Skip to main content

Advertisement

SpringerLink
Log in

Attention-deficit/hyperactivity disorder dimensionality: the reliable ‘g’ and the elusive ‘s’ dimensions

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The best structural model for attention-deficit/hyperactivity disorder (ADHD) symptoms remains a matter of debate. The objective of this study is to test the fit and factor reliability of competing models of the dimensional structure of ADHD symptoms in a sample of randomly selected and high-risk children and pre-adolescents from Brazil. Our sample comprised 2512 children aged 6–12 years from 57 schools in Brazil. The ADHD symptoms were assessed using parent report on the development and well-being assessment (DAWBA). Fit indexes from confirmatory factor analysis were used to test unidimensional, correlated, and bifactor models of ADHD, the latter including “g” ADHD and “s” symptom domain factors. Reliability of all models was measured with omega coefficients. A bifactor model with one general factor and three specific factors (inattention, hyperactivity, impulsivity) exhibited the best fit to the data, according to fit indices, as well as the most consistent factor loadings. However, based on omega reliability statistics, the specific inattention, hyperactivity, and impulsivity dimensions provided very little reliable information after accounting for the reliable general ADHD factor. Our study presents some psychometric evidence that ADHD specific (“s”) factors might be unreliable after taking common (“g” factor) variance into account. These results are in accordance with the lack of longitudinal stability among subtypes, the absence of dimension-specific molecular genetic findings and non-specific effects of treatment strategies. Therefore, researchers and clinicians might most effectively rely on the “g” ADHD to characterize ADHD dimensional phenotype, based on currently available symptom items.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Angold A, Erkanli A, Copeland W, Goodman R, Fisher PW, Costello EJ (2012) Psychiatric diagnostic interviews for children and adolescents: a comparative study. J Am Acad Child Adolesc Psychiatry 51:506–517

    Article  PubMed  PubMed Central  Google Scholar 

  2. APA (2013) Diagnostic and statistical manual of mental disorders. American Psychiatric Publishing, Arlington

    Google Scholar 

  3. APA (1994) Diagnostic and statistical manual of mental disorders—text revision. American Psychiatric Association, Washington

    Google Scholar 

  4. Bauermeister JJ, Canino G, Polanczyk G, Rohde LA (2010) ADHD across cultures: is there evidence for a bidimensional organization of symptoms? J Clin Child Adolesc Psychol 39:362–372

    Article  PubMed  Google Scholar 

  5. Bentler PM (2009) Alpha, dimension-free, and model-based internal consistency reliability. Psychometrika 74:137–143

    Article  PubMed  PubMed Central  Google Scholar 

  6. Brouwer D, Meijer RR, Zevalkink J (2013) On the factor structure of the Beck Depression Inventory-II: G is the key. Psychol Assess 25:136–145

    Article  PubMed  Google Scholar 

  7. Brunner M, Nagy G, Wilhelm O (2012) A tutorial on hierarchically structured constructs. J Pers 80:796–846

    Article  PubMed  Google Scholar 

  8. Caci HM, Morin AJS, Bouchez J, Baylé FJ (2013) Bifactor models support ICD-10 construct of ADHD against DSM-IV, both in children rated by teachers and self-rated in adults. Eur Psychiatry 28:1

    Google Scholar 

  9. Chen FF, Hayes A, Carver CS, Laurenceau JP, Zhang Z (2012) Modeling general and specific variance in multifaceted constructs: a comparison of the bifactor model to other approaches. J Pers 80:219–251

    Article  PubMed  Google Scholar 

  10. Chen FF, West SG, Sousa KH (2006) A comparison of bifactor and second-order factor models of quality of life. Multivariate Behav Res 41:189–225

    Article  Google Scholar 

  11. Cook KF, Kallen MA, Amtmann D (2009) Having a fit: impact of number of items and distribution of data on traditional criteria for assessing IRT’s unidimensionality assumption. Qual Life Res 18:447–460

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dumenci L, McConaughy SH, Achenbach TM (2004) A hierarchical three-factor model of inattention-hyperactivity-impulsivity derived from the attention problems syndrome of the teacher’s report form. School Psychol Rev 33:287–301

    Google Scholar 

  13. Frazier TW, Youngstrom EA, Naugle RI (2007) The latent structure of attention-deficit/hyperactivity disorder in a clinic-referred sample. Neuropsychology 21:45–64

    Article  PubMed  Google Scholar 

  14. Gibbins C, Toplak ME, Flora DB, Weiss MD, Tannock R (2012) Evidence for a general factor model of ADHD in adults. J Atten Disord 16:635–644

  15. Gomez R, Vance A, Gomez RM (2013) Validity of the ADHD Bifactor model in general community samples of adolescents and adults, and a clinic-referred sample of children and adolescents. J Atten Disord [Epub ahead of print]

  16. Goodman R, Ford T, Richards H, Gatward R, Meltzer H (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41:645–655

    Article  PubMed  CAS  Google Scholar 

  17. Haslam N, Williams B, Prior M, Haslam R, Graetz B, Sawyer M (2006) The latent structure of attention-deficit/hyperactivity disorder: a taxometric analysis. Aust N Z J Psychiatry 40:639–647

    Article  PubMed  Google Scholar 

  18. Holzinger KJ, Swineford F (1937) The bi-factor method. Psychmetrika 2:41–54

    Article  Google Scholar 

  19. Hu L, Bentler PM (1998) Fit indices in covariance structure modeling: sensitivity to under parameterized model misspecification. Psychol Methods 3:424–453

    Article  Google Scholar 

  20. Krueger RF, Hicks BM, Patrick CJ, Carlson SR, Iacono WG, McGue M (2002) Etiologic connections among substance dependence, antisocial behavior, and personality: modeling the externalizing spectrum. J Abnorm Psychol 111:411–424

    Article  PubMed  Google Scholar 

  21. Lahey BB, Pelham WE, Loney J, Lee SS, Willcutt E (2005) Instability of the DSM-IV Subtypes of ADHD from preschool through elementary school. Arch Gen Psychiatry 62:896–902

    Article  PubMed  Google Scholar 

  22. Larsson H, Anckarsater H, Rastam M, Chang Z, Lichtenstein P (2012) Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8500 twin pairs. J Child Psychol Psychiatry 53:73–80

    Article  PubMed  Google Scholar 

  23. Levy F, Hay DA, McStephen M, Wood C, Waldman I (1997) Attention-deficit hyperactivity disorder: a category or a continuum? Genetic analysis of a large-scale twin study. J Am Acad Child Adolesc Psychiatry 36:737–744

    Article  PubMed  CAS  Google Scholar 

  24. Lucke JF (2005) The alfa and the omega of congeneric test theory: an extension of reliability and internal consistency to heterogeneous tests. Appl Psychol Measure 29:65–81

    Article  Google Scholar 

  25. Marcus DK, Barry TD (2011) Does attention-deficit/hyperactivity disorder have a dimensional latent structure? A taxometric analysis. J Abnorm Psychol 120:427–442

    Article  PubMed  PubMed Central  Google Scholar 

  26. Marcus DK, Norris AL, Coccaro EF (2012) The latent structure of attention deficit/hyperactivity disorder in an adult sample. J Psychiatr Res 46:782–789

    Article  PubMed  PubMed Central  Google Scholar 

  27. Martel MM, Roberts B, Gremillion M, von Eye A, Nigg JT (2011) External validation of bifactor model of ADHD: explaining heterogeneity in psychiatric comorbidity, cognitive control, and personality trait profiles within DSM-IV ADHD. J Abnorm Child Psychol 39:1111–1123

    Article  PubMed  PubMed Central  Google Scholar 

  28. Martel MM, von Eye A, Nigg JT (2010) Revisiting the latent structure of ADHD: is there a ‘g’ factor? J Child Psychol Psychiatry 51:905–914

    Article  PubMed  PubMed Central  Google Scholar 

  29. Matte B, Anselmi L, Salum GA, Kieling C, Goncalves H, Menezes A, Grevet EH, Rohde LA (2014) ADHD in DSM-5: a field trial in a large, representative sample of 18- to 19-year-old adults. Psychol Med 23:1–13

    Google Scholar 

  30. McDonald R (1999) Test theory: a unified approach. Lawrence Erlbaum Associates, Mahwah

    Google Scholar 

  31. Muthén LK, Muthén BO (2012) Mplus User’s Guide. Muthén & Muthén, Los Angeles

    Google Scholar 

  32. Nigg JT, Willcutt EG, Doyle AE, Sonuga-Barke EJ (2005) Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes? Biol Psychiatry 57:1224–1230

    Article  PubMed  Google Scholar 

  33. Normand S, Flora DB, Toplak ME, Tannock R (2011) Evidence for a general ADHD factor from a longitudinal general school population study. J Abnorm Child Psychol 40:555–567

    Article  Google Scholar 

  34. Polderman TJ, Derks EM, Hudziak JJ, Verhulst FC, Posthuma D, Boomsma DI (2007) Across the continuum of attention skills: a twin study of the SWAN ADHD rating scale. J Child Psychol Psychiatry 48:1080–1087

    Article  PubMed  Google Scholar 

  35. Reise SP (2012) Invited paper: the rediscovery of bifactor measurement models. Multivariate Behav Res 47:667–696

    Article  PubMed  PubMed Central  Google Scholar 

  36. Reise SP, Bonifay WE, Haviland MG (2013) Scoring and modeling psychological measures in the presence of multidimensionality. J Pers Assess 95:129–140

    Article  PubMed  Google Scholar 

  37. Reise SP, Moore TM, Haviland MG (2010) Bifactor models and rotations: exploring the extent to which multidimensional data yield univocal scale scores. J Pers Assess 92:544–559

    Article  PubMed  PubMed Central  Google Scholar 

  38. Reise SP, Scheines R, Widaman KF, Haviland MG (2013) Multidimensionality and structural coefficient bias in structural equation modeling: a bifactor perspective. Educ Psychol Measure 73:5–26

    Article  Google Scholar 

  39. Rios J, Wells C (2014) Validity evidence based on internal structure. Psicothema 26:108–116

    PubMed  Google Scholar 

  40. Rohde L, Szobot C, Polanczyk G, Schmitz M, Martins S, Tramontina S (2005) Attention-deficit/hyperactivity disorder in a diverse culture: do research and clinical findings support the notion of a cultural construct for the disorder? Biol Psychiatry 57:1436–1441

    Article  PubMed  Google Scholar 

  41. Salum GA, Gadelha A, Pan PM, Moriyama TS, Graeff-Martins AS, Tamanaha AC, Alvarenga P, Krieger FV, Fleitlich-Bilyk B, Jackowski A, Sato JR, Brietzke E, Polanczyk GV, Brentani H, Mari JD, Do Rosario MC, Manfro GG, Bressan RA, Mercadante MT, Miguel EC, Rohde LA (2015) High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results. Int J Methods Psychiatry Res 24:58–73

  42. Salum GA, Mogg K, Bradley BP, Gadelha A, Pan P, Tamanaha AC, Moriyama T, Graeff-Martins AS, Jarros RB, Polanczyk G, do Rosario MC, Leibenluft E, Rohde LA, Manfro GG, Pine DS (2013) Threat bias in attention orienting: evidence of specificity in a large community-based study. Psychol Med 43:733–745

    Article  PubMed  CAS  Google Scholar 

  43. Salum GA, Sonuga-Barke E, Sergeant J, Vandekerckhove J, Gadelha A, Moriyama TS, Graeff-Martins AS, Manfro GG, Polanczyk G, Rohde LA (2014) Mechanisms underpinning inattention and hyperactivity: neurocognitive support for ADHD dimensionality. Psychol Med 44:3189–3201

    Article  PubMed  CAS  Google Scholar 

  44. Shaw P, Gilliam M, Liverpool M, Weddle C, Malek M, Sharp W, Greenstein D, Evans A, Rapoport J, Giedd J (2011) Cortical development in typically developing children with symptoms of hyperactivity and impulsivity: support for a dimensional view of attention deficit hyperactivity disorder. Am J Psychiatry 168:143–151

    Article  PubMed  PubMed Central  Google Scholar 

  45. Smith LC, Tamm L, Hughes CW, Bernstein IH (2013) Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder. Atten Deficit Hyperact Disord 5:9–20

    Article  Google Scholar 

  46. Sonuga-Barke EJ (2005) Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol Psychiatry 57:1231–1238

    Article  PubMed  Google Scholar 

  47. Toplak ME, Pitch A, Flora DB, 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. J Abnorm Child Psychol 37:1137–1150

    Article  PubMed  Google Scholar 

  48. Toplak ME, Sorge GB, Flora DB, Chen W, Banaschewski T, Buitelaar J, Ebstein R, Eisenberg J, Franke B, Gill M, Miranda A, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Steinhausen HC, Thompson M, Tannock R, Asherson P, Faraone SV (2012) The hierarchical factor model of ADHD: invariant across age and national groupings? J Child Psychol Psychiatry 53:292–303

    Article  PubMed  PubMed Central  Google Scholar 

  49. Ullebo AK, Breivik K, Gillberg C, Lundervold AJ, Posserud MB (2012) The factor structure of ADHD in a general population of primary school children. J Child Psychol Psychiatry 53:927–936

    Article  PubMed  Google Scholar 

  50. Valo S, Tannock R (2010) Diagnostic instability of DSM-IV ADHD subtypes: effects of informant source, instrumentation, and methods for combining symptom reports. J Clin Child Adolesc Psychol 39:749–760

    Article  PubMed  Google Scholar 

  51. Wechsler D (1991) Wechsler Intelligence Scale for Children. The Psychological Corporation, San Antonio

    Google Scholar 

  52. Weissman MM, Wickramaratne P, Adams P, Wolk S, Verdeli H, Olfson M (2000) Brief screening for family psychiatric history: the family history screen. Arch Gen Psychiatry 57:675–682

    Article  PubMed  CAS  Google Scholar 

  53. WHO (1993) The ICD-10 classification of mental and behavioral disorders: diagnostic criteria for research. World Health Organization, Geneva

    Google Scholar 

  54. Willcutt EG, Nigg JT, Pennington BF, Solanto MV, Rohde LA, Tannock R, Loo SK, Carlson CL, McBurnett K, Lahey BB (2012) Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. J Abnorm Psychol 121:991–1010

    Article  PubMed  PubMed Central  Google Scholar 

  55. Zinbarg RE, Revelle W, Yovel I, Li W (2005) Cronbach’s α, Revelle’s β, and McDonald’s ω H: their relations with each other and two alternative conceptualizations of reliability. Psychometrika 70:123–133

    Article  Google Scholar 

Download references

Acknowledgments

Funding sources Brazilian government agencies: National Counsel of Technological and Scientific Development (CNPq), The Coordination for Enhancement of Higher Education Personnel (CAPES), Foundation for Research Support of the State of São Paulo (FAPESP) and Foundation for Research Support of the State of Rio Grande do Sul (FAPERGS).

Conflict of interest

L. A. Rohde was on the speakers’ bureau/advisory board and/or acted as consultant for Eli-Lilly, Janssen-Cilag, Novartis and Shire in the past 3 years. The ADHD and Juvenile Bipolar Disorder Out-patient Programs chaired by L.A. Rohde received unrestricted educational and research support from the following pharmaceutical companies in the past 3 years: Eli-Lilly, Janssen-Cilag, Novartis and Shire. He receives authorship royalties from Oxford Press and ArtMed. He has also received travel awards for taking part in the 2014 APA meeting from Shire. Dr. Carlos Renato Moreira Maia receives postdoctoral financial support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), has served as speaker and developed educational material to Novartis, and received travel and registration support to the 4th World Congress on ADHD from the World Federation of ADHD. The other authors declare no conflicts of interest.

Ethical standards

The authors declare all ethical standards procedures were observed and the study was approved by the ethics committee of the University of São Paulo.

Author information

Authors and Affiliations

  1. Attention Deficit/Hyperactivity Disorder Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350 - Room 2202, Porto Alegre, 90035-003, Brazil

    Flávia Wagner, Carlos Renato Moreira Maia, Luis Augusto Rohde & Giovanni Abrahão Salum

  2. Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Flávia Wagner, Carlos Renato Moreira Maia, Luis Augusto Rohde & Giovanni Abrahão Salum

  3. University of Kentucky, Lexington, USA

    Michelle M. Martel

  4. National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, Porto Alegre, Brazil

    Hugo Cogo-Moreira, Pedro Mario Pan, Luis Augusto Rohde & Giovanni Abrahão Salum

  5. Federal University of São Paulo, São Paulo, Brazil

    Hugo Cogo-Moreira & Pedro Mario Pan

  6. São Paulo University, São Paulo, Brazil

    Luis Augusto Rohde

Authors
  1. Flávia Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michelle M. Martel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hugo Cogo-Moreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlos Renato Moreira Maia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pedro Mario Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luis Augusto Rohde
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giovanni Abrahão Salum
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Flávia Wagner.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 250 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wagner, F., Martel, M.M., Cogo-Moreira, H. et al. Attention-deficit/hyperactivity disorder dimensionality: the reliable ‘g’ and the elusive ‘s’ dimensions. Eur Child Adolesc Psychiatry 25, 83–90 (2016). https://doi.org/10.1007/s00787-015-0709-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-015-0709-1

Keywords

Search

Navigation