Romo L, Legauffre C, Mille S, Chèze N, Fougères A-L, Marquez S, Excoffier A, Dubertret C, Adès J
Laboratoire Evaclipsy, SPSE, université Paris-Ouest Nanterre-La Défense, 200, avenue de la République, 92001 Nanterre cedex, France.
Encephale. 2010 Oct;36(5):380-9. doi: 10.1016/j.encep.2009.12.005. Epub 2010 Jan 27.
The objective of this work was to analyse the factorial structure of the two following instruments: (1) the Wender Utah Rating Scale (WURS) evaluates the Attention Deficit Hyperactivity Disorders (ADHD) for adults, with 25 items: the subjects describe their own childhood behaviour when they were 7 years old, (from few to very much, 0 to 4). The items are grouped in four clusters: affects and emotional problems; impulsivity and conduct disorders; impulsivity-hyperactivity; and difficulties in attention. A score of 46 or more strongly suggests diagnosis of a hyperactivity disorder during infancy; (2) Brown's (1996) Attention Deficit Disorders Scale (ADD) is a 40-item self-report. This scale is composed of a range of symptoms beyond the DSM-IV inattention criteria for ADHD. A score of 50 or more is strongly suggestive of ADD. The five clusters of this scale are: organizing and activating work; sustaining attention and concentration; sustaining energy and effort; managing affective interference; utilizing "working memory" and accessing recall.
For comparative purpose, we also used the Adult Self-Report Scale (ASRS), which evaluates ADHD with six items and accepts a cut-off of four or more; the Barratt Impulsivity Scale, and the Personality Inventory Revised, essentially with the neuroticism cluster. A total of 259 adult subjects were enrolled in this study and allocated to three groups: healthy subjects, depressive patients and alcoholic patients.
This study indicates that the internal consistency for the French version of the ADD and WURS scales is adequate (α=0.8-0.9). The WURS and ADD scales are not fully validated, as both sensitivity to change and concurrent validity for all groups are missing. However, these adapted versions are interesting because they facilitate the use of the questionnaires for research and clinical assessment within healthy general and clinical populations. The study confirmed the psychometric properties of the two scales evaluating ADHD: Wender's Hyperactivity Scale during childhood and Brown's Attention Deficit Disorder Scale for adults (ADD). A larger patient sample would permit clearer conclusions. Nevertheless, the obtained results are very encouraging.
The ASRS has already been validated. It has shown its utility as a screening tool (well correlated with the Brown's ADD Scale) and gives us a better understanding of the nature of difficulties met by patients in terms of attention. We would like to complete this study in the short-term by increasing the patient sample size and harmonizing evaluation instruments by applying the three scales (ADD, WURS and ASRS) within the three groups. Our results support the idea that the clinical population showed an elevated presence of ADD and this disorder needs to be assessed.
本研究旨在分析以下两种工具的因子结构:(1)温德犹他评定量表(WURS)用于评估成人注意力缺陷多动障碍(ADHD),共25个项目:受试者描述自己7岁时的童年行为(从很少到非常多,0至4分)。这些项目分为四个类别:情感和情绪问题;冲动和品行障碍;冲动 - 多动;以及注意力困难。得分46分及以上强烈提示婴儿期患有多动障碍;(2)布朗(1996年)注意力缺陷障碍量表(ADD)是一个40项的自我报告量表。该量表包含了一系列超出《精神疾病诊断与统计手册》第四版(DSM-IV)中ADHD注意力不集中标准的症状。得分50分及以上强烈提示患有ADD。该量表的五个类别为:组织和启动工作;维持注意力和专注力;维持精力和努力;管理情感干扰;利用“工作记忆”和提取回忆。
为了进行比较,我们还使用了成人自我报告量表(ASRS),该量表用6个项目评估ADHD,临界值为4分及以上;巴拉特冲动量表,以及修订的人格问卷,主要关注神经质类别。本研究共纳入259名成年受试者,并分为三组:健康受试者、抑郁症患者和酒精依赖患者。
本研究表明,ADD和WURS量表的法语版本内部一致性良好(α = 0.8 - 0.9)。WURS和ADD量表尚未完全验证,因为所有组的变化敏感性和同时效度均缺失。然而,这些改编版本很有意义,因为它们便于在健康普通人群和临床人群中用于研究和临床评估。该研究证实了评估ADHD的两个量表的心理测量特性:儿童期的温德多动量表和成人的布朗注意力缺陷障碍量表(ADD)。更大的患者样本将有助于得出更明确的结论。尽管如此,所获得的结果非常令人鼓舞。
ASRS已经得到验证。它已显示出作为筛查工具的效用(与布朗的ADD量表相关性良好),并使我们能更好地理解患者在注意力方面遇到的困难的本质。我们希望在短期内通过增加患者样本量并在三组中应用这三个量表(ADD、WURS和ASRS)来统一评估工具,从而完成这项研究。我们的结果支持这样一种观点,即临床人群中ADD的发生率较高,这种疾病需要进行评估。