General and specific attention-deficit/hyperactivity disorder factors of children 4 to 6 years of age: An exploratory structural equation modeling approach to assessing symptom multidimensionality.

Abstract

We tested first-order factor and bifactor models of attention-deficit/hyperactivity disorder (ADHD) using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) to adequately summarize the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, (DSM-IV-TR) symptoms observed in a Spanish sample of preschoolers and kindergarteners. Six ESEM and CFA models were estimated based on teacher evaluations of the behavior of 638 children 4 to 6 years of age. An ESEM bifactor model with a central dimension plus 3 specific factors (inattention, hyperactivity, and impulsivity) showed the best fit and interpretability. Strict invariance between the sexes was observed. The bifactor model provided a solution to previously encountered inconsistencies in the factorial models of ADHD in young children. However, the low reliability of the specific factors casts doubt on the utility of the subscales for ADHD measurement. More research is necessary to clarify the nature of G and S factors of ADHD.

Hierarchy and Psychometric Properties of ADHD Symptoms in Spanish Children: An Application of the Graded Response Model

“…The inattention (IA) subscale total score had a mean of 15.15 (SD = 5.89), and the hyperactivity-impulsivity (HI) subscale total had a mean of 16.46 (SD = 6.40). As expected [ 30 ], a sex comparison revealed significant differences: Boys scored higher on symptomology for both the IA ( F (1, 782) = 11.69, p = 0.001) and HI ( F (1, 782) = 5.122, p = 0.024) scales.…”

“…To ensure that the calibrated scale is useful, IRT requires that the empirical data fit the theoretical model. Although we do not have a universally accepted and unambiguous goodness-of-fit test [ 11 , 30 ], we nevertheless offer some evidence, which according to the literature, suggests a good fit [ 46 ]. Thus, we examine how easy it is to reach convergence, the size of the standard errors, M 2 and RMSEA statistics, the standardized local dependence statistics of each couplet of items, and the invariance of the discrimination and localisation parameters in two randomly selected subsamples.…”

“…Second, from the perspective of the clinical application of these evaluations, IRT models provide a considerably deeper knowledge of symptoms that ideally provide precise and valid instruments for the diagnosis, classification, and evaluation of treatment effectiveness. This need is particularly important in the case of ADHD, given the current questions and controversies regarding its nature, evaluation, and latent structure [ 30 – 32 ]. On the other hand, the DSM diagnostic criteria demands the presence of at least six symptoms within any of the two groups (inattention and hyperactivity/impulsivity) for an ADHD diagnosis in any of the subtypes of the disorder (presentations in the case of DSM-5).…”

Is Poor Working Memory a Transdiagnostic Risk Factor for Psychopathology?

“…Bifactor models of ADHD and the disruptive behavior disorders have also been fit (Arias, Ponce, Martínez-Molina, Arias, & Núñez, 2016; Martel, Gremillion, Roberts, von Eye, & Nigg, 2010; Martel, Roberts, Gremillion, von Eye, & Nigg, 2011; Martel, von Eye, & Nigg, 2012; Martel, von Eye, & Nigg, 2010; Toplak et al, 2009; Toplak et al, 2012) and significant bivariate correlations have been reported between (a) performance on the stop signal reaction time task (a measure of inhibitory control) and Trails A/B (a broad measure of set shifting) and (b) latent factor scores for hyperactivity/impulsivity and a general ADHD (but not a specific inattention) factor (Martel et al, 2011). That being said, it’s not clear whether the associations between the specific hyperactivity factor and performance would have remained significant if the relationship to general ADHD had been simultaneously parceled, or if more robust/latent indices of executive control had been used.…”

Measurement invariance of maternal ratings of ADHD symptoms across clinic referred children’s with and without ADHD

“…In general, mea-surement invariance across groups deals with whether the observed scores on a measure are the same across the groups when these scores "represent" the same level (intensity, severity) of the underlying latent trait score. [18,19] Lack of support for invariance indicates that the scores obtained by the groups cannot be accurately compared on the measure used, since any difference could be confounded by discrepancies in the scaling properties of the measure for the groups. [20] When applied to ADHD rating scales, measurement invariance across groups of children with and without ADHD refers to observed ADHD scores being the same across these groups, when individuals in the groups have the same level of the underlying ADHD latent trait.…”