Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes.
Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes.
复制标题
DOI：
10.1037/a0027347
复制
发表时间：
2012-11
影响因子：
4.6
通讯作者：
Lahey, Benjamin B.
中科院分区：
文献类型：
--
作者：
Willcutt, Erik G.;Nigg, Joel T.;Pennington, Bruce F.;Solanto, Mary V.;Rohde, Luis A.;Tannock, Rosemary;Loo, Sandra K.;Carlson, Caryn L.;McBurnett, Keith;Lahey, Benjamin B.
ADHD 的 DSM-IV 标准指定了注意力不集中和多动冲动症状的两个维度，用于定义三种名义亚型：主要多动冲动型 (ADHD-H)、主要注意力不集中型 (ADHD-I) 和组合型 (ADHD-C)。为了帮助 DSM-5 和其他未来诊断系统的决策，完成了对 546 项研究的全面文献综述和荟萃分析，以评估 ADHD DSM-IV 模型的有效性。结果表明，当智力、人口因素和并发的精神病理学受到控制时，DSM-IV 标准可识别出在社交、学术、职业和适应性功能方面存在显着和持续损害的个体。现有数据绝大多数支持注意力不集中和多动-冲动症状之间的区别的并发、预测和判别有效性，并表明名义亚型之间的几乎所有差异都与定义亚型的注意力不集中和多动-冲动症状的相对水平一致。相比之下，DSM-IV 亚型模型的有效性受到以下因素的影响：一年级后 ADHD-H 有效性的证据薄弱，在病因学影响、学业和认知功能以及治疗反应研究中对 ADHD-I 和 ADHD-C 之间区别的支持微乎其微，以及所有三种亚型的显着纵向不稳定性。总体而言，DSM-IV ADHD 亚型提供了一种方便的临床速记来描述当前注意力不集中和多动冲动症状水平的功能和行为相关性，但没有确定具有足够长期稳定性的离散亚组来证明该疾病的不同形式的分类是合理的。对于另一种模型来说，经验支持更强，该模型将用反映评估时注意力不集中和多动冲动症状数量的维度修饰符替换亚型。
DSM-IV criteria for ADHD specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision-making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the validity of the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, it is concluded that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the time of assessment.
登录
查看更多内容
影响因子：
2.3
作者：
Depue, Brendan E.;Burgess, Gregory C.;Willcutt, Erik G.;Bidwell, L. Cinnamon;Ruzic, Luka;Banich, Marie T.
通讯作者：
Banich, Marie T.
影响因子：
3.6
作者：
Gaub, M;Carlson, CL
通讯作者：
Carlson, CL
影响因子：
1.7
作者：
Cao, Qingjiu;Zang, Yufeng;Wang, Yufeng
通讯作者：
Wang, Yufeng
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
DOI：
10.1080/15374416.2010.517162
发表时间：
2010-01-01
影响因子：
4.2
作者：
Beck, Steven J.;Hanson, Christine A.;Benninger, William B.
通讯作者：
Benninger, William B.