Article

Subtypes versus severity differences in attention-deficit/hyperactivity disorder in the Northern Finnish Birth Cohort.

University of Notre Dame, Notre Dame, IN, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 6.35). 01/2008; 46(12):1584-93. DOI: 10.1097/chi.0b013e31815750dd
Source: PubMed

ABSTRACT To investigate whether behaviors of inattention, hyperactivity, and impulsivity among adolescents in Northern Finland reflect qualitatively distinct subtypes of ADHD, variants along a single continuum of severity, or of severity differences within subtypes.
Latent class models, exploratory factor models, and factor mixture models were applied to questionnaire data of ADHD behaviors obtained from the Northern Finland Birth Cohort (NFBC). Latent class models correspond to qualitatively distinct subtypes, factor analysis corresponds to severity differences, and factor mixture analysis allows for both subtypes and severity differences within subtypes.
A comparison of the different models shows that models that distinguish between a low scoring majority class (unaffecteds) and a high scoring minority class (affecteds), and allow for two factors (inattentive, hyperactive-impulsive) with severity differences provide the best fit.
The analysis provides support that a high-scoring minority group (8.8% of males and 6.8% of females) likely reflects an ADHD group in the Northern Finland Birth Cohort, whereas the majority of the population falls into a low-scoring group of unaffecteds. Distinct factors composed of items of inattention and hyperactivity-impulsivity are evident for both sexes with considerable variability in severity within each class.

Download full-text

Full-text

Available from: Gitta H Lubke, Jul 29, 2015
0 Followers
 · 
114 Views
  • Source
    • "One should also be clear whether the major goal of using FMM is to model nonnormality in an otherwise fairly conventional latent trait structure (i.e., factor mixture models that enforce strict invariance) or whether one is more interested in modeling latent subgroups that differ in qualitatively interesting ways, such as factor loadings (Masyn et al., 2010). Some of the most informative applications of FMMs to date have compared models that reflect plausible competing conceptions about the latent structure of psychopathology and that draw directly on prior theory (e.g., Lubke et al., 2007; Shevlin & Elklit, 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Over the past 75 years, the study of personality and personality disorders has been informed considerably by an impressive array of psychometric instruments. Many of these tests drawon the perspective that personality features can be conceptualized in terms of latent traits that vary dimensionally across the population. A purely trait-oriented approach to personality, however, might overlook heterogeneity that is related to similarities among subgroups of people. This article describes how factor mixture modeling (FMM), which incorporates both categories and dimensions, can be used to represent person-oriented and trait-oriented variability in the latent structure of personality. We provide an overview of different forms of FMM that vary in the degree to which they emphasize trait- versus person-oriented variability. We also provide practical guidelines for applying FMM to personality data, and we illustrate model fitting and interpretation using an empirical analysis of general personality dysfunction.
    Journal of Personality Assessment 10/2013; DOI:10.1080/00223891.2013.845201 · 2.01 Impact Factor
  • Source
    • "Finally, we examined correlations between parent and child cognitive performance across three different levels of attention symptoms. Previous work has suggested nonlinear relationships between symptoms and behavior (Lubke et al. 2007). Children's scores on the attention survey were broken into three equal-sized groups. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Understanding the relationship between brain and complex latent behavioral constructs like cognitive control will require an inordinate amount of data. Internet-based methods can rapidly and efficiently refine behavioral measures in very large samples that are needed for genetics and behavioral research. Cognitive control is a multifactorial latent construct that is considered to be an endophenotype in numerous neuropsychiatric disorders, including attention deficit/hyperactivity disorder (ADHD). While previous studies have demonstrated high correlations between Web- and lab-based scores, skepticism remains for its broad implementation. Methods Here, we promote a different approach by characterizing a completely Web-recruited and tested community family sample on measures of cognitive control. We examine the prevalence of attention deficit symptoms in an online community sample of adolescents, demonstrate familial correlations in cognitive control measures, and use construct validation techniques to validate our high-throughput assessment approach. Results A total of 1214 participants performed Web-based tests of cognitive control with over 200 parent-child pairs analyzed as part of the primary study aims. The data show a wide range of "subclinical" symptomatology in a web community sample of adolescents that supports a dimensional view of attention and also provide preliminary narrow-sense heritability estimates for commonly used working memory and response inhibition tests. Conclusions Finally, we show strong face and construct validity for these measures of cognitive control that generally exceeds the evidence required of new lab-based measures. We discuss these results and how broad implementation of this platform may allow us to uncover important brain-behavior relationships quickly and efficiently.
    Brain and Behavior 09/2013; 3(5):552-61. DOI:10.1002/brb3.158
  • Source
    • "The present study examined the patterns of DSM-IVADHD symptoms among adolescents with and without ID, and also investigated whether the two-factor measurement model of ADHD symptoms that has been supported in typically developing samples (Lubke et al. 2007) would replicate in a sample of adolescents with ID. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Children with intellectual and developmental disabilities are at heightened risk for mental disorders. Using current diagnostic criteria, disruptive behavior disorders, specifically Attention-Deficit/Hyperactivity Disorder (ADHD), appear to be the most prevalent co-occurring disorders. However, the validity of ADHD as a diagnosis for children and adolescents with intellectual disabilities remains unclear. The present study examined the clinical presentation of ADHD (prevalence, sex differences, and comorbidity) among adolescents with and without intellectual disability (ID) as well as investigated the validity of ADHD for adolescents with ID by examining similarities in terms of symptom presentation, developmental course, and associated functional impairment. The sample included 142 adolescents and their families, about a third of whom were classified in the ID group and the remaining were in the typically developing (TD) group. Findings indicated that adolescents with ID continue to be at elevated risk for ADHD (risk ratio: 3.38:1) compared to their typically developing peers. Additionally, the presentation of ADHD appeared similar among adolescents with and without ID, supporting the validity of an ADHD diagnosis for this population of adolescents. Implications for public policy and intervention are discussed.
    Journal of Abnormal Child Psychology 12/2012; 41(4). DOI:10.1007/s10802-012-9698-4 · 3.09 Impact Factor
Show more