Shemmassian Shirag K, Lee Steve S
1 University of California, Los Angeles, CA, USA.
J Atten Disord. 2017 Mar;21(5):405-415. doi: 10.1177/1087054714522511. Epub 2016 Jul 28.
To identify ADHD symptoms that are most highly predictive of ADHD diagnostic status and compare them against Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) algorithms in predictions of functional impairment.
Parent and teacher ratings of ADHD were obtained from an ethnically diverse (46% non-White) sample of 151 five- to ten-year-old children (27% female) with ( n = 76) and without ( n = 75) DSM-IV ADHD. We calculated total predictive values to estimate how ratings of each ADHD symptom predicted ADHD diagnostic status based on a structured parent diagnostic interview. Optimal symptom thresholds (i.e., not at all, just a little, pretty much, very much) for predicting ADHD caseness differed for inattention and hyperactivity and parents versus teachers. Algorithms consisting of highly predictive symptoms were then created and compared against DSM-IV-based algorithms to predict independent measures of functional impairment.
Several empirically derived symptom algorithms were more strongly associated with functional impairment than DSM-IV-based algorithms.
These preliminary findings suggest that alternative methods to aggregating ADHD symptoms may improve predictions of impairment.
确定对注意缺陷多动障碍（ADHD）诊断状态具有最高预测性的ADHD症状，并将其与《精神疾病诊断与统计手册》（第4版；DSM-IV）算法在功能损害预测方面进行比较。
从151名5至10岁儿童（27%为女性）的种族多样化样本（46%为非白人）中获取ADHD的家长和教师评分，其中76名患有DSM-IV ADHD，75名未患。我们计算了总预测值，以估计基于结构化家长诊断访谈，每种ADHD症状的评分如何预测ADHD诊断状态。预测ADHD病例的最佳症状阈值（即一点也没有、只是有一点、相当多、非常多）在注意力不集中和多动方面以及家长与教师之间有所不同。然后创建了由高度预测性症状组成的算法，并与基于DSM-IV的算法进行比较，以预测功能损害的独立指标。
与基于DSM-IV的算法相比，几种基于经验得出的症状算法与功能损害的关联更强。
这些初步发现表明，汇总ADHD症状的替代方法可能会改善对损害的预测。
