Exploration of the Factor Structure of ADHD in Adolescence through Self,Parent, and Teacher Reports of Symptomatology

Factor analytic studies of attention-deficit/hyperactivity disorder (ADHD) in children and adults have shown that second-order and bifactor models better represent ADHD symptoms than two- or three-factor models, yet there is far less evidence for a bestfitting model of ADHD in adolescence. Thus, the current study examined the factor structure of ADHD in adolescence and further evaluated the external validity of the best fitting model. Participants were 588 adolescents (22 % female; 366 with a childhood ADHD diagnosis; mean age 15.9 years) from the 8-year assessment of the Multimodal Treatment Study of Children with ADHD (MTA). ADHD symptoms were assessed via adolescent self-report, parent report, and teacher report on the SNAP-IV scale. Potential factor structures for the 18 symptoms of ADHD were tested for each informant, which included traditional one-factor, two-factor, and three-factor models of ADHD, as well as second-order factor (specific factors loading onto general factor) and bifactor (items loading onto both specific and general factors) models. Unique associations between external criteria and the identified factors of each informant’s best fitting model were examined. Although several of the proposed models exhibited good fit, the second-order two-factor model best accounted for ADHD in adolescence according to self-report and parent report, and the second-order three-factor model was optimal according to teacher report. Several key measurement issues emerged for the hierarchical bifactor models, such as numerous Heywood cases and out-of-bound parameter estimates, which rendered them unfit as optimal representations of ADHD in adolescence. These findings and the implications of the best fitting model of ADHD in adolescence suggest that a possible reorganization of this disorder may eventually aid clinicians in the accurate diagnosis of ADHD in adolescents.     

Evidence for a Higher-Order ESEM Structure of ADHD in a Sample of Chinese Children

Exploratory structural equation modeling (ESEM) solutions have been proposed to represent the factor structures of attention-deficit/hyperactivity disorder (ADHD) in recent literature, yet no studies have assessed those structures in Chinese children. The primary aim of this study was to comprehensively examine the factor structures of the Chinese version of the ADHD Rating Scale-IV (ADHD RS-IV): Home Version. Data on 458 Chinese children aged 3–8 years (boys: 246; 54%) were used to test and compare eleven factor models: confirmatory factor analysis (CFA) models (one-factor, two-factor and three-factor), second-order CFA model, bifactor CFA models (two and three specific factors), ESEM models (two-factor and three-factor), second-order ESEM model, and bifactor ESEM models (two and three specific factors). The results showed that, overall, ESEM models displayed better fit than CFA models. Specifically, the second-order ESEM model with three first-order factors best represented of the ADHD factor structure in our sample. In addition, measurement invariance testing results showed that scalar invariance was established across gender, age and informant groups. Implications for future research are discussed.

     

The structure of childhood disruptive behaviors

Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) frequently co-occur. Comorbidity of these 2 childhood disruptive behavior domains has not been satisfactorily explained at either a structural or etiological level. The current study evaluated a bifactor model, which allows for a "g" factor in addition to distinct component factors, in relation to other models to improve understanding of the structural relationship between ADHD and ODD. Participants were 548 children (321 boys, 227 girls) between the ages of 6 years and 18 years who participated in a comprehensive diagnostic assessment incorporating parent and teacher ratings of symptoms. Of these 548 children, 153 children were diagnosed with ADHD (without ODD), 114 children were diagnosed with ADHD + ODD, 26 children were diagnosed with ODD (without ADHD), and 239 children were classified as non-ADHD/ODD comparison children (including subthreshold cases). ADHD symptoms were assessed via parent report on a diagnostic interview and via parent and teacher report on the ADHD Rating Scale. ODD symptoms were assessed via teacher report. A bifactor model of disruptive behavior, comprising a "g" factor and the specific factors of ADHD and ODD, exhibited best fit, compared to 1-factor, 2-factor, 3-factor, and 2nd-order factor models of disruptive behaviors. It is concluded that a bifactor model of childhood disruptive behaviors is superior to existing models and may help explain common patterns of comorbidity between ADHD and ODD.     

The Factor Structure of ADHD – Different Models,Analyses and Informants in a Bifactor Framework

The methodological approach of exploratory structural equation modelling (ESEM) has only been applied once to the construct of Attention-deficit/hyperactivity disorder (ADHD). We decided to compare bifactor models based on confirmatory factor analyses (Bi-CFA) and exploratory equation modeling (Bi-ESEM) only, as there is a growing support of a bifactor structure of ADHD. To examine the factorial validity of the construct we compared three possible bifactor models. One model with two specific factors (inattention and hyperactivity/impulsivity), another model with three specific factors (inattention, hyperactivity and impulsivity) and an alternative, incomplete model with one general ADHD and two specific factors (inattention and impulsivity). We used parent- (N = 1386; Age: M = 11.70, SD = 3.18; Sex: 74.5 % male) and teacher-ratings (N = 110; Age: M = 11.27, SD = 3.04; Sex: 77.5 % male) from clinically referred children between the age of 6 and 18. The results indicate that both methods lead to equally good model fit and for both informants the reliable variance of the specific factor hyperactivity is almost completely explained by the general factor. However, in the teacher condition cross-loadings seem to be of particular importance. Across both methods and informants covariation among ADHD symptom items can be in most part attributed to a general ADHD factor as well as to three (inattention, hyperactivity and impulsivity) or two (inattention and impulsivity) weakly defined specific factors. Further research regarding associations between the specific factors of ADHD and other disorders (e.g. conduct disorder) should be conducted.     

Empirically based dimensions of externalizing symptoms in children and adolescents: a multitrait-multisource approach

The present study sought to refine knowledge about the structure underlying externalizing dimensions. From a “top-down” ICD/DSM-based perspective, externalizing symptoms can be categorized into attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). From a “bottom-up” developmental theory-based perspective, disruptive behaviors can be meaningfully described as aggressive (AGG) and rule-breaking (RB) behaviors. We analyzed five large data sets comprising externalizing symptom ratings obtained with a screening instrument using different sources (parents, teachers, self-ratings) from different samples. Using confirmatory factor analyses, we evaluated several factor models (unidimensional; correlated factors; bifactor (S-1) models) derived from an ICD/DSM- and theory-based perspective. Our optimally fitting models were assessed for measurement invariance across all sources, sample settings, and sex. Following several model-based criteria (model fit indices; factor loadings; omega statistics; model parsimony), we discarded our models stepwise and concluded that both the ICD/DSM-based model with three correlated factors (ADHD, ODD, CD) and the developmental theory-based model with three correlated factors (ADHD, AGG, RB) displayed a statistically sound factor structure and allowed for straightforward interpretability. Furthermore, these two models demonstrated metric invariance across all five samples and across sample settings (community, clinical), as well as scalar invariance across sources and sex. While the dimensions AGG and RB may depict a more empirically coherent view than the categorical perspective of ODD and CD, at this point we cannot clearly determine whether one perspective really outperforms the other. Implications for model selection according to our model-based criteria and clinical research are discussed.

     

Test-Retest Measurement Invariance of Clinic Referred Children’s ADHD Symptoms

This study examined the test-retest measurement invariance of ratings of the ADHD symptoms. Mothers of a group of 217 clinic-referred children (boys?=?169, girls?=?49; age range?=?7 to 17 years) completed ratings of the ADHD symptoms presented in a modified version of the Strengths and Weaknesses of ADHD-Symptoms and Normal Behavior Scale (SWAN-M) twice, 12 months apart. Confirmatory factor analysis (CFA) of their ratings at both time points provided more support for the bifactor model of ADHD [orthogonal general and specific factors for inattention (IA) and hyperactivity/impulsivity (HI) symptoms] over the 2-factor oblique model (factors for inattention IA and HI symptoms). For the bifactor model, measurement invariance testing using multiple-group CFA indicated support for configural and full scalar test-retest invariance when the chi-square difference test was applied. For metric invariance, all but one symptom showed invariance. When the differences in approximate fit indices were applied, there was support for full measurement invariance (configural, metric and scalar). The findings indicate that observed scores (based on maternal ratings of the SWAM-M), twelve months apart, are comparable as they have the same measurement properties. Several practical, theoretical, research and clinical implications of the findings are discussed.     

Testing a Bifactor Model of Relational and Physical Aggression in Early Childhood

Different approaches have been used to classify children as relationally aggressive, physically aggressive, or both relationally and physically aggressive (co-occurring aggression). The goal of the current study (N = 164, 50.9% boys, M _age = 47.75 months, SD = 7.37) was to test a bifactor model of aggression, which allows for aggression to be assessed dimensionally, and postulates a co-occurring aggression factor as well as unique relational and physical aggression factors, during early childhood. Aggression was measured using reliable observer and teacher reports of physical and relational aggression subscales. The two-factor model was an adequate fit to the data but the bifactor model was a significant improvement in model fit compared to the two-factor model. Alternative statistics for evaluating bifactor models were used in the current study. The measurement invariance (e.g., configural invariance, metric invariance, and scalar invariance) of the bifactor model was tested across gender and results from the bifactor model using teacher report showed that the model was invariant across gender. Lastly, the criterion validity of the model was examined by evaluating the relations between the bifactor model and observations of physical and relational aggression and results generally supported the validity of the bifactor model. Overall, results suggest that a bifactor model of aggression may be a useful method for studying aggression in early childhood.     

Psychometric properties of beliefs about relationship violence against women and gender stereotypes scale

This article describes psychometric properties of the Gender-Based Relationship Violence Beliefs Scale (BEREVIWOS) and the Gender Stereotypes and Beliefs (GESTABE) scale in a Nigerian setting. Analysis was based on a convenience sample of 202 respondents. Confirmatory factor analysis (CFA) was used to determine construct validity of the three-factor structure of each scale and measurement invariance procedures were utilised to determine whether the factor structure was equivalent across gender. Convergent and discriminant validity of the scales, and predictive and incremental validity were examined for consistency with theory on gender beliefs/stereotypes and violence in patriarchal society. A single-factor CFA model approach was used to examine common method bias. Results suggest the BEREVIWOS and GESTABE are multidimensional scales with an intercorrelated three-factor structure. The fit of the models and composite reliability were adequate. Scores from the BEREVIWOS and GESTABE appear reliable and valid measures of underlying beliefs and stereotypes associated with violence against women in Nigeria.     

The structure of the Hospital Anxiety and Depression Scale: Theoretical and methodological considerations

The Hospital Anxiety and Depression Scale (HADS; Zigmond - Snaith, 1983) is widely used; however, its factor structure is unclear, with studies reporting differing unidimensional, two-factor and three-factor models. We aimed to address some key theoretical and methodological issues contributing to inconsistencies in HADS structures across samples. We reviewed existing HADS models and compared their fit using confirmatory factor analysis (CFA). We also investigated methodological effects by comparing factor structures derived from Rasch and Principal Components Analysis (PCA) methods, as well as effects of a negative wording factor. An Australian community-dwelling sample consisting of 189 females and 158 males aged 17–86 (M = 35.73, SD = 17.41) completed the 14-item HADS. The Rasch Analysis, PCA and CFA all supported the original two-factor structure. Although some three-factor models had good fit, they had unacceptable reliability. In the CFA, a hierarchical bifactor model with a general distress factor and uncorrelated depression and anxiety subscales produced the best fit, but the general factor was not unidimensional. The addition of a negative wording factor improved model fit. These findings highlight the effects of differing methodologies in producing inconsistent HADS factor structures across studies. Further replication of model fit across samples and refinement of the HADS items is warranted.     

Assessment of Psychopathic Traits in Singaporean Adolescents: Validation of the Antisocial Process Screening Device (APSD)

There is little knowledge available concerning psychopathic traits in Asian adolescents; a lack of a suitable measurement instrument for assessing psychopathy in Asian societies may account for this. This study aimed to validate a widely used scale in the West — the Antisocial Process Screening Device (APSD) — in Singaporean school-based and at-risk adolescents. Using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA), this study examined the two-factor (i.e., grandiose-manipulative/impulsive traits and callous-unemotional traits) and three-factor (i.e., grandiose-manipulative traits, impulsivity, and callous-unemotional traits) models of the APSD in 1027 school-based and 113 at-risk adolescents. School samples are adolescents from three secondary schools, while at-risk samples are adolescents who manifest different types of delinquent behaviors and are either placed in more structured settings or need closer supervision although they have not violated the law. Gender invariance was further tested in the school-based sample by conducting a multigroup CFA. The convergent validity of the APSD was also investigated in the school-based sample. For the school-based adolescents, the APSD revealed that the three-factor model provided a superior fit over the two-factor model and the factorial invariance across gender. Significant relationships between the three dimensions of the APSD and aggression and delinquency support the convergent validity of the APSD. As for the at-risk adolescents, both the two- and three-factor models were acceptable, but the two-factor model was preferred as it was parsimonious and it aligned with the conceptualized characteristics of psychopathic traits. Findings suggest that the APSD is a reliable and sound instrument for measuring psychopathic traits in Asian school-based and at-risk adolescents.     

Evaluation of the Bifactor Structure of the Dispositional Hope Scale

The Dispositional Hope Scale (DHS; Snyder et al., 1991) is composed of items assessing an individual's perception of his or her agency and pathways. This study examined support for the bifactor structure and relation of the factors in this model with depressive symptoms. It also examined cross-gender measurement invariance for the bifactor model. A community sample of 413 women and 257 men completed the DHS. Confirmatory factor analysis indicated more support for the bifactor model than the 1- and 2-factor models. Results also indicated full measurement invariance across gender for the bifactor and the 2-factor models. The general and the specific agency factors, but not the specific pathways factor, correlated with depressive symptoms. The better support for the bifactor model suggests that ideally hope has to be measured and examined by factors reflecting high covariance for agency and pathways, and also factors reflecting unique variances for agency and pathways. The support for full cross-gender measurement invariance indicated that there are no differences in measurement and scaling properties for the DHS across ratings provided by women and men, and therefore the DHS ratings can be scored in the same way for women and men.     

Irritability and Emotional Impulsivity as Core Feature of ADHD and ODD in Children

The categorical approach of diagnosing mental disorders entails the problem of frequently occurring comorbidities, suggesting a more parsimonious structure of psychopathology. In this study, we therefore aim to assess how affective dysregulation (AD) is associated with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children. To assess AD in children aged 8–12 years (n?=?391), we employed the parent version of a newly constructed parent rating scale. Following item reduction, we conducted exploratory and confirmatory factor analyses to establish a factorial structure of AD. One core dimension was identified, comprising irritability and emotional impulsivity, and two smaller dimensions, comprising positive emotionality and exuberance. Subsequently, we examined five different latent factor models – a unidimensional model, a first-order correlated factor model, a second-order correlated factor model, a traditional bifactor model, and a bifactor S-1 model, in which the first-order factor AD-Irritability/Emotional Impulsivity (II) was modeled as the general reference factor. A bifactor S-1 model with the a priori defined general reference domain AD-II provided the best fit to our data and was straightforward to interpret. This model showed excellent model fit and no anomalous factor loadings. This still held true, when comparing it to bifactor S-1 models with ADHD/ODD-related reference factors. Differential correlations with emotion regulation skills and the established Parent Proxy Anger Scale validate the interpretation of the different dimensions. Our results suggest that irritability/emotional impulsivity might be a common core feature of ADHD and ODD.

     

The Unity and Diversity of Inattention and Hyperactivity/Impulsivity in ADHD: Evidence for a General Factor with Separable Dimensions

To examine the unity and diversity of inattention and hyperactivity/impulsivity symptom domains of Attention-Deficit/Hyperactivity Disorder (ADHD) in a clinical sample of adolescents with ADHD. Parents and adolescents were administered a semi-structured diagnostic interview, the Schedule for Affective Disorders and Schizophrenia for School-Age Children — Present and Lifetime Version (K-SADS-PL), to assess adolescent ADHD. Data from 201 parent interviews and 189 adolescent interviews were examined. Four potential factor structures for the 18 ADHD symptoms were tested using confirmatory factor analysis: two models with correlated factors and two bifactor models. A bifactor model with two specific factors best accounted for adolescent symptoms, according to both parent and adolescents’ reports. Replication of these findings from behavioral rating scales completed for this sample by parents and teachers indicates that the findings are not method– or informant-specific. The results suggest that there is an important unitary component to ADHD symptoms and separable dimensional traits of Inattention and Hyperactivity/Impulsivity.     

Factor Structure and Construct Validity of the Dutch Version of the Antisocial Process Screening Device

The goal of the present study was to evaluate the factor structure and construct validity of the Antisocial Process Screening Device (APSD) in a community sample of Dutch adolescents. Confirmatory factor analyses supported the two- and three-factor model, but the two-factor model (Callous-Unemotional and Impulsivity/Conduct Problems) was more parsimonious. Model fit was invariant across gender. Interrater reliability was good and internal consistency of the factors was modest to good, with the exception of the Callous-Unemotional factor. Convergence with the APSD self-report version, divergence with the Big Five personality dimensions of Agreeableness and Conscientiousness, and expected gender differences in mean APSD scores reproduced findings obtained in American samples, supporting the cross-cultural validity of the APSD.     

Evidence for a general factor model of ADHD in adults

Objective: To examine factor structures of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptoms of ADHD in adults. Method: Two sets of models were tested: (a) models with inattention and hyperactivity/impulsivity as separate but correlated latent constructs and (b) hierarchical general factor models with a general factor for all symptoms and separate specific factors for inattention and hyperactivity/impulsivity. Participants were 751 adults with ADHD. Two models with correlated factors and two general factor models of ADHD symptoms were tested. Results: The general factor model provided a better fit of the data than the correlated models. The general factor model with one general and three (inattention, motoric, and verbal hyperactivity/impulsivity) specific factors best accounted for the adults' symptoms. Conclusion: These results suggest a unitary component to ADHD symptoms as well as dimensional specific factors. The replication of a general factor in adults suggests continuity of symptom presentation from childhood into adulthood. Clinical implications are discussed.     

Psychometric Qualities and Measurement Invariance of the Modified Self‐Rated Creativity Scale

The 13‐item self‐rated creativity scale (SRCS) initially developed for supervisory rating of employees’ creativity was modified by some researchers and used as a self‐report of creativity. However, it is not clear if the modified SRCS is psychometrically sound. The present study addressed this gap in three studies (N = 1,033). The exploratory factor analysis (Study 1) revealed a two‐factor solution after removing Item 9 due to low factor loading. Confirmatory factor analysis was then used in Study 2 to examine and compare the conceptual one‐factor model with 13 items (Model 1), one‐factor model with 12 items (Model 2), two‐factor model with 12 items (Model 3), and the 12‐item bifactor model with one general factor and two specific factors (Model 4). The results indicated that Model 4 is more superior to all the competing models. Study 3 further confirmed that the bifactor model, showed support to the reliability and convergent validity, and found partial metric invariance across Chinese and Malay undergraduates. Taken together, the modified (12‐item) SRCS is a psychometrically sound tool for self‐rated creativity in the Malaysian context.     

Applying Bifactor Statistical Indices in the Evaluation of Psychological Measures

The purpose of this study was to apply a set of rarely reported psychometric indices that, nevertheless, are important to consider when evaluating psychological measures. All can be derived from a standardized loading matrix in a confirmatory bifactor model: omega reliability coefficients, factor determinacy, construct replicability, explained common variance, and percentage of uncontaminated correlations. We calculated these indices and extended the findings of 50 recent bifactor model estimation studies published in psychopathology, personality, and assessment journals. These bifactor derived indices (most not presented in the articles) provided a clearer and more complete picture of the psychometric properties of the assessment instruments. We reached 2 firm conclusions. First, although all measures had been tagged “multidimensional,” unit-weighted total scores overwhelmingly reflected variance due to a single latent variable. Second, unit-weighted subscale scores often have ambiguous interpretations because their variance mostly reflects the general, not the specific, trait. Finally, we review the implications of our evaluations and consider the limits of inferences drawn from a bifactor modeling approach.     

A confirmatory factor analysis on the DSM-IV ADHD and ODD symptoms: what is the best model for the organization of these symptoms?

Confirmatory factor analysis (CFA) was used to evaluate five different models for the organization of the DSM-IV ADHD and oppositional defiant disorder (ODD) symptoms (Model 1: a single factor model; Model 2: an ADHD and ODD two factor model; Model 3a: an inattention (INA), hyperactivity/impulsivity (HYP/IMP), and ODD three factor model; Model 3b: an INA, HYP/IMP, and ODD three factor model where the three IMP symptoms cross-load on the ODD factor; Model 4: an INA, HYP, IMP, and ODD four factor model). To evaluate these models, maternal ratings of ADHD and ODD symptoms were obtained at outpatient pediatric clinics on 742 children not in treatment and 91 children in treatment for ADHD. Model 3a resulted in a good fit as well as a significantly better fit than Model 2. Model 3a was also equivalent across treatment status, gender, and age groupings for the most part. Though Models 3b and 4 provided a statistically better fit than Model 3a, the improvement in fit was small and other model selection criteria argued against these more complex models.     

Self-concept in adults from Spain and Portugal

The aim of this work is to confirm the penta-factorial validity of the AF5 Self-Concept Questionnaire in Spanish and Portuguese adults. From the responses of a total of 2058 adults (1508 Spanish, 73.3%, and 550 Portuguese, 26.7%) was analyzed the reliability of the instrument, was compared the validity of the 5 oblique factor model proposed by the authors versus unifactorial and the orthogonal alternative models, and was studied the invariance of the Portuguese translation. The results of structural equation modeling supported the authors' penta-factorial model. The multi-group factorial invariance showed that Portuguese translation of the AF5 does not change neither the original factor weights, nor the variances and covariances of the factors. Finally, the reliability was good for the original Spanish version and Portuguese translation.