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

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Abstract

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.

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  1. Department of Psychological Sciences, University of Vermont, Burlington, VT, USA

    J. Quyen V. A. Nichols, Erin K. Shoulberg, Betsy Hoza, Keith B. Burt & Dianna Murray-Close

  2. Department of Psychology, St. Louis University, St. Louis, MO, USA

    Annie A. Garner

  3. Ohio State University Medical Center, Columbus, OH, USA

    L. Eugene Arnold

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J. Quyen Nichols declares that he has no conflict of interest. Erin Shoulberg declares that she has no conflict of interest. Annie Garner declares that she has no conflict of interest. Betsy Hoza declares that she has no conflict of interest. Keith Burt declares that he has no conflict of interest. Dianna Murray-Close declares that she has no conflict of interest. L. Eugene Arnold has received research funding from Curemark, Forest, Lilly, Neuropharm, Novartis, Noven, Shire, and YoungLiving (as well as NIH and Autism Speaks), and he has consulted with or been on advisory boards for Arbor, Gowlings, Neuropharm, Novartis, Noven, Organon, Otsuka, Pfizer, Roche, Seaside Therapeutics, Sigma Tau, Shire, and Tris Pharma and received travel support from Noven.

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Nichols, J.Q.V.A., Shoulberg, E.K., Garner, A.A. et al. Exploration of the Factor Structure of ADHD in Adolescence through Self, Parent, and Teacher Reports of Symptomatology. J Abnorm Child Psychol 45, 625–641 (2017). https://doi.org/10.1007/s10802-016-0183-3

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