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Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder

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ADHD Attention Deficit and Hyperactivity Disorders

Abstract

There is debate regarding the dimensional versus categorical nature of attention-deficit/hyperactivity disorder (ADHD). This study utilized confirmatory factor analysis to examine this issue. ADHD symptoms rated on interviews and rating scales from a large sample of individuals (ages 3–17, 74 % male, 75 % Caucasian) with ADHD were examined (n = 242). Four potential factor structures were tested to replicate prior findings in a sample with a wide age range and included only participants who met DSM-IV-TR diagnostic criteria for ADHD. Correlations with executive function measures were performed to further assess the separability and validity of the derived factors. The data support a bifactor model with a general ADHD factor and two specific factors, inattention and hyperactivity/impulsivity. Importantly, the individual factors were also differentially correlated with executive functioning measures. This study adds to a growing literature suggesting both a general component to ADHD, as well as dimensional traits of inattention and hyperactivity/impulsivity, associated with distinct executive functioning profiles. The presence of a general underlying factor contraindicates separating the inattentive and combined subtypes of ADHD into distinct disorders.

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Acknowledgments

We are grateful for funding from the Sparrow Foundation which supported data collection and data analysis. The authors would like to thank Chad Barnes for his work on database development, as well as all of the parents and youth who participated. The authors have no financial relationships to disclose, with the exception of Dr. Hughes who receives funding from NIMH (R34MH075762) and is a consultant for Biobehavioral Diagnostics, Inc.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8589, USA

    Lauren C. Smith & Carroll W. Hughes

  2. Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Pediatrics 3333 Burnet Ave. MLC 10006, Cincinnati, OH, 45229-3039, USA

    Leanne Tamm

  3. Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9066, USA

    Ira H. Bernstein

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  1. Lauren C. Smith
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Correspondence to Leanne Tamm.

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Smith, L.C., Tamm, L., Hughes, C.W. et al. Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder. ADHD Atten Def Hyp Disord 5, 9–20 (2013). https://doi.org/10.1007/s12402-012-0091-5

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