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评估儿童和成人的 ADHD 症状:评估客观测量的作用。

Assessing ADHD symptoms in children and adults: evaluating the role of objective measures.

机构信息

Clinical Child and Adolescent Psychology, Department of Psychology, Philipps University Marburg, Gutenbergstr. 18, 35037, Marburg, Germany.

Clinic for Child and Adolescent Psychiatry, University Clinic Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.

出版信息

Behav Brain Funct. 2018 May 18;14(1):11. doi: 10.1186/s12993-018-0143-x.

Abstract

BACKGROUND

Diagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Applying subjective measures always incorporates risks such as informant biases or large differences between ratings obtained from diverse sources. Furthermore, it has been demonstrated that ratings and tests seem to assess somewhat different constructs. The use of objective measures might thus yield valuable information for diagnosing ADHD. This study aims at evaluating the role of objective measures when trying to distinguish between individuals with ADHD and controls. Our sample consisted of children (n = 60) and adults (n = 76) diagnosed with ADHD and matched controls who completed self- and observer ratings as well as objective tasks. Diagnosis was primarily based on clinical interviews. A popular pattern recognition approach, support vector machines, was used to predict the diagnosis.

RESULTS

We observed relatively high accuracy of 79% (adults) and 78% (children) applying solely objective measures. Predicting an ADHD diagnosis using both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5%) and children (86.7%), with the subjective variables proving to be the most relevant.

CONCLUSIONS

We argue that objective measures are more robust against rater bias and errors inherent in subjective measures and may be more replicable. Considering the high accuracy of objective measures only, we found in our study, we think that they should be incorporated in diagnostic procedures for assessing ADHD.

摘要

背景

诊断指南建议使用多种方法来评估和诊断 ADHD。应用主观测量总是会带来一些风险,如信息提供者的偏见或来自不同来源的评分之间的巨大差异。此外,已经证明评分和测试似乎评估了略有不同的结构。因此,客观测量可能会为 ADHD 的诊断提供有价值的信息。本研究旨在评估在试图区分 ADHD 患者和对照组时使用客观测量的作用。我们的样本包括被诊断为 ADHD 的儿童(n=60)和成人(n=76)以及匹配的对照组,他们完成了自我和观察者评分以及客观任务。诊断主要基于临床访谈。我们使用了一种流行的模式识别方法,支持向量机,来预测诊断。

结果

我们观察到,仅使用客观测量的准确率相对较高,分别为 79%(成人)和 78%(儿童)。使用主观和客观测量来预测 ADHD 诊断,对于成人(89.5%)和儿童(86.7%)来说,其准确率都超过了客观测量的准确率,其中主观变量被证明是最相关的。

结论

我们认为,客观测量更能抵抗评分者偏见和主观测量固有的误差,并且可能更具有可重复性。考虑到客观测量的高准确率,我们在研究中发现,我们认为它们应该被纳入 ADHD 评估的诊断程序中。

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