Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark.
Res Dev Disabil. 2022 Jun;125:104220. doi: 10.1016/j.ridd.2022.104220. Epub 2022 Apr 21.
Most studies support a bifactor model of childhood ADHD with two specific factors. However, several studies have not compared this model with a bifactor model with three specific factors, few have tested the actual strength of the factors, and none have examined whether "talks excessively" should be treated as a hyperactivity versus impulsivity symptom in children with ADHD.
To examine the factor structure of ADHD symptoms and evaluate the relative strength of potential factors.
Parent-reports on the ADHD-Rating Scale (ADHD-RS-IV) were collected for 2044 schoolchildren from the general population and 147 children with ADHD from a clinical sample. Single-, two- and three-(correlated and bi-)factor models were tested using confirmatory factor analysis.
Most models had a satisfactory fit. However, a correlated three-factor model where "talks excessively" was included as an indicator of impulsivity, and especially a bifactor model with one strong, well-defined general and two/three (ICD-10 defined) weak specific factors fit the data slightly better than the remaining models.
The factor structure is best characterized by a bifactor model with a strong general factor and two/three weaker specific factors. Therefore, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.
大多数研究支持儿童 ADHD 的双因子模型，有两个特定的因子。然而，一些研究没有将该模型与具有三个特定因子的双因子模型进行比较，很少有研究测试因子的实际强度，也没有研究过“过度说话”是否应该被视为 ADHD 儿童的多动与冲动症状。
检验 ADHD 症状的因子结构，并评估潜在因子的相对强度。
从一般人群中收集了 2044 名学龄儿童和 147 名 ADHD 儿童的 ADHD 评定量表（ADHD-RS-IV）家长报告，使用验证性因子分析对单因子、双因子和三因子（相关和双因子）模型进行了检验。
大多数模型拟合度良好。然而，一个相关的三因子模型，其中“过度说话”被纳入冲动的指标，尤其是一个具有一个强、定义明确的一般因子和两个/三个（ICD-10 定义）弱的特定因子的双因子模型，比其余模型稍微更好地拟合数据。
该因子结构最好由一个具有强一般因子和两个/三个较弱特定因子的双因子模型来描述。因此，我们建议在临床实践中强调 ADHD-RS-IV 的总分而不是子量表分数。
