom over a lack of symptom endorsement. In general, when discrepancies occurred, parents tended to endorse symptoms over adolescent report, which is consistent with others who have reported that adolescents tend to underreport symptoms of ADHD (Barkley, 2006).
 
2
We also conducted these analyses without the psychiatric control group, and found that the bifactor model still fit well without these cases (parent-report KSADS: df = 46, chi-square = 54, CFI = 0.98, TLI = 0.98, RMSEA = 0.03; adolescent-report KSADS: df = 48, chi-square = 60, CFI = 0.98, TLI = 0.98, RMSEA = 0.04).
 
3
Yet another model structure is a second-order factor model, where the correlations among the specific, lower-order factors imply a general, second-order factor that leads to the lower-order factors. However, in the current context, there would be only two lower-order factors (inattention and hyperactivity/impulsivity), and so a second-order model is statistically under-identified (i.e., the model’s parameters cannot be uniquely estimated; Rindskopf and Rose 1988). However, the bifactor model and second-order models are mathematically related, which suggests that similar conceptual interpretations of the factors can be made (see Yung et al. 1999).
 
4
It is not possible to test whether these differences in fit across models are statistically significant because the models are not formally nested (that is, it is not possible to specify a correlated factor model by placing constraints on the parameters of the bifactor model, or vice versa).
 
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Metagegevens
Titel
The Unity and Diversity of Inattention and Hyperactivity/Impulsivity in ADHD: Evidence for a General Factor with Separable Dimensions
Auteurs
Maggie E. Toplak
Ashley Pitch
David B. Flora
Linda Iwenofu
Karen Ghelani
Umesh Jain
Rosemary Tannock
Publicatiedatum
01-11-2009
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 8/2009
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-009-9336-y

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