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Garcia-Rosales A, Cortese S, Vitoratou S. Measurement invariance of Attention Deficit/Hyperactivity Disorder symptom criteria as rated by parents and teachers in children and adolescents: A systematic review. PLoS One 2024; 19:e0293677. [PMID: 38394179 PMCID: PMC10889893 DOI: 10.1371/journal.pone.0293677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/17/2023] [Indexed: 02/25/2024] Open
Abstract
This systematic review aimed to establish the extent to which each Attention Deficit/Hyperactivity Disorder (ADHD) symptom criterion is being assessed without being influenced (biased) by factors such as informant, sex/gender, and age. Measurement invariance (MI) testing using confirmatory factor analysis (CFA) is the prime statistical method to ascertain how these factors may affect the measurement and colour the perception or interpretation of symptom criteria. Such effects (non-invariance) can be operationalised in the form of altered association of a symptom criterion with the measured trait (expressed via variations in CFA loadings which represent the weight of each symptom criterion) due to the factor(s) and/or artificially alter the probability of endorsement of a particular symptom criterion (expressed via variations in the CFA threshold(s) representing how mild or severe a given symptom is). Based on a pre-registered protocol (CRD42022276105), we searched PubMed, Global Health, Embase and PsycInfo up to 21-02-23 for studies that included MI assessments on specific ADHD symptom criteria in individuals aged 0-18 years old, using parental and/or teacher report. Self-reports were excluded, given the poor reliability of self-report in ADHD. All included studies met specific COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria. Results were synthesised in tabular form, grouping results by factors (e.g. informant) from 44 studies retained. Most comparisons indicated both metric (same loadings) and scalar invariance (same thresholds) with regard to informant, gender, age, temporal (repeated assessments) and co-morbidity. Therefore, the available evidence supports the current diagnostic criteria. However, findings could have been improved by systematic reporting of the direction of bias and its effect size. There appears to be a bias towards reporting MI instead of non-invariance. More studies in the literature are needed where the amalgamation of information provided by different informs and the association of specific symptoms with comorbidity are analysed.
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Affiliation(s)
- Alexandra Garcia-Rosales
- MRC Social Genetic Developmental and Psychiatry Centre, King’s College London, Institute of Psychiatry, Psychology, and Neurosciences, London, United Kingdom
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King’s College, London, United Kingdom
- Universidad Autónoma de Madrid, Madrid, Spain
- Kensington & Chelsea Child and Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, United Kingdom
| | - Samuele Cortese
- School of Psychology, Centre for Innovation in Mental Health (CIMH), Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- Hassenfeld Children’s Hospital at NYU Langone, New York University Child Study Center, New York, New York, United States of America
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Horizon Centre, CAMHS West, Solent NHS Trust, Southampton, United Kingdom
| | - Silia Vitoratou
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King’s College, London, United Kingdom
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Osborne JB, Zhang H, Carlson M, Shah P, Jonides J. The association between different sources of distraction and symptoms of attention deficit hyperactivity disorder. Front Psychiatry 2023; 14:1173989. [PMID: 37575583 PMCID: PMC10421702 DOI: 10.3389/fpsyt.2023.1173989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) are generally distractible. Yet, the precise relationship between ADHD and distractibility remains under-specified in two respects. First, different sources of distraction, such as background noise or mind wandering, may not be equally associated with ADHD. Second, ADHD itself comprises a variety of symptoms that show considerable heterogeneity and it is unclear which ADHD symptoms are associated with which type of distraction. Methods The current study addresses these questions using one clinically evaluated sample (N = 69) and two large non-clinically evaluated samples (N = 569, N = 651). In all samples, participants completed questionnaires about their susceptibility to external distraction, unwanted intrusive thoughts, spontaneous mind-wandering and ADHD symptomatology. Results Traditional regression and novel network analyses revealed an overwhelming contribution of spontaneous mind-wandering in explaining ADHD symptoms, although external distraction and unwanted intrusive thoughts were also associated with a small number of ADHD symptoms. Discussion Findings support a growing body of literature linking spontaneous mind-wandering and ADHD, and they highlight the heterogeneity in the association between ADHD symptoms and different sources of distraction.
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Affiliation(s)
- Jahla B. Osborne
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
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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.
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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
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4
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Garcia-Rosales A, Vitoratou S, Faraone SV, Rudaizky D, Banaschewski T, Asherson P, Sonuga-Barke E, Buitelaar J, Oades RD, Rothenberger A, Steinhausen HC, Taylor E, Chen W. Differential utility of teacher and parent-teacher combined information in the assessment of Attention Deficit/Hyperactivity Disorder symptoms. Eur Child Adolesc Psychiatry 2021; 30:143-153. [PMID: 32246275 PMCID: PMC7864845 DOI: 10.1007/s00787-020-01509-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 03/09/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Consistent research findings indicate that parents and teachers observe genuinely different Attention Deficit/Hyperactivity Disorder (ADHD) behaviours in their respective settings. OBJECTIVE To evaluate the utility of information provided by teacher informant assessments (INFAs) of ADHD symptoms, and the implications of aggregation algorithms in combing parents' information, i.e. using 'or-rule' (endorsement by either one informant) versus 'and-rule' (endorsement by both informants). METHOD Teacher ratings on Conners scales and clinical data from parental accounts on 1383 probands and their siblings from the IMAGE study were analysed. The psychometric properties of teacher and combined ratings using the item response theory model (IRT) are presented. Kappa coefficients, intraclass correlations and linear regression were employed. RESULTS First, teacher endorsement of symptoms is located in a narrow part of the trait continuum close to the average levels. Symptoms exhibit comparable perception in the measurement of the trait(s) with similar discrimination ability and information (reliability). Second, the IRT properties of the 'or-rule' ratings are predominantly influenced by parent-INFAs; and the 'and-rule' ratings predominantly by teacher-INFAs ratings. Third, parent-teacher INFAs agreement was low, both for individual items (κ = 0.01-0.15) and for dimensional scores (r = 0.12-0.16). The 'or-rule' captured milder expressions of ADHD symptoms, whereas the 'and-rule' indexed greater severity of ADHD. CONCLUSIONS Parent and teacher-INFAs provide different kinds of information, while both are useful. Teacher-INFA and the 'and-rule' provide a more accurate index of severity than an additive symptom count. Parent-INFA and the 'or-rule' are more sensitive for detecting cases with milder ADHD.
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Affiliation(s)
- Alexandra Garcia-Rosales
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK.
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK.
- Universidad Autónoma de Madrid, Madrid, Spain.
| | - Silia Vitoratou
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Daniel Rudaizky
- Centre for the Advancement of Research on Emotion, School of Psychological Sciences, University of Western Australia, Perth, Australia
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Philip Asherson
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Edmund Sonuga-Barke
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert D Oades
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
- Child and Adolescent Mental Health Center, Capital Region Psychiatry, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Southern Denmark University, Odense, Denmark
| | - Eric Taylor
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Wai Chen
- Complex Attention and Hyperactivity Disorders Service (CAHDS), Child and Adolescent Health Service (CAHS), Department of Health Western Australia, Crawley, Australia
- Faculty of Health and Medical Sciences, Paediatrics, University of Western Australia, Crawley, Australia
- Centre for Child & Adolescent Related Disorders, Graduate School of Education, University of Western Australia, Crawley, Australia
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5
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Vitoratou S, Garcia-Rosales A, Banaschewski T, Sonuga-Barke E, Buitelaar J, Oades RD, Rothenberger A, Steinhausen HC, Taylor E, Faraone SV, Chen W. Is the endorsement of the Attention Deficit Hyperactivity Disorder symptom criteria ratings influenced by informant assessment, gender, age, and co-occurring disorders? A measurement invariance study. Int J Methods Psychiatr Res 2019; 28:e1794. [PMID: 31310449 PMCID: PMC7649942 DOI: 10.1002/mpr.1794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/29/2019] [Accepted: 05/05/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study aims to ascertain whether the differences of prevalence and severity of attention deficit hyperactivity disorder (ADHD) are true or whether children are perceived and rated differently by parent and teacher informant assessments (INFAs) according to gender, age, and co-occurring disorders, even at equal levels of latent ADHD traits. METHODS Use of latent trait models (for binary responses) to evaluate measurement invariance in children with ADHD and their siblings from the International Multicenter ADHD Gene data. RESULTS Substantial measurement noninvariance between parent and teacher INFAs was detected for seven out of nine inattention (IA) and six out of nine hyperactivity/impulsivity (HI) items; the correlations between parent and teacher INFAs for six IA and four HI items were not significantly different from zero, which suggests that parent and teacher INFAs are essentially rating different kinds of behaviours expressed in different settings, instead of measurement bias. However, age and gender did not affect substantially the endorsement probability of either IA or HI symptom criteria, regardless of INFA. For co-occurring disorders, teacher INFA ratings were largely unaffected by co-morbidity; conversely, parental endorsement of HI symptoms is substantially influenced by co-occurring oppositional defiant disorder. CONCLUSIONS Our findings suggest general robustness of Diagnostic and Statistical Manual of Mental Disorders ADHD diagnostic items in relation to age and gender. Further research on classroom presentations is needed.
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Affiliation(s)
- Silia Vitoratou
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Alexandra Garcia-Rosales
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK.,Psychiatry Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Edmund Sonuga-Barke
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert D Oades
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland.,Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.,Child and Adolescent Mental Health Center, Capital Region Psychiatry, Copenhagen, Denmark.,Department of Child and Adolescent Psychiatry, Southern Denmark University, Odense, Denmark
| | - Eric Taylor
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Wai Chen
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK.,Complex Attention and Hyperactivity Disorders Service (CAHDS), Specialised Child and Adolescent Mental Health Services (CAMHS), WA Department of Health, Perth, Western Australia, Australia.,Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, Division of Paediatrics and Child Health and Division of Psychiatry and Clinical Neurosciences, The University of Western Australia, Perth, Western Australia, Australia
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6
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Cortese S, Rohde LA. ADHD diagnoses: are 116 200 permutations enough? THE LANCET. CHILD & ADOLESCENT HEALTH 2019; 3:844-845. [PMID: 31649002 DOI: 10.1016/s2352-4642(19)30328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, and Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK; Solent National Health Service Trust, Southampton, UK; New York University Child Study Center, New York, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Luis Augusto Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, Brazil; Departmento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Silk TJ, Malpas CB, Beare R, Efron D, Anderson V, Hazell P, Jongeling B, Nicholson JM, Sciberras E. A network analysis approach to ADHD symptoms: More than the sum of its parts. PLoS One 2019; 14:e0211053. [PMID: 30657783 PMCID: PMC6338383 DOI: 10.1371/journal.pone.0211053] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 01/07/2019] [Indexed: 01/14/2023] Open
Abstract
In interpreting attention-deficit/hyperactivity disorder (ADHD) symptoms, categorical and dimensional approaches are commonly used. Both employ binary symptom counts which give equal weighting, with little attention to the combinations and relative contributions of individual symptoms. Alternatively, symptoms can be viewed as an interacting network, revealing the complex relationship between symptoms. Using a novel network modelling approach, this study explores the relationships between the 18 symptoms in the Diagnostic Statistical Manual (DSM-5) criteria and whether network measures are useful in predicting outcomes. Participants were from a community cohort, the Children’s Attention Project. DSM ADHD symptoms were recorded in a face-to-face structured parent interview for 146 medication naïve children with ADHD and 209 controls (aged 6–8 years). Analyses indicated that not all symptoms are equal. Frequencies of endorsement and configurations of symptoms varied, with certain symptoms playing a more important role within the ADHD symptom network. In total, 116,220 combinations of symptoms within a diagnosis of ADHD were identified, with 92% demonstrating a unique symptom configuration. Symptom association networks highlighted the relative importance of hyperactive/impulsive symptoms in the symptom network. In particular, the ‘motoric’-type symptoms as well as interrupts as a marker of impulsivity in the hyperactive domain, as well as loses things and does not follow instructions in the inattentive domain, had high measures of centrality. Centrality-measure weighted symptom counts showed significant association with clinical but not cognitive outcomes, however the relationships were not significantly stronger than symptom count alone. The finding may help to explain heterogeneity in the ADHD phenotype.
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Affiliation(s)
- Timothy J. Silk
- School of Psychology, Deakin University, Geelong, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- * E-mail:
| | - Charles B. Malpas
- Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Australia
| | - Richard Beare
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Daryl Efron
- Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- The Royal Children’s Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children’s Research Institute, Melbourne, Australia
- The Royal Children’s Hospital, Melbourne, Australia
| | - Philip Hazell
- Discipline of Psychiatry, University of Sydney, Sydney, Australia
| | - Brad Jongeling
- Joondalup Child Development Centre, Perth, Australia
- Department of Paediatrics, University of Western Australia, Perth, Australia
| | - Jan M. Nicholson
- Murdoch Children’s Research Institute, Melbourne, Australia
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Emma Sciberras
- School of Psychology, Deakin University, Geelong, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- The Royal Children’s Hospital, Melbourne, Australia
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8
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Attention-deficit hyperactivity disorder (ADHD): progress and controversy in diagnosis and treatment. Ir J Psychol Med 2018. [DOI: 10.1017/ipm.2018.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Knowledge about attention-deficit hyperactivity disorder (ADHD) is rapidly accumulating. Recent advances in diagnosis, genetics, neuroimaging, drug and non-drug treatments are considered, and the results are related to the critical attack on the ADHD diagnosis, which argues it a medicalising social construct, unhelpfully sustaining power relationships. The advances reviewed suggest that, while this attack can be conclusively dismissed as wrong and misleading, the phenomenological definition of ADHD is no longer sufficient for construct validity, though continues to be valuable as a guide for clinicians. The humanising and individualising concerns underlying the attack on the diagnosis could usefully be redirected to improving effective measurement of patient outcomes.
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9
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Sturm A, McCracken JT, Cai L. Evaluating the Hierarchical Structure of ADHD Symptoms and Invariance Across Age and Gender. Assessment 2017. [PMID: 28621145 DOI: 10.1177/1073191117714559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The bifactor model of attention-deficit/hyperactivity disorder (ADHD) has been extensively explored, yet the tendency of the bifactor model to overfit data necessitates investigation of alternative, more parsimonious models, such as a modified bifactor structure. The present study used item response theory to compare unidimensional, correlated factors, bifactor, and modified bifactor models of ADHD symptoms in a clinical sample of youth ( N = 1,612) and examined differential item functioning (DIF) by age (<11 and ≥11 years) and gender. Results suggested that two restricted bifactor models showed superior fit compared with alternative models, and support strong general and inattention dimensions, with unreliable hyperactivity and impulsivity dimensions. No DIF was found across gender or age. The present study confirms that the general dimension (i.e., inhibition) and one specific dimension (i.e., sustained attention) represent distinct variability in ADHD symptoms that may improve prediction of symptom persistence, treatment response, or functional outcomes.
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Affiliation(s)
- Alexandra Sturm
- 1 University of California Los Angeles, Los Angeles, CA, USA
| | | | - Li Cai
- 1 University of California Los Angeles, Los Angeles, CA, USA
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10
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Thome J, Dittmann RW, Greenhill LL, Lipsius S, Tanaka Y, Bushe C, Escobar R, Heinloth AN, Upadhyaya H. Predictors of relapse or maintenance of response in pediatric and adult patients with attention-deficit/hyperactivity disorder following discontinuation of long-term treatment with atomoxetine. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2017; 9:219-229. [PMID: 28477289 DOI: 10.1007/s12402-017-0227-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
We identified relapse/maintenance-of-response (MOR) predictors following discontinuation of long-term atomoxetine treatment in pediatric and adult patients with attention-deficit/hyperactivity disorder (ADHD) and assessed correlations between ADHD symptoms and quality of life (QoL). Post hoc analyses of data from two randomized, double-blind, placebo-controlled, phase 3 withdrawal studies in patients with ADHD meeting predefined response criteria before randomization. Study 1: patients (N = 163; 6-15 years) received atomoxetine (1.2-1.8 mg/kg/day) for 1 year, followed by randomization to atomoxetine (n = 81) or placebo (n = 82) for 6 months. Study 2: patients (N = 524; 18-50 years) received atomoxetine (80-100 mg/day) for ~6 months, followed by randomization to atomoxetine (n = 266) or placebo (n = 258) for ~6 months. Placebo patients were used for the analyses. Relapse: ≥50% worsening of prerandomization improvement in ADHD symptoms and ≥2 level severity increase on the Clinical Global Impression-Severity (CGI-S) scale at 2 consecutive visits; MOR: retaining ≥75% of prerandomization symptom improvement and CGI-S ≤ 2 at all visits (study 1); retaining ≥70% of prerandomization symptom improvement and CGI-S ≤ 3 at all visits (study 2). In adults, statistically significantly (P ≤ .05) increased likelihood of relapse was associated with prerandomization presence of Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator-Rated:Screening Version (CAARS-Inv:SV) items "difficulty awaiting turn" and "careless mistakes." In pediatric patients, less MOR was associated with prerandomization presence of ADHD Rating Scale-IV-Parent Version Investigator-Rated item "does not listen"; in adults, less MOR was associated with prerandomization presence of CAARS-Inv:SV items "loses things" and "difficulty awaiting turn." Changes in patients' QoL after withdrawal from atomoxetine moderately correlated with changes in ADHD symptoms in pediatric patients and mildly in adults.
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Affiliation(s)
- Johannes Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Straße 20, 18147, Rostock, Germany
| | - Ralf W Dittmann
- Paediatric Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159, Mannheim, Germany
| | - Laurence L Greenhill
- Departments of Child and Adolescent Psychiatry, New York Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Sarah Lipsius
- inVentiv Health Clinical, LLC, 5430 Data Court, Suite 200, Ann Arbor, MI, 48108, USA
| | - Yoko Tanaka
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Chris Bushe
- Eli Lilly and Company, Lilly House, Priestley Road, Basingstoke, Hampshire, RG24 9NL, UK
| | - Rodrigo Escobar
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Alexandra N Heinloth
- inVentiv Health Clinical, LLC, 5430 Data Court, Suite 200, Ann Arbor, MI, 48108, USA
| | - Himanshu Upadhyaya
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
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Hierarchy and Psychometric Properties of ADHD Symptoms in Spanish Children: An Application of the Graded Response Model. PLoS One 2016; 11:e0164474. [PMID: 27736911 PMCID: PMC5063325 DOI: 10.1371/journal.pone.0164474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 09/26/2016] [Indexed: 11/19/2022] Open
Abstract
The Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria assume that the 18 symptoms carry the same weight in an Attention Deficit with Hyperactivity Disorder (ADHD) diagnosis and bear the same discriminatory capacity. However, it is reasonable to think that symptoms may differ in terms of severity and even in the reliability with they represent the disorder. To test this hypothesis, the aim of this study was to calibrate in a sample of Spanish children (age 4–7; n = 784) a scale for assessing the symptoms of ADHD proposed by Diagnostic and Statistical Manual of Mental Disorders, IV-TR within the framework of Item Response Theory. Samejima’s Graded Response Model was used as a method for estimating the item difficulty and discrimination parameters. The results showed that ADHD subscales (Attention Deficit and Hyperactivity / Impulsivity) had good psychometric properties and had also a good fit to the model. However, relevant differences between symptoms were observed at the level of severity, informativeness and reliability for the assessment of ADHD. This finding suggests that it would be useful to identify the symptoms that are more important than the others with regard to diagnosing ADHD.
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Molina-Carballo A, Checa-Ros A, Muñoz-Hoyos A. Treatments and compositions for attention deficit hyperactivity disorder: a patent review. Expert Opin Ther Pat 2016; 26:799-814. [DOI: 10.1080/13543776.2016.1182989] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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