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The factor structure of attention-deficit/hyperactivity disorder in schoolchildren
Trine Wigh Arildskov1, Anne Virring2, Rikke Lambek3
1Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Background:
Most studies support a bifactor model of childhood ADHD with two specific factors. However, several studies have not compared this model with a bifactor model with three specific factors, few have tested the actual strength of the factors, and none have examined whether "talks excessively" should be treated as a hyperactivity versus impulsivity symptom in children with ADHD.
Aims:
To examine the factor structure of ADHD symptoms and evaluate the relative strength of potential factors.
Methods:
Parent-reports on the ADHD-Rating Scale (ADHD-RS-IV) were collected for 2044 schoolchildren from the general population and 147 children with ADHD from a clinical sample. Single-, two- and three-(correlated and bi-)factor models were tested using confirmatory factor analysis.
Results:
Most models had a satisfactory fit. However, a correlated three-factor model where "talks excessively" was included as an indicator of impulsivity, and especially a bifactor model with one strong, well-defined general and two/three (ICD-10 defined) weak specific factors fit the data slightly better than the remaining models.
Conclusions:
The factor structure is best characterized by a bifactor model with a strong general factor and two/three weaker specific factors. Therefore, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.
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