Frazier Thomas W, Youngstrom Eric A, Naugle Richard I
Department of Psychiatry and Psychology, Section of Neuropsychology, The Cleveland Clinic.
Department of Psychology, University of North Carolina at Chapel Hill.
Neuropsychology. 2007 Jan;21(1):45-64. doi: 10.1037/0894-4105.21.1.45.
The question of whether attention-deficit/hyperactivity disorder (ADHD) represents a continuum of attentional and executive dysfunction or a natural category has yet to be extensively investigated. Subjective report and neuropsychological data from 437 individuals referred for neuropsychological evaluation were analyzed using latent class and taxometric analyses (mean above minus below a cut [MAMBAC], maximum eigenvalue [MAXEIG], and latent mode [LMODE]). Results indicated no significant evidence for a taxonic representation of ADHD across multiple procedures and indicator sets. Similarly, there was no evidence that ADHD subtypes represent a qualitative distinction. These findings may suggest that current diagnostic conceptualizations are inadequate for accurately identifying and characterizing individuals with problems related to attention and executive dysfunction. Alternatively, the null findings may have resulted from inadequate indicator selection. A dimensional model may better facilitate accurate identification of individuals at risk for functional impairment.
注意缺陷多动障碍（ADHD）究竟是代表注意力和执行功能障碍的连续体还是一个自然类别，这一问题尚未得到广泛研究。使用潜在类别分析和分类分析（平均高于减去低于切点 [MAMBAC]、最大特征值 [MAXEIG] 和潜在模式 [LMODE]）对437名因神经心理评估前来就诊的个体的主观报告和神经心理数据进行了分析。结果表明，在多种程序和指标集上，没有显著证据支持ADHD的分类表征。同样，也没有证据表明ADHD亚型代表了质的区别。这些发现可能表明，当前的诊断概念不足以准确识别和描述与注意力和执行功能障碍相关问题的个体。或者，无显著结果可能是由于指标选择不当所致。维度模型可能更有助于准确识别有功能损害风险的个体。
