Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder.

Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8589, USA.
ADHD Attention Deficit and Hyperactivity Disorders 09/2012; 5(1). DOI: 10.1007/s12402-012-0091-5
Source: PubMed

ABSTRACT There is debate regarding the dimensional versus categorical nature of attention-deficit/hyperactivity disorder (ADHD). This study utilized confirmatory factor analysis to examine this issue. ADHD symptoms rated on interviews and rating scales from a large sample of individuals (ages 3-17, 74 % male, 75 % Caucasian) with ADHD were examined (n = 242). Four potential factor structures were tested to replicate prior findings in a sample with a wide age range and included only participants who met DSM-IV-TR diagnostic criteria for ADHD. Correlations with executive function measures were performed to further assess the separability and validity of the derived factors. The data support a bifactor model with a general ADHD factor and two specific factors, inattention and hyperactivity/impulsivity. Importantly, the individual factors were also differentially correlated with executive functioning measures. This study adds to a growing literature suggesting both a general component to ADHD, as well as dimensional traits of inattention and hyperactivity/impulsivity, associated with distinct executive functioning profiles. The presence of a general underlying factor contraindicates separating the inattentive and combined subtypes of ADHD into distinct disorders.

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    ABSTRACT: Objective: Studies demonstrate sluggish cognitive tempo (SCT) symptoms to be distinct from inattentive and hyperactive-impulsive dimensions of ADHD. No study has examined SCT within a bi-factor model of ADHD, whereby SCT may form a specific factor distinct from inattention and hyperactivity/impulsivity while still fitting within a general ADHD factor, which was the purpose of the current study. Method: A total of 168 children were recruited from an ADHD clinic. Most (92%) met diagnostic criteria for ADHD. Parents and teachers completed measures of ADHD and SCT. Results: Although SCT symptoms were strongly associated with inattention, they loaded onto a factor independent of ADHD g. Results were consistent across parent and teacher ratings. Conclusion: SCT is structurally distinct from inattention as well as from the general ADHD latent symptom structure. Findings support a growing body of research suggesting SCT to be distinct and separate from ADHD.
    Journal of Attention Disorders 07/2014; DOI:10.1177/1087054714539995 · 2.40 Impact Factor
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    ABSTRACT: The best structural model for attention-deficit/hyperactivity disorder (ADHD) symptoms remains a matter of debate. The objective of this study is to test the fit and factor reliability of competing models of the dimensional structure of ADHD symptoms in a sample of randomly selected and high-risk children and preadolescents from Brazil. Our sample comprised 2512 children aged 6–12 years from 57 schools in Brazil. The ADHD symptoms were assessed using parent report on the development and well-being assessment (DAWBA). Fit indexes from confirmatory factor analysis were used to test unidimensional, correlated, and bifactor models of ADHD, the latter including “g” ADHD and “s” symptom domain factors. Reliability of all models was measured with omega coefficients. A bifactor model with one general factor and three specific factors (inattention, hyperactivity, impulsivity) exhibited the best fit to the data, according to fit indices, as well as the most consistent factor loadings. However, based on omega reliability statistics, the specific inattention, hyperactivity, and impulsivity dimensions provided very little reliable information after accounting for the reliable general ADHD factor. Our study presents some psychometric evidence that ADHD specific (“s”) factors might be unreliable after taking common (“g” factor) variance into account. These results are in accordance with the lack of longitudinal stability among subtypes, the absence of dimension-specific molecular genetic findings and non-specific effects of treatment strategies. Therefore, researchers and clinicians might most effectively rely on the “g” ADHD to characterize ADHD dimensional phenotype, based on currently available symptom items.
    European Child & Adolescent Psychiatry 04/2015; DOI:10.1007/s00787-015-0709-1 · 3.55 Impact Factor
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    ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) is a heritable, chronic, neurobehavioral disorder that is characterized by hyperactivity, inattention, and impulsivity. It is commonly believed that the symptoms of ADHD are closely associated with hypo-function of the dopamine system. Dopamine D2 receptor activation decreases the excitability of dopamine neurons, as well as the release of dopamine. Physical exercise is known to improve structural and functional impairments in neuropsychiatric disorders. We investigated the therapeutic effect of exercise on ADHD. Open field task and elevated-plus maze task were used in the evaluation of hyperactivity and impulsivity, respectively. Dopamine D2 receptor expression in the substantia nigra and striatum were evaluated by western blotting. The present results indicated that ADHD rats showed hyperactivity and impulsivity. Dopamine D2 receptor expression in the substantia nigra and striatum were increased in ADHD rats. Exercise alleviated hyperactivity and impulsivity in ADHD rats. Furthermore, dopamine D2 receptor expression in ADHD rats was also decreased by exercise. We thus showed that exercise effectively alleviates ADHD-induced symptoms through enhancing dopamine D2 expression in the brain.
    12/2014; 18(4):379-84. DOI:10.5717/jenb.2014.18.4.379

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