Bifactor Models of Attention-Deficit/Hyperactivity Disorder (ADHD): An Evaluation of Three Necessary but Underused Psychometric Indexes

Arias, Víctor; Ponce, Fernando P.; Núñez, Daniel

doi:10.1177/1073191116679260

Cited by 51 publications

(74 citation statements)

References 67 publications

(75 reference statements)

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“…The most important line of evidence comes from findings, largely in youths, that support a bifactor model rather than a simpler 2-factor model. 11 Bifactor models are defined as having a global factor (G) that captures variance shared by all symptoms, as well as specific factors (S) that capture variance shared among a smaller subset of symptoms that is uncorrelated with both the global factor and the other specific factors. It has been argued that bifactor models more accurately represent the etiological heterogeneity of ADHD: a bottom-up pathway resulting in hyperactivity/impulsivity, with inattention being secondary to those symptoms, and a top-down pathway leading mostly to inattention.…”

Section: Introductionmentioning

confidence: 99%

Examining the validity of the ADHD concept in adults and older adults

Callahan

Plamondon

2018

CNS Spectr.

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ObjectiveIt is crucial to clarify the structure of attention-deficit/hyperactivity disorder (ADHD) symptomatology in all age groups to determine how to best conceptualize this disorder across the lifespan. We tested the ADHD factor structure across adulthood and investigated independent associations with executive functions.MethodData from 645 adults aged 18–59 and 233 adults aged 60–85 were drawn from the Nathan Kline Institute Rockland Sample. Participants completed the Conners Adult ADHD Rating Scale and tests of executive functioning. Invariance of the ADHD factor structure was investigated using confirmatory factor analyses. Associations with cognition were explored using multiple linear regression.ResultsResults confirmed a bifactor model with 3 specific factors (inattention, hyperactivity, and impulsivity). Factor loadings and item intercepts were invariant across ages. Levels of hyperactivity and impulsivity were lower in older adults. Inattentive symptoms in young adults were positively related to cognitive flexibility. In older adults, ADHD symptoms predicted poorer working memory.ConclusionADHD symptoms manifest similarly across adulthood. The lack of robust associations between ADHD symptomatology and executive functions raises concerns about the usefulness of neuropsychological measures in diagnosing adult ADHD. These results support the validity of the ADHD concept in older adults but suggest a need for age-appropriate normative criteria.

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Section: Introductionmentioning

confidence: 99%

Examining the validity of the ADHD concept in adults and older adults

Callahan

Plamondon

2018

CNS Spectr.

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“…These findings accord with the scant reliability indices reported for specific factors within bifactor models of psychopathology (Martel, Pan, et al, 2017). Moreover, they accord with reliability of specific factors from bifactor models of narrower clinical constructs, including those of attention-deficit/hyperactivity disorder (Arias, Ponce, & Núñez, 2018;Willoughby, Fabiano, Schatz, Vujnovic, & Morris, 2017), disgust (Olatunji, Ebesutani, & Reise, 2015), and obsessive-compulsive disorder (Olatunji, Ebesutani, & Abramowitz, 2017).…”

Section: Summary and Implicationsmentioning

confidence: 64%

Riskier Tests of the Validity of Bifactor Models of Psychopathology

Watts¹,

Poore²,

Waldman³

2019

Preprint

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We advanced several “riskier tests” of the validity of bifactor models of psychopathology, which included that the general and specific factors should be reliable and well-represented by their indicators, and that including a general factor should improve the correlated factor model’s external validity. We compared bifactor and correlated factors models using data from a community sample of youth (N=2498) whose parents provided ratings on psychopathology and external criteria (i.e., temperament, aggression, antisociality). Bifactor models tended to yield either general or specific factors that were unstable and difficult to interpret. The general factor appeared to reflect a differentially-weighted amalgam of psychopathology rather than a liability for psychopathology broadly construed. With rare exceptions, bifactor models did not explain additional variance in psychopathology symptom dimensions or external criteria compared with correlated factors models. Together, our findings call into question the validity of bifactor models of psychopathology, and the p-factor more broadly.

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“…The dimensionality and internal structure of ADHD symptoms has been intensively researched in the last decades, in both the models proposed by the DSM and the International Statistical Classification of Diseases (ICD) (Bauermeister et al, 2010;Willcut et al, 2012) and alternative models that attempt to explain the high covariance among the totality of ADHD symptoms (e.g., Burns et al, 2014;Arias, Ponce, & Núñez, 2016). Most of these studies have been based on factor analysis.…”

Section: Manuscript To Be Reviewedmentioning

confidence: 99%

Peer Review #1 of "Identifying potentially marker symptoms of attention-deficit/hyperactivity disorder (v0.2)"

2018

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Background. For the diagnosis of attention-deficit/hyperactivity disorder (ADHD), the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes that adherence to six symptoms in either group (inattention and hyperactivity/impulsivity) will lead to the diagnosis of one of three presentations of the disorder. Underlying this diagnostic algorithm is the assumption that the 18 symptoms have equal relevance for the diagnosis of ADHD, all are equally severe, and all have the same power to detect the presence of the disorder in all its degrees of severity, without considering the possibility of using marker symptoms. However, several studies have suggested that ADHD symptoms differ in both their power to discriminate the presence of the disorder and the degree of severity they represent. The aim of the present study was to replicate the results of previous research by evaluating the discriminative capacity and relative severity of ADHD symptoms, as well as to extend the investigation of this topic to Spanish-speaking Latin American samples. Methods. The properties of ADHD symptoms rated by the parents of 474 Chilean children were analyzed. Symptom parameters were estimated using the graded response model. Results. The results suggest that symptoms of ADHD differ substantially in both the accuracy with which they reflect the presence of the disorder, and its relative severity. Symptoms "easily distracted by extraneous stimuli" and "have difficulty sustaining attention in tasks" (inattention) and "is on the go, acting as if driven by motor" (hyperactivity/impulsivity) were the most informative, and those with relatively lower severity thresholds. Discussion. The fact that symptoms differ substantially in the probability of being observed conditionally to the trait level suggests the need to refine the diagnostic process by weighting the severity of the symptom, and even to assess the possibility of defining ADHD marker symptoms, as has been done in other disorders.

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Bifactor Models of Attention-Deficit/Hyperactivity Disorder (ADHD): An Evaluation of Three Necessary but Underused Psychometric Indexes

Cited by 51 publications

References 67 publications

Examining the validity of the ADHD concept in adults and older adults

Examining the validity of the ADHD concept in adults and older adults

Riskier Tests of the Validity of Bifactor Models of Psychopathology

Peer Review #1 of "Identifying potentially marker symptoms of attention-deficit/hyperactivity disorder (v0.2)"

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