1
|
Trejo S, Chamorro Y, Bolaños MDL, Matute E. Utility for Clinical Practice of a Bifactor ADHD Model in an Elementary School Population in Mexico. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01633-7. [PMID: 37955801 DOI: 10.1007/s10578-023-01633-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
We assessed the appropriateness of the bifactor model for a Mexican ADHD symptom questionnaire (BMQ-ADHD) applied to parents and teachers of elementary school children. With a sample of 765 reports of children's behavior (48.7% with ADHD A1 criteria, 42.6% girls, mean age 8.5 years [± 1.6 sd]), we examined construct validity, measurement invariance, differences for gender and school level, and the appropriateness of using summed scores. The BMQ-ADHD questionnaire was characterized by good construct validity for the bifactor model for parents' and teachers' reports. For both corpora, we detected invariance for gender and school level. There were differences in ADHD symptoms by gender, but not by school year. The summed scores may represent the factors accurately for females but may present difficulty for males in the parents' questionnaires. The present study revealed good BMQ-ADHD psychometric properties for a unidimensional-hierarchical ADHD scale segregated by gender for parents' and teachers' reports.
Collapse
Affiliation(s)
- Salvador Trejo
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana, México
| | - Yaira Chamorro
- Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, México
| | - María de Lourdes Bolaños
- Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, México
| | - Esmeralda Matute
- Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, México.
- Departamento de Estudios en Educación, Centro Universitario de Ciencias Sociales y Humanidades, Universidad de Guadalajara, Guadalajara, México.
| |
Collapse
|
2
|
Karalunas SL, Antovich D, Miller N, Nigg JT. Prospective prediction of developing internalizing disorders in ADHD. J Child Psychol Psychiatry 2022; 64:768-778. [PMID: 36464786 DOI: 10.1111/jcpp.13731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Clinical course in attention-deficit/hyperactivity disorder (ADHD) is highly heterogeneous with respect to both core symptoms and associated features and impairment. Onset of comorbid anxiety and mood disorders during later childhood and adolescence is one critical aspect of divergent outcomes in ADHD. Characterizing heterogeneity in onset of anxiety and depression and identifying prospective predictors of these divergent courses may facilitate early identification of the children most at risk. METHODS A total of 849 children recruited for a case-control study of ADHD development, aged 7-12 years at baseline, completed up to six annual waves of comprehensive clinical and cognitive assessment, including multi-informant behavior ratings, parent semi-structured clinical diagnostic interviews, and measures of executive function (EF). Latent class growth curve analyses (LCGAs) characterized patterns of anxiety and depression over time. Trajectories were predicted from baseline parent-rated child temperament, lab-measured child EF, coded parental criticism, and child-reported self-blame for inter-parental conflict. RESULTS Latent class growth curve analyses separately identified three trajectories for anxiety and three for depression: persistently high, persistently low, and increasing. Temperamental fear/sadness and irritability were independent predictors that interacted with family characteristics. Baseline parental criticism and self-blame for inter-parental conflict exerted influence but only in the context of low temperamental risk. Better baseline child working memory was associated with delayed onset of depression. CONCLUSIONS The interaction of baseline child emotional features with EF or family environment predicted divergent courses of both anxiety and depression from middle-childhood to mid-adolescence. Results suggest modifiable risk factors associated with prospective differences in long-term outcomes.
Collapse
Affiliation(s)
| | - Dylan Antovich
- Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - Natalie Miller
- Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - Joel T Nigg
- Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| |
Collapse
|
3
|
Arildskov TW, Virring A, Lambek R, Carlsen AH, Sonuga-Barke EJS, Østergaard SD, Thomsen PH. The factor structure of attention-deficit/hyperactivity disorder in schoolchildren. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 125:104220. [PMID: 35462238 DOI: 10.1016/j.ridd.2022.104220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/21/2022] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Most studies support a bifactor model of childhood ADHD with two specific factors. However, several studies have not compared this model with a bifactor model with three specific factors, few have tested the actual strength of the factors, and none have examined whether "talks excessively" should be treated as a hyperactivity versus impulsivity symptom in children with ADHD. AIMS To examine the factor structure of ADHD symptoms and evaluate the relative strength of potential factors. METHODS Parent-reports on the ADHD-Rating Scale (ADHD-RS-IV) were collected for 2044 schoolchildren from the general population and 147 children with ADHD from a clinical sample. Single-, two- and three-(correlated and bi-)factor models were tested using confirmatory factor analysis. RESULTS Most models had a satisfactory fit. However, a correlated three-factor model where "talks excessively" was included as an indicator of impulsivity, and especially a bifactor model with one strong, well-defined general and two/three (ICD-10 defined) weak specific factors fit the data slightly better than the remaining models. CONCLUSIONS The factor structure is best characterized by a bifactor model with a strong general factor and two/three weaker specific factors. Therefore, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.
Collapse
Affiliation(s)
- Trine Wigh Arildskov
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Anne Virring
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | | | - Edmund J S Sonuga-Barke
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Søren D Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Affective Disorders, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
| | - Per Hove Thomsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
4
|
Liu L, Wang Y, Chen W, Gao Y, Li H, Wang Y, Chan RCK, Qian Q. Network analysis of 18 attention-deficit/hyperactivity disorder symptoms suggests the importance of " Distracted" and " Fidget" as central symptoms: Invariance across age, gender, and subtype presentations. Front Psychiatry 2022; 13:974283. [PMID: 36339870 PMCID: PMC9633674 DOI: 10.3389/fpsyt.2022.974283] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
The network theory of mental disorders conceptualizes psychiatric symptoms as networks of symptoms that causally interact with each other. Our present study aimed to explore the symptomatic structure in children with attention-deficit/hyperactivity disorder (ADHD) using network analyses. Symptom network based on 18 items of ADHD Rating Scale-IV was evaluated in 4,033 children and adolescents with ADHD. The importance of nodes was evaluated quantitatively by examining centrality indices, including Strength, Betweenness and Closeness, as well as Predictability and Expected Influence (EI). In addition, we compared the network structure across different subgroups, as characterized by ADHD subtypes, gender and age groups to evaluate its invariance. A three-factor-community structure was identified including inattentive, hyperactive and impulsive clusters. For the centrality indices, the nodes of "Distracted" and "Fidget" showed high closeness and betweenness, and represented a bridge linking the inattentive and hyperactive/impulsive domains. "Details" and "Fidget" were the most common endorsed symptoms in inattentive and hyperactive/impulsive domains respectively. On the contrary, the "Listen" item formed a peripheral node showing weak links with all other items within the inattentive cluster, and the "Loss" item as the least central node by all measures of centrality and with low predictability value. The network structure was relatively invariant across gender, age and ADHD subtypes/presentations. The 18 items of ADHD core symptoms appear not equivalent and interchangeable. "Distracted" and "Fidget" should be considered as central, or core, symptoms for further evaluation and intervention. The network-informed differentiation of these symptoms has the potentials to refine the phenotype and reduce heterogeneity.
Collapse
Affiliation(s)
- Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wai Chen
- Mental Health Service, Fiona Stanley Hospital, Perth, WA, Australia.,Curtin Medical School, Curtin University, Perth, WA, Australia.,Curtin enAble Institute, Curtin University, Bentley, WA, Australia.,Graduate School of Education, University of Western Australia, Perth, WA, Australia.,School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Psychology, Murdoch University, Perth, WA, Australia
| | - Yuan Gao
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Haimei Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| |
Collapse
|
5
|
Longitudinal network model of the co-development of temperament, executive functioning, and psychopathology symptoms in youth with and without ADHD. Dev Psychopathol 2021; 33:1803-1820. [DOI: 10.1017/s0954579421000900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AbstractAttention-deficit hyperactivity disorder (ADHD) is a common, chronic, and impairing disorder, yet presentations of ADHD and clinical course are highly heterogeneous. Despite substantial research efforts, both (a) the secondary co-occurrence of ADHD and complicating additional clinical problems and (b) the developmental pathways leading toward or away from recovery through adolescence remain poorly understood. Resolving these requires accounting for transactional influences of a large number of features across development. Here, we applied a longitudinal cross-lagged panel network model to a multimodal, multilevel dataset in a well-characterized sample of 488 children (nADHD = 296) to test Research Domain Criteria initiative-inspired hypotheses about transdiagnostic risk. Network features included Diagnostic and Statistical Manual of Mental Disorders symptoms, trait-based ratings of emotional functioning (temperament), and performance-based measures of cognition. Results confirmed that ADHD symptom domains, temperamental irritability, and working memory are independent transdiagnostic risk factors for psychopathology based on their direct associations with other features across time. ADHD symptoms and working memory each had direct, independent associations with depression. Results also demonstrated tightly linked co-development of ADHD symptoms and temperamental irritability, consistent with the possibility that this type of anger dysregulation is a core feature that is co-expressed as part of the ADHD phenotype for some children.
Collapse
|
6
|
Nigg JT, Karalunas SL, Feczko E, Fair DA. Toward a Revised Nosology for Attention-Deficit/Hyperactivity Disorder Heterogeneity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:726-737. [PMID: 32305325 PMCID: PMC7423612 DOI: 10.1016/j.bpsc.2020.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/20/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is among the many syndromes in the psychiatric nosology for which etiological signal and clinical prediction are weak. Reducing phenotypic and mechanistic heterogeneity should be useful to arrive at stronger etiological and clinical prediction signals. We discuss key conceptual and methodological issues, highlighting the role of dimensional features aligned with Research Domain Criteria and cognitive, personality, and temperament theory as well as neurobiology. We describe several avenues of work in this area, utilizing different statistical, computational, and machine learning approaches to resolve heterogeneity in ADHD. We offer methodological and conceptual recommendations. Methodologically, we propose that an integrated approach utilizing theory and advanced computational logic to address targeted questions, with consideration of developmental context, can render the heterogeneity problem tractable for ADHD. Conceptually, we conclude that the field is on the cusp of justifying an emotionally dysregulated subprofile in ADHD that may be useful for clinical prediction and treatment testing. Cognitive profiles, while more nascent, may be useful for clinical prediction and treatment assignment in different ways depending on developmental stage. Targeting these psychological profiles for neurobiological and etiological study to capture different pathophysiological routes remains a near-term opportunity. Subtypes are likely to be multifactorial, cut across multiple dimensions, and depend on the research or clinical outcomes of interest for their ultimate selection. In this context parallel profiles based on cognition, emotion, and specific neural signatures appear to be on the horizon, each with somewhat different utilities. Efforts to integrate such cross-cutting profiles within a conceptual dysregulation framework are well underway.
Collapse
Affiliation(s)
- Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon.
| | - Sarah L Karalunas
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
| | - Eric Feczko
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon
| | - Damien A Fair
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon
| |
Collapse
|
7
|
Early life predictors of attention deficit/hyperactivity disorder symptomatology profiles from early through middle childhood. Dev Psychopathol 2019; 32:791-802. [PMID: 31439070 DOI: 10.1017/s0954579419001135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study used repeated measures data to identify developmental profiles of elevated risk for ADHD (i.e., six or more inattentive and/or hyperactive-impulsive symptoms), with an interest in the age at which ADHD risk first emerged. Risk factors that were measured across the first 3 years of life were used to predict profile membership. Participants included 1,173 children who were drawn from the Family Life Project, an ongoing longitudinal study of children's development in low-income, nonmetropolitan communities. Four heuristic profiles of ADHD risk were identified. Approximately two thirds of children never exhibited elevated risk for ADHD. The remaining children were characterized by early childhood onset and persistent risk (5%), early childhood limited risk (10%), and middle childhood onset risk (19%). Pregnancy and delivery complications and harsh-intrusive caregiving behaviors operated as general risk for all ADHD profiles. Parental history of ADHD was uniquely predictive of early onset and persistent ADHD risk, and low primary caregiver education was uniquely predictive of early childhood limited ADHD risk. Results are discussed with respect to how changes to the age of onset criterion for ADHD in DSM5 may affect etiological research and the need for developmental models of ADHD that inform ADHD symptom persistence and desistance.
Collapse
|
8
|
Dobrean A, Păsărelu CR, Balazsi R, Predescu E. Measurement Invariance of the ADHD Rating Scale-IV Home and School Versions Across Age, Gender, Clinical Status, and Informant. Assessment 2019; 28:86-99. [PMID: 31253044 DOI: 10.1177/1073191119858421] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present study aimed to investigate the measurement invariance across age, gender, clinical status, and informant of the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) Home and School versions. The participants were 1,106 Romanian children and adolescents (mean age = 12.74 years, standard deviation = 2.84, age range 6-18 years). Both parents and teachers assessed ADHD symptoms. The factorial structure of the scale was assessed using confirmatory factor analysis, and measurement invariance was assessed using multigroup confirmatory factor analysis. The results supported the reliability of the ADHD-RS-IV, with high internal consistency coefficients for both versions. Confirmatory factor analysis validated a two-factor model. Multigroup confirmatory factor analysis confirmed the measurement invariance of ADHD-RS-IV across age, gender, clinical status, and informant. ADHD-RS-IV had good psychometric properties in a sample of Romanian children and adolescents. It is a reliable instrument given its strong invariance. Implications for evidence-based assessment of ADHD are discussed.
Collapse
Affiliation(s)
- Anca Dobrean
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health/Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Costina-Ruxandra Păsărelu
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health/Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | | | - Elena Predescu
- Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|