Validity of the age-of-onset criterion for ADHD: A report from the DSM-IV field trials
Validity of the age-of-onset criterion for ADHD: A report from the DSM-IV field trials
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DOI：
10.1097/00004583-199709000-00013
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发表时间：
1997-09-01
影响因子：
13.3
通讯作者：
Shaffer, D
中科院分区：
文献类型：
--
作者：
Applegate, B;Lahey, BB;Shaffer, D
目的：检验 DSM-IV 要求因症状而出现损伤的年龄为 7 岁之前的有效性，以诊断注意力缺陷/多动障碍 (ADHD)。方法：在 380 名 4 至 17 岁青少年的临床样本中检验该标准的有效性，通过比较符合 ADHD 症状标准且在 7 岁之前表现出或未表现出障碍的青少年。结果：几乎所有符合多动冲动亚型症状标准的青少年也符合损伤的发病年龄标准，但满足混合型症状标准的青少年中有 18% 以及满足注意力不集中型症状标准的青少年中有 43% 在 7 岁之前没有表现出损伤。对于后两种亚型，要求在 7 岁之前出现损伤会降低识别当前 ADHD 损伤病例的准确性，并降低与临床医生判断的一致性。结论：这些发现对 DSM-IV 对 ADHD 发病年龄定义的有效性提出了质疑。 ADHD 三种亚型的症状和损害出现年龄的显着差异支持了 DSM-IV 中区分这些亚型的有效性。
Objective: To examine the validity of the DSM-IV requirement of an age of onset of impairment due to symptoms before 7 years of age for the diagnosis of attention-deficit/hyperactivity disorder (ADHD). Method: The validity of this criterion was examined in a clinic sample of 380 youths aged 4 through 17 years by comparing youths who met symptom criteria for ADHD and either did or did not display impairment before age 7 years. Results: Nearly all youths who met symptom criteria for the predominantly hyperactive-impulsive subtype also met the age of onset of impairment criterion, but 18% of youths who met symptom criteria for the combined type, and 43% of youths who met symptom criteria for the predominantly inattentive type, did not manifest impairment before 7 years. For the latter two subtypes, requiring impairment before age 7 years reduced the accuracy of identification of currently impaired cases of ADHD and reduced agreement with clinicians' judgments. Conclusions: These findings raise questions about the validity of the DSM-IV definition of age of onset of ADHD. Marked differences in the ages of onset of both symptoms and impairment for the three subtypes of ADHD support the validity of distinguishing among these subtypes in DSM-IV.