McBurnett K, Pfiffner L J, Willcutt E, Tamm L, Lerner M, Ottolini Y L, Furman M B
Department of Psychiatry, University of Chicago, IL 60637, USA.
J Am Acad Child Adolesc Psychiatry. 1999 Jan;38(1):17-24. doi: 10.1097/00004583-199901000-00015.
To examine the discriminant validity of DSM-IV attention-deficit/hyperactivity disorder (ADHD) types by testing the hypothesis that types are associated with specific kinds of functional impairment and to compare overlap of DSM-IV and DSM-III-R ADHD.
Consecutive referrals (n = 692) to a pediatric subspecialty clinic for ADHD were classified into 1 of each of the 3 DSM-IV types of ADHD using parent and teacher checklist ratings of ADHD symptoms. The resulting types were compared on clinical correlates and on whether the children also met criteria for DSM-III-R ADHD.
The validity of DSM-IV types was supported by dimension-specific impairment and other distinct correlates. Academic problems aggregated in the 2 types defined by extreme inattention, and externalizing problems aggregated in the 2 types defined by extreme hyperactivity.
DSM-IV appeared superior to DSM-III-R in subcategorical homogeneity and in exhaustiveness (ability to classify all apparent cases).
通过检验ADHD类型与特定功能损害相关这一假设，来考察《精神疾病诊断与统计手册》第四版（DSM-IV）中注意缺陷/多动障碍（ADHD）各类型的判别效度，并比较DSM-IV和《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中ADHD的重叠情况。
连续转诊至一家儿科亚专科门诊的692名ADHD患儿，根据家长和教师对ADHD症状的清单评分，被分类为DSM-IV中3种ADHD类型中的一种。对所得类型在临床相关因素以及儿童是否也符合DSM-III-R中ADHD标准方面进行比较。
DSM-IV各类型的效度得到了特定维度损害及其他不同相关因素的支持。学业问题集中在由极度注意力不集中所定义的2种类型中，而外化问题集中在由极度多动所定义的2种类型中。
在亚类同质性和详尽性（对所有明显病例进行分类的能力）方面，DSM-IV似乎优于DSM-III-R。
