Wagner Flávia, Martel Michelle M, Cogo-Moreira Hugo, Maia Carlos Renato Moreira, Pan Pedro Mario, Rohde Luis Augusto, Salum Giovanni Abrahão
Attention Deficit/Hyperactivity Disorder Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350 - Room 2202, Porto Alegre, 90035-003, Brazil.
Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Eur Child Adolesc Psychiatry. 2016 Jan;25(1):83-90. doi: 10.1007/s00787-015-0709-1. Epub 2015 Apr 17.
The best structural model for attention-deficit/hyperactivity disorder (ADHD) symptoms remains a matter of debate. The objective of this study is to test the fit and factor reliability of competing models of the dimensional structure of ADHD symptoms in a sample of randomly selected and high-risk children and pre-adolescents from Brazil. Our sample comprised 2512 children aged 6-12 years from 57 schools in Brazil. The ADHD symptoms were assessed using parent report on the development and well-being assessment (DAWBA). Fit indexes from confirmatory factor analysis were used to test unidimensional, correlated, and bifactor models of ADHD, the latter including "g" ADHD and "s" symptom domain factors. Reliability of all models was measured with omega coefficients. A bifactor model with one general factor and three specific factors (inattention, hyperactivity, impulsivity) exhibited the best fit to the data, according to fit indices, as well as the most consistent factor loadings. However, based on omega reliability statistics, the specific inattention, hyperactivity, and impulsivity dimensions provided very little reliable information after accounting for the reliable general ADHD factor. Our study presents some psychometric evidence that ADHD specific ("s") factors might be unreliable after taking common ("g" factor) variance into account. These results are in accordance with the lack of longitudinal stability among subtypes, the absence of dimension-specific molecular genetic findings and non-specific effects of treatment strategies. Therefore, researchers and clinicians might most effectively rely on the "g" ADHD to characterize ADHD dimensional phenotype, based on currently available symptom items.
注意缺陷多动障碍（ADHD）症状的最佳结构模型仍存在争议。本研究的目的是在来自巴西的随机选择的高危儿童和青少年前期样本中，检验ADHD症状维度结构竞争模型的拟合度和因子可靠性。我们的样本包括来自巴西57所学校的2512名6至12岁的儿童。使用家长对发育与幸福感评估（DAWBA）的报告来评估ADHD症状。验证性因子分析的拟合指数用于检验ADHD的单维、相关和双因子模型，后者包括“g”ADHD和“s”症状领域因子。所有模型的可靠性用ω系数衡量。根据拟合指数以及最一致的因子载荷，一个包含一个一般因子和三个特定因子（注意力不集中、多动、冲动）的双因子模型对数据的拟合最佳。然而，基于ω可靠性统计，在考虑了可靠的一般ADHD因子后，特定的注意力不集中、多动和冲动维度提供的可靠信息很少。我们的研究提供了一些心理测量学证据，表明在考虑共同（“g”因子）方差后，ADHD特定（“s”）因子可能不可靠。这些结果与亚型之间缺乏纵向稳定性、缺乏维度特异性分子遗传学发现以及治疗策略的非特异性效应相一致。因此，基于目前可用的症状条目，研究人员和临床医生可能最有效地依靠“g”ADHD来描述ADHD维度表型。
