Bi-factor models of attention deficit/hyperactivity symptomatology in adolescents Criterion validity and implications for clinical practice
This study evaluated the fit and criterion validity of a bifactor model for 18 DSM-IV attention deficit/hyperactivity disorder (ADHD) symptoms, along with nine supplementary symptoms that represented the manifestation of inattention and hyperactivity-impulsivity in adolescence and early adulthood. Participants included N = 172 adolescents who were diagnosed with combined type ADHD and who were enrolled in a treatment study. A bifactor model provided reasonably good fit to combined parent- and teacher-reported DSM symptoms and supplemental items at baseline prior to treatment. Across models, the general factor was characterized by high reliability (ω = .93, .95), while specific inattentive and hyperactive-impulsive factors were characterized by poor reliability (ω = .30-.50). With respect to criterion validity, the general ADHD and specific inattentive factors were uniquely associated with home and school impairment ( R2 = .13-.29) but not adolescent risk-tasking behavior. Results are discussed with respect to the ways in which bifactor models of ADHD inform the diagnostic criteria for ADHD.
Willoughby, M., Fabiano, G. A., Schatz, N. K., Vujnovic, R. K., & Morris, K. L. (2017). Bi-factor models of attention deficit/hyperactivity symptomatology in adolescents: Criterion validity and implications for clinical practice. Assessment. https://doi.org/10.1177/1073191117698755