Journal of Abnormal Child Psychology

, Volume 46, Issue 4, pp 659–669 | Cite as

Evidence for the Trait-Impulsivity Etiological Model in a Clinical Sample: Bifactor Structure and Its Relation to Impairment and Environmental Risk

  • Klaas Rodenacker
  • Christopher Hautmann
  • Anja Görtz-Dorten
  • Manfred Döpfner


The trait-impulsivity etiological model assumes that a general factor (trait-impulsivity) underlies attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and other externalizing disorders. We investigated the plausibility of this assumption by testing the factor structure of ADHD and ODD in a bifactor framework for a clinical sample of 1420 children between 6 and 18 years of age (M = 9.99, SD = 3.34; 85% male). Further, the trait-impulsivity etiological model assumes that ODD emerges only if environmental risk factors are present. Our results support the validity of the trait-impulsivity etiological model, as they confirm that ADHD and ODD share a strong general factor of disruptive behavior (DB) in this clinical sample. Furthermore, unlike the subdimensions of ADHD, we found that the specific ODD factor explained as much true score variance as the general DB factor. This suggests that a common scale of ADHD and ODD may prove to be as important as a separate ODD subscale to assess externalizing problems in school-age children. However, all other subscales of ADHD may not explain sufficient true score variance once the impact of the general DB factor has been taken into consideration. In accordance with the trait-impulsivity model, we also showed that all factors, but predominantly the general factor and specific inattention factor, predicted parent-rated impairment, and that predominantly ODD and impulsivity are predicted by environmental risk factors.


Attention-deficit/hyperactivity disorder Oppositional defiant disorder Bifactor Confirmatory factor analysis Trait-impulsivity etiological model 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). Arlington: American Psychiatric Publishing, Inc..CrossRefGoogle Scholar
  2. Arias, V. B., Ponce, F. P., Martínez-Molina, A., Arias, B., & Núñez, D. (2016). General and specific attention-deficit/hyperactivity disorder factors of children 4 to 6 years of age: An exploratory structural equation modeling approach to assessing symptom multidimensionality. Journal of Abnormal Psychology, 125, 125–137. doi: 10.1037/abn0000115.CrossRefPubMedGoogle Scholar
  3. Asparouhov, T., & Muthén, B. (2010). Weighted least squares estimation with missing data. Mplus Technical Appendix, 1-10.Google Scholar
  4. Beauchaine, T. P. (2015). Future directions in emotion dysregulation and youth psychopathology. Journal of Clinical Child & Adolescent Psychology, 44, 875–896. doi: 10.1080/15374416.2015.1038827.CrossRefGoogle Scholar
  5. Beauchaine, T. P., & McNulty, T. (2013). Comorbidities and continuities as ontogenic processes: Toward a developmental spectrum model of externalizing psychopathology. Development and Psychopathology, 25, 1505–1528. doi: 10.1017/S0954579413000746.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Beauchaine, T. P., Hinshaw, S. P., & Pang, K. L. (2010). Comorbidity of attention-deficit/hyperactivity disorder and early-onset conduct disorder: Biological, environmental, and developmental mechanisms. Clinical Psychology: Science and Practice, 17, 327–336. doi: 10.1111/j.1468-2850.2010.01224.x.Google Scholar
  7. Bohlinger, S. (2012). Internationale Standardklassifikation im Bildungswesen. BWP, 4, 16–19.Google Scholar
  8. Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.Google Scholar
  9. Burke, J. D., Boylan, K., Rowe, R., Duku, E., Stepp, S. D., Hipwell, A. E., & Waldman, I. D. (2014). Identifying the irritability dimension of ODD: Application of a modified bifactor model across five large community samples of children. Journal of Abnorm Psychology, 123, 841–851.CrossRefGoogle Scholar
  10. Burns, G. L., Boe, B., Walsh, J. A., Sommers-Flanagan, R., & Teegarden, L. A. (2001). A confirmatory factor analysis on the DSM-IV ADHD and ODD symptoms: What is the best model for the organization of these symptoms? Journal of Abnormal Child Psychology, 29, 339–349. doi: 10.1023/A:1010314030025.CrossRefPubMedGoogle Scholar
  11. Burns, G. L., Walsh, J. A., Servera, M., Lorenzo-Seva, U., Cardo, E., & Rodríguez-Fornells, A. (2013). Construct validity of ADHD/ODD rating scales: Recommendations for the evaluation of forthcoming DSM-V ADHD/ODD scales. Journal of Abnormal Child Psychology, 41, 15–26. doi: 10.1007/s10802-012-9660-5.CrossRefPubMedGoogle Scholar
  12. Burns, G. L., de Moura, M. A., Beauchaine, T. P., & McBurnett, K. (2014). Bifactor latent structure of ADHD/ODD symptoms: Predictions of dual-pathway/trait-impulsivity etiological models of ADHD. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 55, 393–401. doi: 10.1111/jcpp.12165.CrossRefPubMedGoogle Scholar
  13. Byrne, B. M. (2012). Structural equation modeling with Mplus: Basic concepts, applications, and programming (multivariate applications series). New York: Routledge/Taylor & Francis Group.Google Scholar
  14. Caci, H. M., Morin, A. J., & Tran, A. (2016). Teacher ratings of the ADHD-RS IV in a community sample: Results from the ChiP-ARD study. Journal of Attention Disorders, 20, 434–444. doi: 10.1177/ 1087054712473834.CrossRefPubMedGoogle Scholar
  15. Canino, G., Polanczyk, G., Bauermeister, J. J., Rohde, L. A., & Frick, P. J. (2010). Does the prevalence of CD and ODD vary across cultures? Social Psychiatry and Psychiatric Epidemiology, 45, 695–704. doi: 10.1007/s00127-010-0242-y.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., et al. (2014). The p factor one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2, 119–137.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14, 464–504. doi: 10.1080/10705510701301834.CrossRefGoogle Scholar
  18. Conger, R. D., Conger, K. J., & Martin, M. J. (2010). Socioeconomic status, family processes, and individual development. Journal of Marriage and the Family, 72, 685–704. doi: 10.1111/j.1741-3737.2010.00725.x.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Deault, L. C. (2010). A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry & Human Development, 41, 168–192. doi: 10.1007/s10578-009-0159-4.CrossRefGoogle Scholar
  20. DeGarmo, D. S., Forgatch, M. S., & Martinez, C. R. (1999). Parenting of divorced mothers as a link between social status and Boys' academic outcomes: Unpacking the effects of socioeconomic status. Child Development, 70, 1231–1245.CrossRefPubMedGoogle Scholar
  21. Dodge, K. A., Pettit, G. S., & Bates, J. E. (1994). Socialization mediators of the relation between socioeconomic status and child conduct problems. Child Development, 65, 649–665. doi: 10.2307/1131407.CrossRefPubMedGoogle Scholar
  22. Döpfner, M., Görtz-Dorten, A., Lehmkuhl, G., Breuer, D., & Goletz, H. (2008). Diagnostik-System für psychische Störungen nach ICD-10 und DSM-IV für Kinder und Jugendliche - II [Diagnostic System for Children's and Adolescents' Mental Disorders]. Germany: Hogrefe.Google Scholar
  23. Döpfner, M., Hautmann, C., Görtz-Dorten, A., Klasen, F., & Ravens-Sieberer, U. (2015). Long-term course of ADHD symptoms from childhood to early adulthood in a community sample. European Child & Adolescent Psychiatry, 24, 665–673. doi: 10.1007/s00787-014-0634-8.CrossRefGoogle Scholar
  24. Elia, J., Ambrosini, P., & Berrettini, W. (2008). ADHD characteristics: I. Concurrent co-morbidity patterns in children & adolescents. Child and Adolescent Psychiatry and Mental Health, 2, 1–9. doi: 10.1186/1753-2000-2-15.CrossRefGoogle Scholar
  25. Frazier-Wood, A. C., Rommel, A. S., & Kuntsi, J. (2014). Attention deficit hyperactivity disorder: Insight from quantitative genetic research. In S. H. Rhee & A. Ronald (Eds.), Behavior genetics of psychopathology (pp. 1–32). New York: Springer.Google Scholar
  26. Freitag, C. M., & Retz, W. (2010). Family and twin studies in attention-deficit hyperactivity disorder. In W. Retz, & R. G. Klein (Eds.), Attention-deficit hyperactivity disorder (ADHD) in adults. Key issues in mental health (Vol. 176, pp. 38–57). Basel: Karger.Google Scholar
  27. Gibbins, C., Toplak, M. E., Flora, D. B., Weiss, M. D., & Tannock, R. (2012). Evidence for a general factor model of ADHD in adults. Journal of Attention Disorders, 16, 635–644. doi: 10.1177/1087054711416310.CrossRefPubMedGoogle Scholar
  28. Gomez, R., Kyriakides, C., & Devlin, E. (2014). Attention-deficit/hyperactivity disorder symptoms in an adult sample: Associations with Rothbart’s temperament dimensions. Personality and Individual Differences, 60, 73–78. doi: 10.1016/j.paid.2013.12.023.CrossRefGoogle Scholar
  29. Gomez, R., Vance, A., & Gomez, R. M. (2016). Maternal ratings of the ADHD symptoms: Subtypes versus severity in clinic-referred children and adolescents. Journal of Attention Disorders, 20, 414–423. doi: 10.1177/1087054713514606.CrossRefPubMedGoogle Scholar
  30. Greene, R. W., Biederman, J., Zerwas, S., Monuteaux, M. C., Goring, J. C., & Faraone, S. V. (2002). Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. American Journal of Psychiatry, 159, 1214–1224. doi: 10.1176/appi.ajp.159.7.1214.CrossRefPubMedGoogle Scholar
  31. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. doi: 10.1080/10705519909540118.CrossRefGoogle Scholar
  32. Johnston, C., Mash, E. J., Miller, N., & Ninowski, J. E. (2012). Parenting in adults with attention-deficit/hyperactivity disorder (ADHD). Clinical Psychology Review, 32, 215–228. doi: 10.1016/j.cpr.2012.01.007.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Kiff, C. J., Lengua, L. J., & Zalewski, M. (2011). Nature and nurturing: Parenting in the context of child temperament. Clinical Child and Family Psychology Review, 14, 251–301. doi: 10.1007/s10567-011-0093-4.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Lee, S., Burns, G. L., Beauchaine, T. P., & Becker, S. P. (2015). Bifactor latent structure of attention-deficit/hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD) symptoms and first-order latent structure of sluggish cognitive tempo symptoms. Psychological Assessment. doi: 10.1037/pas0000232.
  35. Livingstone, L. T., Coventry, W. L., Corley, R. P., Willcutt, E. G., Samuelsson, S., Olson, R. K., & Byrne, B. (2016). Does the environment have an enduring effect on ADHD? A longitudinal study of monozygotic twin differences in children. Journal of Abnormal Child Psychology, 44, 1487–1501. doi: 10.1007/s10802-016-0145-9.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Loeber, R., Burke, J., & Pardini, D. A. (2009). Perspectives on oppositional defiant disorder, conduct disorder, and psychopathic features. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 50, 133–142. doi: 10.1111/j.1469-7610.2008.02011.x.CrossRefPubMedGoogle Scholar
  37. Lubke, G. H., & Muthén, B. (2005). Investigating population heterogeneity with factor mixture models. Psychological Methods, 10, 21–39.CrossRefPubMedGoogle Scholar
  38. Millsap, R. E., & Yun-Tein, J. (2004). Assessing factorial invariance in ordered-categorical measures. Multivariate Behavioral Research, 39, 479–515. doi: 10.1207/S15327906MBR3903_4.CrossRefGoogle Scholar
  39. Mitchison, G. M., & Njardvik, U. (2015). Prevalence and gender differences of ODD, anxiety, and depression in a sample of children with ADHD. Journal of Attention Disorders, Advanced online publication. doi: 10.1177/1087054715608442.
  40. Morin, A., Tran, A., & Caci, H. (2016). Factorial validity of the ADHD adult symptom rating scale in a french community sample: Results from the ChiP-ARDS study. Journal of Attention Disorders, 20, 530–541. doi: 10.1177/1087054713488825.CrossRefPubMedGoogle Scholar
  41. Muthén, L. K., & Muthén, B. O. (1998-2012). Mplus User’s Guide (7th ed.). Los Angeles: Muthén & Muthén.Google Scholar
  42. Nikolas, M., Klump, K. L., & Burt, S. A. (2011). Youth appraisals of inter-parental conflict and genetic and environmental contributions to attention-deficit hyperactivity disorder: Examination of GxE effects in a twin sample. Journal of Abnormal Child Psychology, 40, 543–554. doi: 10.1007/s10802-011-9583-6.CrossRefGoogle Scholar
  43. Normand, S., Flora, D. B., Toplak, M. E., & Tannock, R. (2012). Evidence for a general ADHD factor from a longitudinal general school population study. Journal of Abnormal Child Psychology, 40, 555–567. doi: 10.1007/s10802-011-9584-5.CrossRefPubMedGoogle Scholar
  44. Pinderhughes, E. E., Dodge, K. A., Zelli, A., Bates, J. E., & Pettit, G. S. (2000). Discipline responses: Influences of Parents' socioeconomic status, ethnicity, beliefs about parenting, stress, and cognitive–emotional processes. Journal of Family Psychology, 14, 380–400.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Pliszka, S. R. (2015). Conceptual issues in understanding comorbidity in ADHD. In L. A. Adler, T. J. Spencer, & T. E. Wilens (Eds.), Attention-deficit hyperactivity disorder in adults and children (pp. 63–71). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  46. Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. American Journal of Psychiatry, 164, 942–948. doi: 10.1176/ajp.2007.164.6.942.CrossRefPubMedGoogle Scholar
  47. Reise, S. P. (2012). Invited paper: The rediscovery of bifactor measurement models. Multivariate Behavioral Research, 47, 667–669. doi: 10.1080/00273171.2012.715555.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Reise, S. P., Bonifay, W. E., & Haviland, M. G. (2013). Scoring and modeling psychological measures in the presence of multidimensionality. Journal of Personality Assessment, 95, 129–140. doi: 10.1080/00223891.2012.725437.CrossRefPubMedGoogle Scholar
  49. Rodenacker, K., Hautmann, C., Görtz-Dorten, A., & Döpfner, M. (2016). Bifactor models show a superior model fit: Examination of the factorial validity of parent-reported and self-reported symptoms of attention-deficit/hyperactivity disorders in children and adolescents. Psychopathology, 49, 31–39.CrossRefPubMedGoogle Scholar
  50. Rodenacker, K., Hautmann, C., Görtz-Dorten, A., & Döpfner, M. (2017). The factor structure of ADHD – Different models, analyses and informants in a Bifactor framework. [journal article]. Journal of Psychopathology and Behavioral Assessment, 39, 92–102. doi: 10.1007/s10862-016-9565-7.CrossRefGoogle Scholar
  51. Rodriguez, A., Reise, S. P., & Haviland, M. G. (2015). Applying bifactor statistical indices in the evaluation of psychological measures. Journal of Personality Assessment, 98, 223–237. doi: 10.1080/00223891.2015.1089249.CrossRefPubMedGoogle Scholar
  52. Rowe, R., Costello, E. J., Angold, A., Copeland, W. E., & Maughan, B. (2010). Developmental pathways in oppositional defiant disorder and conduct disorder. Journal of Abnormal Psychology, 119, 726–738. doi: 10.1037/a0020798.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Schachar, R. (2014). Genetics of attention deficit hyperactivity disorder (ADHD): Recent updates and future prospects. Current Developmental Disorders Reports, 1, 41–49. doi: 10.1007/s40474-013-0004-0.CrossRefGoogle Scholar
  54. Toplak, M. E., Pitch, A., Flora, D. B., Iwenofu, L., Ghelani, K., Jain, U., & Tannock, R. (2009). The unity and diversity of inattention and hyperactivity/impulsivity in ADHD: Evidence for a general factor with separable dimensions. Journal of Abnormal Child Psychology, 37, 1137–1150. doi: 10.1007/s10802-009-9336-y.CrossRefPubMedGoogle Scholar
  55. Toplak, M. E., Sorge, G. B., Flora, D. B., Chen, W., Banaschewski, T., Buitelaar, J., et al. (2012). The hierarchical factor model of ADHD: Invariant across age and national groupings? Journal of Child Psychology and Psychiatry, and Allied Disciplines, 53, 292–303. doi: 10.1111/j.1469-7610.2011.02500.x.CrossRefPubMedGoogle Scholar
  56. Ullebø, A. K., Breivik, K., Gillberg, C., Lundervold, A. J., & Posserud, M.-B. (2012). The factor structure of ADHD in a general population of primary school children. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 53, 927–936. doi: 10.1111/j.1469-7610.2012.02549.x.CrossRefPubMedGoogle Scholar
  57. Wagner, F., Martel, M., Cogo-Moreira, H., Maia, C., Pan, P., Rohde, L., & Salum, G. (2016). Attention-deficit/hyperactivity disorder dimensionality: The reliable ‘g’ and the elusive ‘s’ dimensions. European Child & Adolescent Psychiatry, 25, 83–90. doi: 10.1007/s00787-015-0709-1.CrossRefGoogle Scholar
  58. Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R., et al. (2012). Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991–1010. doi: 10.1037/a0027347.CrossRefPubMedPubMedCentralGoogle Scholar
  59. Zinbarg, R. E., Revelle, W., Yovel, I., & Li, W. (2005). Cronbach's α, Revelle's β, and Mcdonald's ωH: Their relations with each other and two alternative conceptualizations of reliability. Psychometrika, 70, 123–133. doi: 10.1007/s11336-003-0974-7.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Klaas Rodenacker
    • 1
  • Christopher Hautmann
    • 2
  • Anja Görtz-Dorten
    • 2
  • Manfred Döpfner
    • 1
  1. 1.Department of Child and Adolescent Psychiatry, Psychosomatics and PsychotherapyUniversity of CologneCologneGermany
  2. 2.School of Child and Adolescent Cognitive Behavior Therapy (AKiP)University of CologneCologneGermany

Personalised recommendations