Invariance of ADHD Symptoms Across Sex and Age: a Latent Analysis of ADHD and Impairment Ratings from Early Childhood into Adolescence
A population-based longitudinal sample of 489 twin pairs was assessed at six time points over ten years to examine the measurement invariance and stability of attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as the developmental relations between inattention (IN), hyperactivity-impulsivity (HI), and multiple aspects of functional impairment. Parent ratings of ADHD symptoms and functional impairment were obtained in preschool and after the completion of kindergarten, first, second, fourth, and ninth grades. Results of the temporal and sex invariance models indicated that parent ratings of the 18 ADHD symptoms function in the same manner for females and males from early childhood into adolescence. In addition to establishing this prerequisite condition for the interpretation of longitudinal and between-sex differences in the IN and HI symptom dimensions, cross-lagged models indicated that both IN and HI were associated with increased risk for both concurrent and future overall, social, and recreational impairment, whereas only IN was uniquely associated with later academic impairment. Taken together, the current results demonstrate that IN and HI are highly stable from preschool through ninth grade, invariant between females and males, and indicative of risk for impairment in multiple areas, thereby providing strong support for the validity of the symptom dimensions among both sexes.
KeywordsInattention Hyperactivity Invariance Gender Impairment Longitudinal
This research was supported by grants from the National Institute of Child Health and Human Development (R01 HD38526 and R01 HD68728). The authors were also supported by NIH grants F31 HD091967, P50 HD27802, and R24 HD75460 during the preparation of this report. We also gratefully acknowledge the participants, their caregivers, and the research staff that have made this ongoing project possible.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All participants and parents read and agreed to the informed consent or assent document prior to their initial enrollment in the study and at each follow-up assessment.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- Burns, G. L., Servera, M., Bernad, M. D. M., Carrillo, J. M., & Geiser, C. (2014). Ratings of ADHD symptoms and academic impairment by mothers, fathers, teachers, and aides: Construct validity within and across settings as well as occasions. Psychological Assessment, 26(4), 1247–1258.CrossRefGoogle Scholar
- Burns, G. L., Becker, S. P., Servera, M., Bernad, M. D. M., & Garcia-Banda, G. (2017). Sluggish cognitive tempo and attention-deficit/hyperactivity disorder (ADHD) inattention in the home and school contexts: Parent and teacher invariance and cross-setting validity. Psychological Assessment, 29(2), 209–220. https://doi.org/10.1037/pas0000325.
- Christopher, M. E., Hulslander, J., Byrne, B., Samuelsson, S., Keenan, J. M., Pennington, B. F., et al. (2013). The genetic and environmental etiologies of individual differences in early reading growth in Australia, the United States, and Scandinavia. Journal of Experimental Child Psychology, 125, 453–467.CrossRefGoogle Scholar
- Hartung, C. M., Lefler, E. K., Canu, W. H., Stevens, A. E., Jaconis, M., LaCount, P. A., … Willcutt, E. G. (2016). DSM-5 and other symptom thresholds for ADHD: Which is the best predictor of impairment in college students? Advance online publication. Journal of Attention Disorders. https://doi.org/10.1177/1087054716629216.
- Little, T. D. (2013). Longitudinal structural equation modeling. New York: Guilford Press.Google Scholar
- Muthen, L. K., & Muthen, B. O. (2012). Mplus user's guide (7th ed.). Los Angeles: Muthen and Muthen.Google Scholar
- Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children (2nd ed.). Circle Pines: American Guidance Service.Google Scholar
- Ros, R. & Graziano, P.A. (2017). Social functioning in children with or at risk for attention deficit/hyperactivity disorder: A meta-analytic review. Journal of Clinical Child and Adolescent Psychology. Advance online publication.Google Scholar
- Spitzer, R. L., & Wakefield, J. C. (1999). DSM-IV diagnostic criterion for clinical significance: Does it help solve the false positives problem? American Journal of Psychiatry, 156, 1856–1864.Google Scholar
- Willcutt, E. G., Betjemann, R. S., Pennington, B. F., Olson, R. K., DeFries, J. C., & Wadsworth, S. J. (2007a). Longitudinal study of reading disability and attention-deficit/hyperactivity disorder: Implications for education. Mind, Brain, and Education, 1(4), 181–192. https://doi.org/10.1111/j.1751-228X.2007.00019.x.CrossRefGoogle Scholar