Parent–Adolescent Agreement on Disruptive Behavior Symptoms: A Multitrait-Multimethod Model

This study examined parent–adolescent agreement on reports of inattention, hyperactivity/impulsivity, and conduct disorder in 203 adolescents (94 girls, 109 boys) ranging in age from 13 to 18 years (M = 15.21, SD = 1.37). Results of confirmatory factor analyses provided additional evidence of construct validity for these traits in adolescents. Internal consistency was examined for parent reports and adolescent self-reports. In addition, correlational analyses were used in a multitrait-multimethod format (MTMM; D. T. Campbell & D. W. Fiske, 1959) to examine convergent and discriminant validity. Results showed that parents provided more consistent and valid reports of inattention and hyperactivity/impulsivity, whereas adolescents provided more consistent and valid reports of conduct disorder. In addition, interviews produced higher levels of convergence than rating scales. These findings are discussed in terms of implications for assessment of disruptive behavior disorders.     

Assessing inattention and impulsivity in children during the Go/NoGo task

Behavioural performance in the Go/NoGo task was compared with caregiver and teacher reports of inattention and hyperactivity‐impulsivity in 1,151 children (N=557 boys; N=594 girls) age 9–10 years old. Errors of commission (NoGo errors) were significantly correlated with symptom counts of hyperactivity‐impulsivity, while errors of omission (Go errors) were significantly correlated with symptom counts for inattention in both caregiver and teacher reports. Cross‐correlations were also evident, however, such that errors of commission were related to inattention symptoms, and errors of omission were related to hyperactivity‐impulsivity. Moreover, hyperactivity‐impulsivity and inattention symptoms were highly intercorrelated in both caregiver (r=.52) and teacher reports (r=.70), while errors of commission and omission were virtually uncorrelated in the Go/NoGo task (r=.06). The results highlight the difficulty in disentangling hyperactivity‐impulsivity and inattention in questionnaires, and suggest that these constructs may be more clearly distinguished in laboratory measures such as the Go/NoGo task.     

The validity of vigilance tasks in differential diagnosis of children referred for attention and learning problems

This study was conducted to evaluate the convergent and discriminant validity of vigilance measures of attention and impulsivity in children. One hundred children referred for evaluation of attention and learning problems were administered a battery of tests including two vigilance tasks, other laboratory measures of inattention and impulsivity, and parent and teacher ratings. It was predicted that vigilance task performance would correlate with teacher ratings and laboratory measures of inattention while correlations with ratings of aggressive behavior were predicted to be lower. Moderate correlations were obtained between the vigilance task scores and other laboratory measures of inattention and impulsivity. However, the vigilance scores did not correlate with teacher or parent ratings of behavior. A factor analysis, conducted to identify underlying dimensions of attention in the battery of tests, revealed strong source effects. The implications for use of vigilance measures in diagnosis are discussed.Portions of this paper were presented at the 1990 Learning Disabilities Association of America International Conference, Anaheim, California.     

A multitrait-multisource confirmatory factor analytic approach to the construct validity of ADHD rating scales

Confirmatory factor analysis was used to model a multitrait-multisource design to evaluate the construct validity of attention-deficit/hyperactivity disorder (ADHD) rating scales. The 2 trait factors were the ADHD inattention and hyperactivity/impulsivity dimensions. The 2 source factors were parents and teachers. In Study 1, parents and teachers rated 1,475 Australian elementary school children on the ADHD symptoms. In Study 2, parents and teachers rated 285 Brazilian elementary school children on the ADHD symptoms. Similar results occurred in both studies with most of the ADHD symptoms containing more source than trait variance, thus providing weak evidence for the convergent and discriminant validity of the symptoms as measured by rating scales. The study outlines the implications of such strong source effects for understanding ADHD.     

A Preliminary Study of ADHD Symptoms and Correlates: Do Abused Children Differ from Nonabused Children?

In this pilot study, differences in inattention, impulsivity, and hyperactivity as well as demographic factors were investigated in a community sample of 8- through 11-year-olds, approximately half of whom had experienced child abuse or neglect. Parents completed the Attention Deficit Hyperactivity Disorder Test, the SNAP-IV, the Brief Betrayal Trauma Survey – Parent version, and additional questions. Abused children had more severe impulsivity and inattention, but not hyperactivity, symptoms. Abused boys and girls had a similar age of onset of symptoms, whereas nonabused girls had a much later age of onset than nonabused boys. ADHD is a significant problem among maltreated children. These data support large scale studies investigating possible differences in etiology, presentation, and treatment.     

Temperament Pathways to Childhood Disruptive Behavior and Adolescent Substance Abuse: Testing a Cascade Model

Temperament traits may increase risk for developmental psychopathology like Attention-Deficit/Hyperactivity Disorder (ADHD) and disruptive behaviors during childhood, as well as predisposing to substance abuse during adolescence. In the current study, a cascade model of trait pathways to adolescent substance abuse was examined. Component hypotheses were that (a) maladaptive traits would increase risk for inattention/hyperactivity, (b) inattention/hyperactivity would increase risk for disruptive behaviors, and (c) disruptive behaviors would lead to adolescent substance abuse. Participants were 674 children (486 boys) from 321 families in an ongoing, longitudinal high risk study that began when children were 3 years old. Temperament traits assessed were reactive control, resiliency, and negative emotionality, using examiner ratings on the California Q-Sort. Parent, teacher, and self ratings of inattention/hyperactivity, disruptive behaviors, and substance abuse were also obtained. Low levels of childhood reactive control, but not resiliency or negative emotionality, were associated with adolescent substance abuse, mediated by disruptive behaviors. Using a cascade model, family risk for substance abuse was partially mediated by reactive control, inattention/hyperactivity, and disruptive behavior. Some, but not all, temperament traits in childhood were related to adolescent substance abuse; these effects were mediated via inattentive/hyperactive and disruptive behaviors. This work was supported by NIAAA grant R01-AA12217 to Robert Zucker and Joel Nigg, NIAAA grant R37-AA07065 to Robert Zucker and Hiram Fitzgerald, and NIMH grant R01-MH59105 to Joel Nigg. Martel was supported by 1 F31 MH075533-01A2. The authors thank the participants and Susan Refior, the long term MLS Field Director, whose steadfast commitment and support have made this study possible.     

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.     

A multitrait-multimethod analysis of variance of teachers' ratings of aggression,hyperactivity, and inattention

The convergent and discriminant validities of three teacher rating scale measures of the traits of hyperactivity, aggression, and inattention were explored, using the multitrait-multimethod matrix approach of Campbell and Fiske (1959), as well as an analysis of variance procedure (Stanley, 1961). In the present study teachers rated children from their elementary school classrooms on the above traits. The results provided strong evidence for convergent validity. Data also indicated that these traits can be reliably differentiated by teachers, suggesting that research aimed at better understanding the unique contributions of hyperactivity, aggression, and inattention is warranted. The respective benefits of analyzing multitrait-multimethod matrices by employing the ANOVAprocedure or by using the Campbell and Fiske (1959) criteria were discussed.     

The Tourette's Disorder Scale (TODS): development, reliability, and validity

To address the lack of a simple and standardized instrument to assess overall illness severity of Tourette's disorder (TD), the authors developed and tested a 15-item scale to measure a broad range of common symptoms including tics, inattention, hyperactivity, obsessions, compulsions, aggression, and emotional symptoms. Independent investigators used the 15-item Tourette's Disorder Scale (TODS) to assess 60 TD patients who were taking part in a double-blind placebo-controlled multicenter 8-week treatment study. Interrater reliability, internal consistency, convergent and discriminant validity, and sensitivity to change were examined. The TODS was associated with good interrater reliability, excellent internal consistency, and favorable levels of validity and sensitivity to change. Individual TODS items showed good convergent and discriminant validity against other measures. The TODS is a simple, efficient way for clinicians and parents to rate the severity of multiple symptoms commonly found in patients with Tourette's disorder.     

Antisocial behavior reduces the association between subdimensions of ADHD symptoms and alcohol use in a large population‐based sample of adolescents

The aim of this study was to investigate possible effects of antisocial behavior on reducing the association between subdimensions of ADHD symptoms (inattention, hyperactivity and impulsivity) and alcohol use. Boys and girls were analyzed separately using a population‐based Swedish adolescent sample. A randomly selected cross‐sectional survey was performed in secondary and upper secondary schools in Västmanland County during 2010. Participants were a population of 2,439 15–16 year‐olds and 1,425 17–18 year‐olds (1,947 girls and 1,917 boys). Psychosocial adversity, antisocial behaviors, symptoms of ADHD and alcohol use were assessed by questionnaires. Except for girls' inattention, subdimensions of ADHD symptoms were not associated with alcohol use when variance due to antisocial behavior was accounted for. Among boys, instead of an indirect effect of antisocial behavior on the association between impulsivity and alcohol use, a moderating effect was found. Among girls, the inattention component of ADHD was independently associated with alcohol use even when adjusted for antisocial behavior. The reduced associations between symptoms of hyperactivity, impulsivity, and alcohol use for boys and girls after adjusting for antisocial behavior suggest a considerable overlap between hyperactivity, impulsivity, and antisocial behavior. The direct pathway between inattention and alcohol use among girls suggests that girls with inattention symptoms are at risk of alcohol use regardless of antisocial behavior. Special attention should be given to these girls. Accounting for antisocial behavior reduced the relation between subdimensions of ADHD symptoms and alcohol use, and antisocial behaviors should therefore be screened for when symptoms of ADHD are present.     

Convergent and Discriminant Validity of Trait and Source Effects in ADHD-Inattention and Hyperactivity/Impulsivity Measures Across a 3-Month Interval

Confirmatory factor analysis was used to model a multitrait (ADHD-inattention and hyperactivity/ impulsivity) by multisource (teachers and parents) design across a 3-month interval in a sample of 360 Australian elementary school children. The purpose was to evaluate the convergent and discriminant validity of the ADHD-inattention (IN) and hyperactivity/impulsivity (H/I) measures. Although similar traits and similar sources showed stronger correlations across time than dissimilar traits and dissimilar sources, the amount of source variance in the ADHD-IN and ADHD-H/I measures was substantial and consistent across the interval (M = 59%; range = 35–84%). This large amount of source variance raises the possibility that the correlations of the IN and H/I rating scales with other constructs (e.g., social competence, conduct problems) represent mostly source rather than trait effects. Multitrait by multisource analyses provide a means to answer this question and further advance understanding of ADHD.     

Parenting Practices and Prospective Levels of Hyperactivity/Inattention Across Early- and Middle-Childhood

This study examined specific parenting practices as predictors of prospective levels of children’s hyperactivity/inattention across early- and middle-childhood. Participants were a mixed-sex community cohort (N?=?976; 52 % boys) aged 4–10 years (M?=?6.5, SD?=?1.3). Measures of parenting practices, hyperactivity/inattention, conduct problems, and maternal education were collected at baseline, and hyperactivity/inattention re-assessed at 12-month follow-up. Analyses examined predictors of 12-month hyperactivity/inattention while controlling for levels at baseline. High levels of parental involvement were associated with reduced levels of hyperactivity/inattention, but only across early childhood. Conversely, increases in child age were associated with increased levels of hyperactivity/inattention across middle-childhood, but only among children exposed to high levels of inconsistent discipline. Inconsistent discipline and parental involvement appear to be uniquely associated with prospective hyperactivity/inattention across childhood, independent of associated conduct problems. Our results further suggest some developmental specificity with regard to the effects of these distinct dimensions of parenting on hyperactivity/inattention at different points in childhood.     

Associations Between Attachment Narratives and Self-Report Measures of Attachment in Middle Childhood: Extending Evidence for the Validity of the Child Attachment Interview

The assessment of attachment security in infancy and adulthood is well-studied, but middle childhood has been relatively neglected in the literature. The Child Attachment Interview (CAI) represents a promising assessment of attachment in middle childhood; recent evidence supports its reliability and validity in restricted samples. We assessed the construct validity of the CAI among a diverse sample of 104 8–12 year-old children (M _age  = 9.80 years; 50 boys; 49 % family income <$40,000; 38 % Latino/a). We evaluated associations among CAI variables and self-report measures of attachment (convergent validity). Further, we evaluated whether CAI variables uniquely relate to theoretically-relevant constructs (internalizing symptoms) above and beyond self-reported attachment (incremental validity) and a theoretically-distinct construct, child temperament (discriminant validity). Our findings support the CAI’s validity, and have important implications for assessing and understanding attachment processes in middle childhood, as well as their development across the lifespan.     

The relationship of compliance with inattention and hyperactivity/impulsivity

The aim of the study was to investigate the relationship between Attention Deficit Hyperactivity Disorder (ADHD) inattention and hyperactivity/impulsivity symptoms in predicting compliance. It was hypothesised that inattention symptoms are a better predictor of compliance than hyperactivity/impulsivity. There were two different groups of participants: 367 college students (both males and females) and 89 male prisoners. All participants had completed the Gudjonsson Compliance Scale (GCS) and the DSM-IV-TR (Screening) Checklist for adult ADHD symptoms. Significant correlations emerged between compliance and ADHD symptoms, but the correlations were higher for inattention than hyperactivity/impulsivity among both samples. This was confirmed by multiple regression analyses (hierarchical), which showed that the variance in compliance explained by ADHD inattention versus hyperactivity/impulsivity symptoms increased from 2% to 8% for college students and 8% to 24% for prisoners after entering inattention into the model (hyperactivity/impulsivity was entered first in the regression models). The findings suggest that inattention is a more powerful predictor of compliance than hyperactivity/impulsivity. This is a novel and an important finding.     

Developmental change in the relation between executive functions and symptoms of ADHD and co‐occurring behaviour problems

In a sample of 92 children aged 6–13 years this study investigates the normal developmental change in the relation between executive functioning (EF) and the core behavioural symptoms associated with attention deficit hyperactivity disorder (ADHD) (hyperactivity/impulsivity and inattention) as well as symptoms often co‐occurring with childhood hyperactivity (conduct‐ and internalizing problems). EF was assessed by using multiple tests grouped through prior factor analysis, resulting in cognitive measures relating to disinhibition, speed/arousal, verbal working memory, non‐verbal working memory, and fluency. The results showed that although disinhibition was positively related to hyperactivity/impulsivity and inattention mainly for the youngest age group, there were no significant age effects for these relations. Instead, age effects were found for the relations between speed/arousal and inattention as well as for the relations between verbal working memory/fluency and inattention. In the oldest age group poor performance on these cognitive measures was associated with high ratings of inattention. For the total sample a relation was obtained between disinhibition and hyperactivity/impulsivity as well as between both working memory measures and internalizing problems. In conclusion, the results from this study suggest that poor inhibition is most clearly associated with ADHD symptoms for younger children, whereas poor functioning with regard to later developing and more complex executive functions such as working memory and fluency is associated with ADHD symptoms for older children. Copyright © 2006 John Wiley & Sons, Ltd.     

Validity of the Sluggish Cognitive Tempo, Inattention, and Hyperactivity Symptom Dimensions: Neuropsychological and Psychosocial Correlates

This study examined the latent structure and validity of inattention, hyperactivity-impulsivity, and sluggish cognitive tempo (SCT) symptomatology. We evaluated mother and teacher ratings of ADHD and SCT symptoms in 140 Puerto Rican children (55.7% males), ages 6 to 11?years, via factor and regression analyses. A three-factor model (inattention, hyperactivity-impulsivity, and SCT) provided the best fit for both sets of ratings. Inattention was the strongest correlate of lower scores on neuropsychological, achievement, and psychosocial measures. Externalizing problems were most strongly associated with hyperactivity-impulsivity, and internalizing problems were most strongly associated with parent-rated SCT and teacher-rated Inattention. SCT was not associated with executive function but was negatively associated with math. Inattention accounted for a disproportionate amount of ADHD-related impairment, which may explain the restricted discriminant validity of DSM-IV types. The distinct factors of hyperactivity-impulsivity and SCT had unique associations with impairing comorbidities and are roughly equivalent in predicting external correlates of ADHD-related impairment.     

A Multitrait–Multisource Confirmatory Factor Analytic Approach to the Construct Validity of ADHD and ODD Rating Scales with Malaysian Children

Confirmatory factor analysis (CFA) was used to model a multitrait by multisource matrix to determine the convergent and discriminant validity of measures of attention-deficit hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) in 917 Malaysian elementary school children. The three trait factors were ADHD-IN, ADHD-HI, and ODD. The two source factors were parents and teachers. Similar to earlier studies with Australian and Brazilian children, the parent and teacher measures failed to show convergent and discriminant validity with Malaysian children. The study outlines the implications of such strong source effects in ADHD-IN, ADHD-HI, and ODD measures for the use of such parent and teacher scales to study the symptom dimensions.     

Etiology of Inattention and Hyperactivity/Impulsivity in a Community Sample of Twins with Learning Difficulties

A community sample of 373 8 to 18 year-old twin pairs in which at least one twin in each pair exhibited a history of learning difficulties was utilized to examine the etiology of inattention and hyperactivity/impulsivity (hyp/imp). Symptoms of attention-deficit/hyperactivity disorder (ADHD) were assessed by the DSM-III Diagnostic Interview for Children and Adolescents. Inattention and hyp/imp composite scores were created based on results of a factor analysis. Results indicated that extreme ADHD scores were almost entirely attributable to genetic influences across several increasingly extreme diagnostic cutoff scores. Extreme inattention scores were also highly heritable whether or not the proband exhibited extreme hyp/imp. In contrast, the heritability of extreme hyp/imp increased as a linear function of the number of inattention symptoms exhibited by the proband. This finding suggests that extreme hyp/imp may be attributable to different etiological influences in individuals with and without extreme inattention. If this result can be replicated in other samples, it would provide evidence that the hyp/imp symptoms exhibited by individuals with Combined Type ADHD and Predominantly Hyp/Imp Type ADHD may be attributable to different etiological influences.     

Evidence for a General ADHD Factor from a Longitudinal General School Population Study

Recent factor analytic studies in Attention-Deficit/Hyperactivity Disorder (ADHD) have shown that hierarchical models provide a better fit of ADHD symptoms than correlated models. A hierarchical model includes a general ADHD factor and specific factors for inattention, and hyperactivity/impulsivity. The aim of this 12-month longitudinal study was to test the generalizability of the hierarchical models of ADHD within an elementary school population of 6–9 year old children (250 boys, 260 girls). Examination of differences as a function of informant (parent vs. teacher ratings), sex, and time was conducted. Six potential factor structures for the 18 items of the SWAN (Strengths and Weaknesses of ADHD-symptoms and Normal-behavior) scale were tested using confirmatory and exploratory factor analyses. Hierarchical models with a general ADHD factor and two or three specific factors best accounted for parent and teacher reports of symptoms for both boys and girls and at two time points separated by a 12-month interval. Findings indicate that the 18 SWAN items measure a common latent trait as well as orthogonal factors or dimensions of inattention and hyperactivity/impulsivity.     

Internal and External Validity of Self-Report and Parent-Report Measures of Sluggish Cognitive Tempo in South Korean Adolescents

This study evaluated the internal and external validity of self-report and parent-report measures of sluggish cognitive tempo (SCT) in South Korean adolescents. Adolescents (N =?469, ages 13–17 years; 50.2% boys) completed self-report measures of SCT and attention-deficit/hyperactivity disorder inattention (ADHD-IN) in addition to measures of internalizing and externalizing psychopathology, social problems, and grades. Parents rated adolescents on SCT, ADHD-IN, internalizing and externalizing psychopathology, and social problems. Using adolescent self-report, 11 of 15 SCT symptoms showed convergent and discriminant validity with ADHD-IN. Using parent-report, all 15 SCT symptoms showed convergent and discriminant validity with ADHD-IN. For within source analyses, SCT showed unique and stronger associations than ADHD-IN with internalizing psychopathology whereas ADHD-IN showed unique and stronger associations than SCT with externalizing psychopathology. SCT and ADHD-IN showed similar unique associations with social problems, whereas ADHD-IN was more strongly related than SCT to grades. Across source analyses also supported the differential unique associations of SCT and ADHD-IN with internalizing and externalizing psychopathologies. This study provides initial evidence for the internal and external validity of SCT with South Korean adolescents, extending support for the transcultural validity of SCT to the important developmental period of adolescence.