Maternal ratings of attention problems in ADHD: evidence for the existence of a continuum.
Maternal ratings of attention problems in ADHD: evidence for the existence of a continuum.
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ADHD中注意力问题的产妇评分：存在连续体的证据。
DOI：
10.1097/chi.0b013e3181ba3dbb
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发表时间：
2009-11
影响因子：
13.3
通讯作者：
Boomsma DI
中科院分区：
文献类型：
--
作者：
Lubke GH;Hudziak JJ;Derks EM;van Bijsterveldt TCEM;Boomsma DI
调查评估注意力问题的项目是否提供了注意力问题（AP）的数量差异或分类不同亚型的证据，并调查经验推导的潜在类别与注意力缺陷多动/冲动障碍（ADHD）亚型的DSM-IV诊断的关系，例如，组合亚型（CT）、主要疏忽型（PI）和主要多动/冲动型（H/I）。注意力问题的数据来自母亲对儿童行为检查表（CBCL）的评分。潜在的类模型，假设分类不同的亚型，因子混合模型，允许严重程度的差异，拟合从荷兰男孩在7岁（N=8079），10（N=5278）和12（N=3139）的数据。比较不同模型对数据的拟合，以决定哪种模型以及AP的哪种相应解释最合适。接下来，ADHD诊断回归到儿童子样本中的潜在类别成员资格。在所有3个年龄，区分三个主要数量上不同的类别（例如，轻度、中度和重度注意力问题）提供了对数据的最佳拟合。在每个类别中，CBCL项目测量三个相关的连续因素，可以解释为多动/冲动，注意力不集中/多梦和神经行为。AP重度类别包含所有诊断为ADHD-CT的受试者。一些被诊断患有ADHD PI的受试者处于中度AP类别。因子混合分析提供的证据表明，CBCL AP综合征的变化沿着轻度，中度，严重的注意力问题的严重程度连续。患有ADHD的儿童处于连续体的极端。这些数据对于临床医生、研究学者和DSM-V的制定者来说都很重要，因为它们提供了证据，证明ADHD诊断存在于一个连续体中，而不是作为离散的类别。
To investigate whether items assessing attention problems provide evidence of quantitative differences or categorically distinct subtypes of attention problems (AP), and to investigate the relation of empirically derived latent classes to DSM-IV diagnoses of subtypes of attention deficit hyperactivity/impulsivity disorder (ADHD), e.g., combined subtype (CT), Predominantly Inattentive Type (PI), and Predominantly Hyperactive/Impulsive Type (H/I). Data on attention problems were obtained from maternal ratings on the Child Behavior Check List (CBCL). Latent class models, which assume categorically different subtypes, and factor mixture models, which permit severity differences, are fitted to data obtained from Dutch boys at age 7 (N=8079), 10 (N=5278) and 12 (N=3139). The fit of the different models to the data is compared in order to decide which model, and hence which corresponding interpretation of AP, is most appropriate. Next, ADHD diagnoses are regressed on latent class membership in a subsample of children. At all 3 ages, models that distinguish between three mainly quantitatively different classes (e.g., mild, moderate, and severe attention problems) provide the best fit to the data. Within each class, the CBCL items measure three correlated continuous factors that can be interpreted in terms of hyperactivity/impulsivity, inattentiveness/dreaminess, and nervous behavior. The AP Severe class contains all subjects diagnosed with ADHD-CT. Some subjects diagnosed with ADHD PI are in the moderate AP class. Factor Mixture analyses provide evidence that the CBCL AP syndrome varies along a severity continuum of mild, moderate, to severe attention problems. Children affected with ADHD are at the extreme of the continuum. These data are important for clinicians, research scholars, and the framers of the DSM-V as they provide evidence that ADHD diagnoses exist on a continuum rather than as discrete categories.