Replication and external validation of a bi-factor parameterization of attention deficit/hyperactivity symptomatology

This study evaluated the fit and criterion validity of a recently proposed bi-factor structure for attention deficit/hyperactivity disorder (ADHD) symptoms. Participants were 1,093 children, drawn from an ongoing prospective longitudinal study, whose ADHD symptoms were rated by parents and teachers when children were in 1st grade. The criterion validity of the bi-factor model was established using a range of school-based outcomes that included treatment utilization, teacher perceptions of the need for treatment, academic functioning, and peer and teacher relationship quality. Results indicated that a bi-factor model parameterization provided an equally good fit to parent, teacher, and combined reports of ADHD symptoms as did traditional 1-, 2-, and 3-factor models. However, in contrast to traditional models, the bi-factor parameterization acknowledged both the unity and diversity of ADHD symptoms. The general ADHD latent factor explained the vast majority of the observed variation in every symptom. Whereas the general ADHD latent factor was significantly associated with all 15 outcomes, the specific Inattentive factor explained unique variation in 9 (primarily the academically oriented) outcomes and the specific Hyperactive-Impulsive factor explained unique variation in 2 outcomes. The general ADHD factor was more strongly correlated with each of the observed ADHD symptom scores (total, inattentive, hyperactive-impulsive) than was either specific factor. Results are discussed with respect to how changes in the conceptualization of the factor structure correspond to recent changes to the diagnostic criteria for ADHD, as well as whether/how individual differences in inattention and hyperactivity-impulsivity might be used to differentiate children who are diagnosed with ADHD.