Willoughby Michael T, Blanton Zane E
a FPG Child Development Institute, University of North Carolina at Chapel Hill.
J Clin Child Adolesc Psychol. 2015;44(1):68-79. doi: 10.1080/15374416.2013.850702. Epub 2013 Nov 20.
This study evaluated the fit and criterion validity of a recently proposed bi-factor structure for attention deficit/hyperactivity disorder (ADHD) symptoms. Participants were 1,093 children, drawn from an ongoing prospective longitudinal study, whose ADHD symptoms were rated by parents and teachers when children were in 1st grade. The criterion validity of the bi-factor model was established using a range of school-based outcomes that included treatment utilization, teacher perceptions of the need for treatment, academic functioning, and peer and teacher relationship quality. Results indicated that a bi-factor model parameterization provided an equally good fit to parent, teacher, and combined reports of ADHD symptoms as did traditional 1-, 2-, and 3-factor models. However, in contrast to traditional models, the bi-factor parameterization acknowledged both the unity and diversity of ADHD symptoms. The general ADHD latent factor explained the vast majority of the observed variation in every symptom. Whereas the general ADHD latent factor was significantly associated with all 15 outcomes, the specific Inattentive factor explained unique variation in 9 (primarily the academically oriented) outcomes and the specific Hyperactive-Impulsive factor explained unique variation in 2 outcomes. The general ADHD factor was more strongly correlated with each of the observed ADHD symptom scores (total, inattentive, hyperactive-impulsive) than was either specific factor. Results are discussed with respect to how changes in the conceptualization of the factor structure correspond to recent changes to the diagnostic criteria for ADHD, as well as whether/how individual differences in inattention and hyperactivity-impulsivity might be used to differentiate children who are diagnosed with ADHD.
本研究评估了最近提出的注意力缺陷/多动障碍（ADHD）症状双因素结构的拟合度和效标效度。参与者为1093名儿童，来自一项正在进行的前瞻性纵向研究，当儿童一年级时，由家长和教师对其ADHD症状进行评分。使用一系列基于学校的结果来确定双因素模型的效标效度，这些结果包括治疗利用情况、教师对治疗需求的看法、学业功能以及同伴和师生关系质量。结果表明，双因素模型参数化与传统的单因素、双因素和三因素模型一样，对家长、教师以及ADHD症状的综合报告具有同样良好的拟合度。然而，与传统模型不同的是，双因素参数化承认了ADHD症状的统一性和多样性。一般ADHD潜在因子解释了每种症状中绝大多数观察到的变异。虽然一般ADHD潜在因子与所有15项结果均显著相关，但特定的注意力不集中因子解释了9项（主要是与学业相关的）结果中的独特变异，特定的多动冲动因子解释了2项结果中的独特变异。一般ADHD因子与每个观察到的ADHD症状评分（总分、注意力不集中、多动冲动）的相关性比任何一个特定因子都更强。讨论了因子结构概念化的变化如何与ADHD诊断标准的近期变化相对应，以及注意力不集中和多动冲动方面的个体差异是否/如何可用于区分被诊断为ADHD的儿童。
