Measurement Invariance of the ADHD Rating Scale-IV Home and School Versions Across Age, Gender, Clinical Status, and Informant

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.

Cross-Cultural and Gender Differences in ADHD Among Young Adults

OBJECTIVE

This study explored the effect of cultural and gender differences in ADHD among Spanish, African American, Hispanic American, and European American young adults.

METHOD

Structural equivalence between the four groups was examined by Tucker's phi coefficient. A MANCOVA was carried out with cultural groups and gender as factors and age as covariate.

RESULTS

Structural equivalence was observed across all groups, and no differential item functioning was found. No significant effect was found for gender, although, with the exception of the Hispanic group, males scored higher than females. Furthermore, small, though significant, cultural differences were found. The lowest levels of ADHD were observed in the European American group and the highest in the Hispanic American group. ADHD symptoms, notably inattention, showed some decline with age.

CONCLUSION

Findings extend existing data and suggest a relationship between culture and the development of ADHD, which might be mediated by parenting style.

A network analysis of developmental change in ADHD symptom structure from preschool to adulthood

Although there is substantial support for the validity of the diagnosis of ADHD, there is considerable disagreement about how to best capture developmental changes in the expression of ADHD symptomatology. The current paper examines the associations among the 18 individual ADHD symptoms using a novel network analysis approach, from preschool to adulthood. The 1,420 participants were grouped into four age brackets: Preschool (age 3-6, n = 109), childhood (age 6-12, n = 548), adolescence (age 13-17, n = 357), and young adulthood (age 18-36, n = 406). All participants completed a multi-stage, multi-informant diagnostic process, and self and informant symptom ratings were obtained. Network analysis indicated ADHD symptom structure became more differentiated over development. Two symptoms Often easily distracted and Difficulty sustaining attention appeared as central, or core, symptoms across all age groups. Thus, a small number of core symptoms may warrant extra weighting in future diagnostic systems.

Latino Cultural Differences in Maternal Assessments of Attention Deficit/Hyperactivity Symptoms in Children

Many aspects of attention deficit/hyperactivity disorder (ADHD) are likely influenced by culture, particularly the differences in perceptions of child behavior and the demands of the environment in homes, schools, and communities of people from different ethnic and cultural groups. In particular, ADHD-related behaviors must be understood within the context of cultural environments and expectations. This study examined differences in parental evaluations of ADHD-related child behaviors in the following three Latino ethnic populations: Mexican ( n = 81), Mexican American ( n = 179), and Puerto Rican ( n = 60). Overall, results indicate an important role for acculturation in mothers’ perceptions of ADHD-related behaviors but only in the measures of hyperactivity and not in the attention deficit aspects of the disorder. Mothers from different Latino cultures and at different levels of acculturation differentially assess specific symptoms of ADHD, indicating the need for careful reassessment of the validity of the disorder for Latino families.

Hyperactivity and Motoric Activity in ADHD: Characterization, Assessment, and Intervention

The aim of the present literature review is threefold. (1) We will review theories, models, and studies on symptomatic hyperactivity and motoric activity in attention-deficit/hyperactivity disorder (ADHD). (2) Another focus will be on assessment methods that have been proven to be effective in the detection of hyperactivity and motoric activity in children, adolescents, and adults with and without ADHD and emerging areas of research in the field of ADHD. We will compare subjective methods (i.e., rating scales) and objective methods (i.e., accelerometers). (3) Finally, physical activity intervention studies aiming at a modification of activity and overactive behavior will be summarized that seem to be promising candidates for alleviating hyperactivity symptoms in children, adolescents, and adults with ADHD.

Developmental differences in structure of attention-deficit/hyperactivity disorder (ADHD) between childhood and adulthood

The current paper utilizes a bifactor modeling approach to evaluate the structure of attention-deficit/hyperactivity disorder (ADHD) in adulthood and assess developmental continuity of ADHD structure between childhood and adulthood. The study compared traditional one-factor, two-factor, three-factor, and second-order factor models of ADHD with a bifactor model of ADHD. Developmental differences in ADHD structure were examined using an extension of the bifactor model: a two-group model comparing children and adults. Participants were 406 adults (49% male; 145 of 406 with ADHD), (18 to 37) years old, and 548 children (58% male; 302 of 548 with ADHD), 6 to 18 years old. A bifactor model of ADHD exhibited the best fit in adults and children compared to traditional models, suggesting continuity in the ADHD latent construct across development. However, significant differences in the factor loadings were evident between children and adults in the two-group bifactor model, suggesting changes in the relative importance of particular symptoms over time. Namely, hyperactivity symptoms appear to decline in importance relative to the ADHD phenotype between childhood and adulthood.

Cross-national invariance of Attention-Deficit/Hyperactivity Disorder factors in Japanese and U.S. university students

Prior research with children generally supports the two-dimensional structure of Attention-Deficit/Hyperactivity Disorder (ADHD; inattentive and hyperactive/impulsive factors) of the DSM-IV-TR as well as invariance of the two-factor structure across nations and cultures. Research with adults supports either a two-factor or three-factor structure depending on reporting source and breadth of symptoms assessed. However, research with adults is limited and there are few studies addressing cross-national invariance in adults. The purposes of this study were to (1) assess relative fit of two- versus three-factor solutions for self-report of childhood and recent ADHD symptoms in adults; and (2) further establish cross-national invariance of factors. Participants included 271 U.S. and 712 Japanese university students who completed a rating scale assessing the 18 DSM-IV-TR ADHD symptoms. Confirmatory factor analysis using Mplus (Version 6) and the mean and variance-adjusted weighted least squares (WLSMV) procedure showed invariance of two- and three-factor models across U.S. and Japanese samples. The two- and three-factor models showed similar fit indices. Neither a two-factor or three-factor model was clearly superior. The two-factor model was favored, however, because it is more parsimonious and consistent with current theory, and because of high correlations between hyperactive and impulsive factors in the three-factor models. Invariance across nations is consistent with previous studies and supports ADHD as a universally valid syndrome rather than a cultural construct. These results add to the limited knowledge of assessment of ADHD symptoms in Japan.

The structure of DSM-IV ADHD, ODD, and CD criteria in adolescent boys: a hierarchical approach

Numerous studies have examined the structure of the childhood externalizing disorder symptoms of Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD), both separately as well as simultaneously. The present study expanded on previous findings by implementing a multi-level hierarchical approach to investigating the component structure of ADHD, ODD, and CD criteria in 487 14-year-old boys from the Minnesota Twin Family Study (MTFS). We found support for a hierarchical conceptualization of externalizing behavior criteria in early adolescent boys by specifying how one-, two-, three-, four-, five- and six-factor models of externalizing criteria can be integrated. These results suggest that it may be more beneficial to conceptualize different levels of this hierarchy as relevant to different issues in case conceptualization and research design, from the broad level of an overall externalizing spectrum, to the level of finer-grained subtypes within specific disorders.

Dimensions and correlates of attention deficit/hyperactivity disorder and Sluggish Cognitive Tempo

The present study examined Sluggish Cognitive Tempo (SCT) in relation to ADHD symptoms, clinical diagnosis, and multiple aspects of adjustment in a clinical sample. Parent and teacher reports were gathered for 322 children and adolescents evaluated for behavioral, emotional, and/or learning problems at a university clinic. Confirmatory factor analyses (CFA) supported the presence of three separate, but correlated factors (SCT, inattention, and hyperactivity/impulsivity) in both parent and teacher ratings. As expected, SCT symptoms were greatest in youth with ADHD Inattentive type, but were also found in non-ADHD clinical groups. SCT symptoms were related to inattention, internalizing, and social problems across both parent and teacher informants; for parent reports, SCT was also related to more externalizing problems. Findings support the statistical validity of the SCT construct, but its clinical utility is still unclear.

ADHD across cultures: is there evidence for a bidimensional organization of symptoms?

We examined the phenotypic expression of attention-deficit/hyperactivity disorder (ADHD) across cultures by assessing the factor/latent class structure of its core symptoms. We conducted a systematic review of the literature published from January 1987 to November 2008 using Medline and PsycINFO. We systematically reviewed 2,511 article abstracts, and 48 of these abstracts were included in this review. Research with school-age children from 15 countries including different samples, informants, and rating instruments supported a two-factor ADHD model consisting of inattention and combined hyperactivity and impulsivity. This model was not supported for preschool children. Cross-cultural equivalence for the two-factor model was suggested in some studies. Latent class analyses using parental data and more recent approaches like factor mixture modeling are generally consistent with factor analyses. These findings argue in favor of a cross-cultural validity of the syndrome. The implications of these findings for further research and classificatory systems in mental health like the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) are discussed.

Revisiting the latent structure of ADHD: is there a 'g' factor?

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is presumed to be heterogeneous, but the best way to describe this heterogeneity remains unclear. Considerable evidence has accrued suggesting that inattention versus hyperactivity-impulsivity symptom domains predict distinct clinical outcomes and may have partially distinct etiological influence. As a result, some conceptualizations emphasize two distinct inputs to the syndrome. Yet formal testing of models that would accommodate such assumptions using modern methods (e.g., second-order factor and bifactor models) has been largely lacking.

METHODS

Participants were 548 children (321 boys) between the ages of 6 and 18 years. Of these 548 children, 302 children met DSM-IV criteria for ADHD, 199 were typically developing controls without ADHD, and 47 were classified as having situational or subthreshold ADHD. ADHD symptoms were assessed via parent report on a diagnostic interview and via parent and teacher report on the ADHD Rating Scale.

RESULTS

A bifactor model with a general factor and specific factors of inattention and hyperactivity-impulsivity fit best when compared with one-, two-, and three-factor models, and a second-order factor model.

CONCLUSIONS

A bifactor model of ADHD latent symptom structure is superior to existing factor models of ADHD. This finding is interpreted in relation to multi-component models of ADHD development, and clinical implications are discussed.

Gender differences in the effect of linguistic acculturation on substance use among Mexican-origin youth in the southwest United States

This study tested for gender differences in the impact of linguistic acculturation on pro-drug norms, substance use intentions, and actual substance use among youth of Mexican heritage in a large metropolitan area in the Southwest United States. The authors analyzed baseline survey data provided by 2,487 middle school students of Mexican heritage who were part of a larger, multiethnic randomized efficacy trial of a drug abuse prevention program. Using multi-group structural equation modeling, the authors found that linguistic acculturation was positively and directly related to adherence to pro-drug norms, substance use intentions, and recent alcohol use, controlling for age, poor grades, and socioeconomic status. In addition, linguistic acculturation had an indirect effect on substance use intentions and recent alcohol use through pro-drug norms. The direct effect of linguistic acculturation on pro-drug norms was stronger for girls than for boys, as was its indirect effect on substance use intentions.

Assessing the concordance of measures used to diagnose adult ADHD

OBJECTIVE

Recent evidence suggests that ADHD persists into adulthood, but the best means of diagnosis and the concordance of measures used to diagnose adult ADHD are unknown.

METHOD

The current study explores the relationships of these measures in a sample of 69 mothers of children with ADHD.

RESULTS

This study determines the concordance of (a) self- and collateral reports on diagnostic interviews and (b) diagnostic interviews and self-report paper-and-pencil ADHD symptom measures.

CONCLUSION

Results suggest that self- and collateral reports of inattentive and hyperactive/impulsive symptoms are highly correlated, as are self-report measures and diagnostic interviews. Additionally, it was found that probands report more inattentive symptoms than collaterals in both childhood and currently. Potential implications for the assessment of adult ADHD are presented.

Attention on inattention: the differential effect of caregiver education on endorsement of ADHD symptoms

The impact of caregiver education level on endorsement of attention-deficit hyperactivity disorder (ADHD) symptoms for inattention (IA) and hyperactivity-compulsivity (HA) in a sample of high-risk youths was examined. Participants were 1347 caregivers of varying educational backgrounds who completed the ADHD module of the Diagnostic Interview Schedule for Children IV. The relationship of caregiver education to ADHD symptom endorsement was examined in three sets of analyses in which IA and HA symptoms were simultaneously regressed on caregiver years of education. Both multivariate analysis of covariance and logistic regression analyses revealed significantly lower rates of IA symptom endorsement by caregivers with less education, while there was no effect for HA symptoms. A multiple indicator multiple cause (MIMIC) model analysis also revealed that caregiver years of education was significantly positively associated with IA but not with HA symptoms, even when other demographic factors were controlled. There is a clear effect of caregiver education on ADHD symptom endorsement patterns, raising concerns that demographic factors related to symptom measurement may contribute to discrepancies in the assessment and treatment of ADHD.

Self-report of ADHD symptoms in university students: cross-gender and cross-national prevalence

Little research has examined the structure and prevalence of attention-deficit/hyperactivity disorder (ADHD) symptoms in university students, including whether symptom structure conforms to the bidimensional (i.e., inattention and hyperactivity-impulsivity) conceptualization of the Diagnostic and Statistical Manual of Mental Disorders (DSMV-IV; American Psychiatric Association, 1994) and whether self-reported symptoms vary across gender and country. A sample of 1,209 university students from three countries (Italy, New Zealand, and the United States) completed a 24-item self-report measure (the Young Adult Rating Scale) tapping ADHD symptomatology. Factor analyses within the U.S. and New Zealand samples supported a bidimensional symptom structure, whereas weaker support for this conceptualization was provided by the Italian sample. Participants did not vary significantly by gender in symptom report; however, Italian students reported significantly more inattention and hyperactivity-impulsivity symptoms than students from the United States, and students from New Zealand reported more inattention symptoms than students from the United States. The prevalence of self-reported ADHD symptoms beyond DSM-IV thresholds for diagnosis ranged from 0% (Italian women) to 8.1% (New Zealand men). The implications of these results for the use of DSM-IV criteria in identifying university students with ADHD are discussed.