Latent Structure of Sluggish Cognitive Tempo and ADHD Symptoms

认知节奏缓慢和多动症症状的潜在结构

• 批准号: 7586451
• 负责人: Robert Keith McBurnett
• 金额: $ 23.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7586451
• 关键词: Address; Anxiety; Arousal; Attention; Attention Deficit Disorder; Attention deficit hyperactivity disorder; Categories; Characteristics; Child; Classification; Clinic; Cognitive; Comorbidity; DSM-III; DSM-IV; Data; Data Reporting; Daydreams; Diagnostic; Diagnostic Procedure; Diagnostic and Statistical Manual; Diamond; Dimensions; Disease; Factor Analysis; Fatigue; Genetic; Hyperactive behavior; Impairment; Impulsivity; Interview; Interviewer; Left; Literature; Measurement; Measures; Mental disorders; Methods; Modeling; Mood Disorders; Movement; Parents; Patients; Prevalence; Psychometrics; Psychopathology; Research; Schedule; Schizophrenia; School-Age Population; Secondary to; Short-Term Memory; Sleep Deprivation; Structural Models; Structure; Symptoms; Syndrome; System; Testing; Typology; Universities; Update; alertness; base; biological adaptation to stress; depression; design; disease classification; falls; follow-up; inattention; informant; information processing; instrument; medical specialties; novel; novel diagnostics; novel strategies; public health relevance; response; teacher; treatment response

DESCRIPTION (provided by applicant): We propose to evaluate a new method of assessing Sluggish Cognitive Tempo (SCT), and to characterize its latent structure in relation to DSM-IV symptoms of ADHD. SCT is a syndrome that is distinct from Hyperactivity-Impulsivity and Inattention. It is associated with inattenttive types of ADHD. The original features of SCT were daydreams and seems sluggish or drowsy. The construct has been broadened descriptively refer to slow information processing, inconsistent working memory, difficulty maintaining alertness and arousal, difficulty maintaining orientation, and tendency toward slow movement and passivity (low initiative). Research into SCT has been constrained by unresolved measurement issues. No empirically-based method of assessing SCT is available. Most studies have used only 2-3 SCT items, a number far fewer than recommended for reliable measurement of a latent construct (Devellis, 2003). Another limitation is that SCT items are non-specific and may be related to a range of transitory states (fatigue, sleep deprivation, etc.) and other psychopathological conditions. Left uncorrected, this aspect of SCT items would spuriously increase the observed prevalence of SCT and the apparent comorbidity between SCT and internalizing disorders. The proposed study seeks to remedy this gap in the literature by evaluating an interviewer- based diagnostic interview, the Kiddie Sluggish Cognitive Tempo Interview (K-SCT). The K- SCT contains an expanded item pool (16 items). It prompts the interviewer to classify endorsed items as being either primary, or as secondary to another condition or to a transient state. We will use psychometric criteria, factor analysis, and latent class analysis to evaluate items and to explore what the nosological effects may be of introducing SCT into the ADHD symptom pool. ADHD-I has been criticized for being heterogeneous and for being incorrectly nested within the externalizing disorders. Such problems are the consequences of relying solely on the number of hyperactivity-impulsivity symptoms as the criterion for differentiating types. SCT items may make it possible to define ADHD-I in terms of a set of characteristic symptoms, rather than as children who display the same symptoms of inattention as ADHD-C, but fall short of 6 symptoms of hyperactivity-impulsivity. If SCT indeed characterizes the prototypical case of attention deficit disorder without hyperactivity, then latent modeling of an expanded pool of ADHD symptoms (ADHD+SCT) may aggregate cases into groups with more within-group similarities and fewer between-group similarities than is seen using the current system. This would facilitate the identification of genetic and treatment response differences among types. PUBLIC HEALTH RELEVANCE: The proposed study will evaluate a novel diagnostic procedure for Sluggish Cognitive Tempo (SCT) that overcomes several current limitations. It will also examine how SCT fits in with the existing ADHD symptoms in DSM-IV. The results may provide a guide for updating the diagnostic criteria for ADHD in a way that would enhance efforts to identify genetic and treatment response differences among the types.

描述（由申请人提供）：我们建议评估一种评估缓慢认知节奏（SCT）的新方法，并描述其与 ADHD 的 DSM-IV 症状相关的潜在结构。 SCT 是一种不同于多动冲动和注意力不集中的综合征。它与注意力缺陷多动症的注意力不集中类型有关。 SCT最初的特征是白日梦，看起来呆滞或昏昏欲睡。该结构已被描述性地扩大，涉及信息处理缓慢、工作记忆不一致、难以保持警觉和唤醒、难以保持方向以及缓慢运动和被动（主动性低）的倾向。 SCT 的研究受到未解决的测量问题的限制。没有基于经验的 SCT 评估方法。大多数研究仅使用 2-3 个 SCT 项目，这个数量远远少于可靠测量潜在结构所推荐的数量（Devellis，2003）。另一个限制是 SCT 项目是非特异性的，可能与一系列短暂状态（疲劳、睡眠不足等）和其他精神病理状况有关。如果不加以纠正，SCT 项目的这一方面将虚假地增加观察到的 SCT 患病率以及 SCT 与内化障碍之间的明显共病。拟议的研究旨在通过评估基于访谈者的诊断性访谈，即儿童缓慢认知节奏访谈（K-SCT）来弥补文献中的这一空白。 K-SCT 包含一个扩展的项目池（16 个项目）。它提示访谈者将认可的项目分类为主要项目，或作为其他条件或暂时状态的次要项目。我们将使用心理测量标准、因子分析和潜在类别分析来评估项目，并探讨将 SCT 引入 ADHD 症状库可能产生的疾病分类学影响。 ADHD-I 因异质性和错误地嵌套在外化障碍中而受到批评。这些问题都是单纯依靠多动冲动症状的数量作为区分类型的标准造成的。 SCT 项目可能可以根据一组特征症状来定义 ADHD-I，而不是像 ADHD-C 那样表现出相同的注意力不集中症状，但不具备 6 种多动冲动症状的儿童。如果 SCT 确实表征了没有多动症的注意力缺陷障碍的典型病例，那么对 ADHD 症状扩展库（ADHD+SCT）的潜在模型可能会将病例分组为组，与使用当前系统相比，组内相似性更多，组间相似性更少。这将有助于识别不同类型之间的遗传和治疗反应差异。公共健康相关性：拟议的研究将评估一种新的认知节奏缓慢 (SCT) 诊断程序，该程序克服了当前的一些限制。它还将检查 SCT 如何适应 DSM-IV 中现有的 ADHD 症状。这些结果可能为更新 ADHD 诊断标准提供指导，从而加强识别各类型之间遗传和治疗反应差异的努力。