Pineda David A, Puerta Isabel C, Aguirre Daniel C, García-Barrera Mauricio A, Kamphaus Randy W
Neurosciences Group, University of Antioquia, Medellín, Colombia.
Pediatr Neurol. 2007 Jun;36(6):373-81. doi: 10.1016/j.pediatrneurol.2007.02.002.
Attention, memory, executive function, language, and visual-motor skills were evaluated in a sample of 621 children, 6 to 11 years old, to assess the discriminant validity of neuropsychologic testing. Attention deficit hyperactivity disorder cases (249) and controls (372) were identified and tested. Analysis of covariance, nonparametric comparison tests, effect sizes, discriminant function, factor analyses, and receiver-operator characteristics curve analyses were used to establish the best diagnostic cutoff points for each variable. Statistically significant differences were found on cognitive effort, auditory skills, continuous performance test, working memory, visual-motor skills, verbal comprehension, and executive function measures (P < 0.05); however, the effect of group sizes was low to modest (0.24 to 0.54). Receiver-operator characteristics curve analysis showed modest sensitivity and low specificity, demonstrating that an important proportion of the variance in test scores was overlapping. Factor analysis of neuropsychologic testing results revealed a structure of six factors each for attention deficit hyperactivity disorder, control, and combined samples. The latent variables produced one discriminant function with a total correct classification accuracy of 61.9%. Neuropsychologic tests should be used as Attention Deficit Hyperactivity Disorder diagnostic tools with caution, but they hold promise for identifying core cognitive deficits and processes that can aid prevention and intervention.
对621名6至11岁儿童的样本进行了注意力、记忆力、执行功能、语言和视动技能评估，以评估神经心理学测试的判别效度。确定并测试了注意力缺陷多动障碍病例（249例）和对照组（372例）。使用协方差分析、非参数比较测试、效应大小、判别函数、因子分析和受试者工作特征曲线分析来确定每个变量的最佳诊断临界点。在认知努力、听觉技能、连续操作测试、工作记忆、视动技能、语言理解和执行功能测量方面发现了统计学上的显著差异（P<0.05）；然而，组间大小的效应较低至中等（0.24至0.54）。受试者工作特征曲线分析显示敏感性中等，特异性较低，表明测试分数的很大一部分方差存在重叠。对神经心理学测试结果的因子分析揭示了注意力缺陷多动障碍、对照组和合并样本各有六个因子的结构。潜在变量产生了一个判别函数，总正确分类准确率为61.9%。神经心理学测试应谨慎用作注意力缺陷多动障碍的诊断工具，但它们有望识别可有助于预防和干预的核心认知缺陷和过程。
