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International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2006 Mar 24;11(1):33–44. doi: 10.1002/mpr.121

Factorial validity, reliability of assessments and prevalence of ADHD behavioural symptoms in day and residential treatment centres for children with behavioural problems

EM Scholte 1,, IA Van Berckelaer‐Onnes 1, JD Van Der Ploeg 2
PMCID: PMC6878406  PMID: 12459803

Abstract

This study uses the attention deficit/hyperactivity disorder (ADHD) symptom ratings of professional care workers to estimate the prevalence of ADHD symptoms among children in day treatment centres (N = 162) and residential treatment centres (N = 195) in Holland. Although further research is needed, the study supports the suggestion that such ratings can add to reliable diagnostic outcomes when assessing the behavioural symptoms of ADHD in children in the centres. It is estimated that nearly a fifth of the children in such centres exhibit the symptoms of ADHD in the judgement of professional care workers.

Model testing using confirmatory factor analysis favours a dimensional behavioural model that comprises all the three constitutional symptom dimensions of ADHD (inattention, hyperactivity and impulsivity) instead of the two‐factor model as used in the DSM‐IV (inattention and hyperactivity/impulsivity). However, the differences of fit between both models were only small and the hyperactivity and impulsivity factors were highly correlated. This suggests that, in practice, a two‐factor model can also be appropriate. The issue of whether a two‐factor or a three‐factor model is more appropriate thus remains unsolved in this study. Copyright © 2002 Whurr Publishers Ltd.

Keywords: ADHD, symptoms, residential care centres

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References

  1. Achenbach TM, Edelbrock CS. The classification of child psychopathology: a review and analysis of empirical efforts. Psychological Bulletin 1978; 85: 1275–301. [PubMed] [Google Scholar]
  2. Achenbach, TM . Manual for the Child Behaviour Checklist/4‐18. Burlington: University of Vermont, Department of Psychiatry, 1991. [Google Scholar]
  3. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, 3 edn. Washington DC: APA, 1987. [Google Scholar]
  4. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, 4 edn. Washington DC: APA, 1994. [Google Scholar]
  5. Anderson JC, Gerbing DW. Structural equation modeling in practice: a review and recommended two‐steps approach. Psychological Bulletin 1988; 103: 411–23. [Google Scholar]
  6. Angold A, Costello EJ, Erkalani A. Comorbidity. Journal of Child Psychology and Child Psychiatry 1999; 40: 57–87. [PubMed] [Google Scholar]
  7. Barkley RA. Attention‐Deficit Hyperactivity Disorders. A Handbook for Diagnosis and Treatment. New York: Guilford, 1988. [Google Scholar]
  8. Barkley RA. Theories of attention‐deficit/hyperactivity disorder In Quay HC, Hogan AE. (eds) Handbook of Disruptive Behaviour Disorders. New York: Kluwer Academic/Plenum Publishers, 1999. [Google Scholar]
  9. Bauermeister JJ, Alegria M, Bird H, Rubio‐Stipic M, Canino G. Are attentional‐hyperactivity deficits unidimensional or multidimensional syndromes? Empirical findings from a community survey. Journal of the American Academy of Child and Adolescent Psychiatry 1992; 32: 423–32. [DOI] [PubMed] [Google Scholar]
  10. Baumgartel A, Wolraich ML, Dietrich M. Comparison of diagnostic criteria for attention deficit disorders in a German elementary school sample. Journal of the American Academy of Child and Adolescent Psychiatry 1995; 34: 629–38. [DOI] [PubMed] [Google Scholar]
  11. Bentler PM. Comparative fit indexes in structural models. Psychological Bulletin 1988; 107: 238–46. [DOI] [PubMed] [Google Scholar]
  12. Bentler PM, Dijkstra T (1989) Efficient estimation via linearization in structural models In Krishnaiah PR. (eds) Multivariate Analysis VI. Amsterdam: North‐Holland Publishing, 1989. [Google Scholar]
  13. Bentler PM. On the fit of models to covariances and methodology to the bulletin. Psychological Bulletin 1992; 112: 400–4. [DOI] [PubMed] [Google Scholar]
  14. Bentler PM. EQS Structural Equations Program Manual. Encino CA: Multivariate Software, Inc, 1995. [Google Scholar]
  15. Brito GN, Pinto RCA, Lins MFC. A behavioural assessment scale for attention deficit disorder in Brazilian children based on DSM‐III‐R criteria. Journal of Abnormal Child Psychology 1995; 23: 509–20. [DOI] [PubMed] [Google Scholar]
  16. Browne MW, Cudeck R (1993) Alternative ways of assessing model fit In Bollen KA, Long JS. (eds) Testing Structural Equation Models. Newbury Park CA: Sage, 1993. [Google Scholar]
  17. Burns GL, Walsh JA, Patterson DR, Holte CS, Sommers‐Flanagan R, Parker CM. Internal validity of the disruptive behaviour disorder symptoms: implications from parents ratings for a dimensional approach to symptom validity. Journal of Abnormal Child Psychology 1997; 25: 307–19. [DOI] [PubMed] [Google Scholar]
  18. Byrne BM. Structural Equation Modeling with EQS and EQS/Windows. London: Sage, 1994. [Google Scholar]
  19. Carmines EG, Zeller RA. Reliability and Validity Assessment In Lewis‐Beck M. (ed.) Basic Measurement. London: Sage, 1994. [Google Scholar]
  20. Chow SL. Statistical Significance: Rationale, Validity and Utility. London: Sage, 1996. [DOI] [PubMed] [Google Scholar]
  21. Conners KC. Symptom patterns in hyperkinetic, neurotic and normal children. Child Development 1970; 41: 667–82. [Google Scholar]
  22. Deyo RA, Diehr P, Patrick DL. Reproducibility and Responsiveness of Health Status Measures. Controlled Clinical Trials, 1991; 12: 142s–58s. [DOI] [PubMed] [Google Scholar]
  23. Dunn G, Everitt B, Pickles A. Modelling Covariances and Latent Variables using EQS. London: Chapman‐Hall, 1993. [Google Scholar]
  24. Fleiss JL. Statistical Methods for Rates and Proportions. New York: Wiley, 1981. [Google Scholar]
  25. Gomez R, Harvey J, Quick C, Scharer I, Harris G. DSM‐IV AD/HD: Confirmatory factors models, prevalence, and gender and age differences based on parent and teacher ratings of Australian primary school children. Journal of Child Psychology and Psychiatry, 1999; 40: 265–74. [PubMed] [Google Scholar]
  26. Grodzinsky GM, Barkley RA. Predictive power of frontal lobe tests in the diagnosis of attention‐deficit hyperactivity disorder. Clinical‐Neuropsychologist 1999; 13: 12–21. [DOI] [PubMed] [Google Scholar]
  27. Healy JM, Newcorn JH, Halperin JM, Wolf IE, Pascualvaca DM, Schmeidler J, O'Brien JD. The factor structure of ADHD items in DSM‐II‐R: internal consistency and external validation. Journal of Abnormal Child Psychology 1993; 21: 441–53. [DOI] [PubMed] [Google Scholar]
  28. Hinshaw SP. On the distinction between attentional deficits/hyperactivity and conduct problem/aggression in child psychopathology. Psychological Bulletin 1987; 101: 443–63. [PubMed] [Google Scholar]
  29. Hobwenko H. Attention Deficit/Hyperactivity Disorder. London/Philadelphia: Jessica Kingsley Publishers, 1999. [Google Scholar]
  30. Holland ML, Gimpel GA, Merrel KW. Innovations in assessing ADHD: Development, psychometric properties, and factor structure of the ADHD Symptoms Rating Scale. Journal of Psychopathology and Behavioural Assessment 1998; 20: 307–32. [Google Scholar]
  31. Kalverboer AF. Disorders in attention and motor behaviour in children (De nieuwe buitenbeentjes. Stoornissen in aandacht en motoriek bij kinderen). Rotterdam: Lemniscaat, 1996. [Google Scholar]
  32. Lahey BA, Carlson CL. Validity of the diagnostic category of attention deficit disorder without hyperactivity: a review of the literature. Journal of Learning Disabilities 1991; 24: 110–20. [DOI] [PubMed] [Google Scholar]
  33. Lahey BA, Pelham WE, Schaughency E, Atkins MS. Dimensions and types of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry 1988; 27: 330–5. [DOI] [PubMed] [Google Scholar]
  34. Landis JR, Koch GG. The measurement of Observer Agreement for categorical Data. Biometrics 1977; 33: 159–74. [PubMed] [Google Scholar]
  35. Loeber R, Lahey BA, Thomas C. The diagnostic conundrum of oppositional defiant disorder, conduct disorder and its subtypes. Journal of Abnormal Psychology 1991; 100: 379–90. [DOI] [PubMed] [Google Scholar]
  36. Long JS. Confirmatory Factor Analysis. London: Sage, 1983. [Google Scholar]
  37. Munden A, Arcelus J. The ADHD‐Handbook. London/Philadelphia: Jessica Kingsley Publishers, 1999. [Google Scholar]
  38. Nelson‐Gray RO. DSM‐IV: Empirical guidelines from psychometrics. Journal of Abnormal Psychology 1991; 100: 308–15. [DOI] [PubMed] [Google Scholar]
  39. McCallum RC, Browne MW, Sugawara HM. Power analysis and determination of sample size for covariance structural modelling. Psychological Methods 1996; 1: 130–49. [Google Scholar]
  40. Pelham WE, Gnacy EM, Greenslade KE, Milich R. Teacher ratings of DSM‐III‐R symptoms for the disruptive behaviour disorders. J. Am. Acad. Adolesc. Psychiatry 1992; 31: 210–18. [DOI] [PubMed] [Google Scholar]
  41. Pillow DR, Pelham WE, Hoza B, Molina BSG, Stultz CH. Confirmatory factor analysis examining attention deficit hyperactivity disorder symptoms and other childhood disruptive behaviours. J. Abn. Child Psych. 1998; 26: 293–310. [DOI] [PubMed] [Google Scholar]
  42. Quay HC. Classification In Quay HC. and Werry JS. (eds). Psychopathological Disorders of Childhood. New‐York: John Wiley, 1979. [Google Scholar]
  43. Sattora A, Bentler PM. Corrections to test statistics and standard errors in covariance structure analysis In Van Eye A. and Clogg CC. (eds) Latent Variables Analysis: Applications for Developmental Research. Thousand Oaks: Sage, 1994. [Google Scholar]
  44. Swanson JM, Sergeant JA, Taylor E, Sonuga‐Barke EJS, Jensen PS, Cantwell DP. Attention‐deficit hyperactivity disorder and hyperkinetic disorder. The Lancet 1998; 351: 429–33. [PubMed] [Google Scholar]
  45. Scholte EM. Social Welfare in Holland In Colton M, Casas F, Drakeford M, Roberts S, Scholte EM. and Williams M. (eds) Stigma and Social Welfare: An International Comparative Study. Aldershot: Avebury, 1997. [Google Scholar]
  46. Scholte EM, Van der Ploeg JD. Exploring factors governing succesful residential treatment of youngsters with serious behavioural difficulties. Findings from a longitudinal study in Holland. Childhood. A Global Journal of Child Research 1000; 7: 129–53. [Google Scholar]
  47. Taylor, E . Attention Deficit and Conduct Disorder Syndromes In Rutter M, Hussian M, Tuma A, Lann IS. (eds) Assessment and Diagnosis in Child Psychopathology. London: David Fulton, 1988. [Google Scholar]
  48. Taylor E. Syndromes of attention Defiict and Overactivity In Rutter M, Taylor E, Hersov L. (eds) Child and Adolescent Psychiatry. Modern Approaches (2 edn.) Oxford: Blackwell, 1994. [Google Scholar]
  49. Van der Ploeg JD, Bruininks ACM (1996) ADHD – Problem and Methods of Treatment. Delft/Amsterdam: Eburon/Nippo, 1996. [Google Scholar]
  50. Wenar C, Kerig P. Developmental Psychopathology. From Infancy through Adolescence. New‐York: McGraw‐Hill, 1999. [Google Scholar]

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