Latent Class and Factor Analysis of DSM-IV ADHD: A Twin Study of Female Adolescents

doi:10.1097/00004583-199808000-00015

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 37, Issue 8, August 1998, Pages 848-857

https://doi.org/10.1097/00004583-199808000-00015 Get rights and content

ABSTRACT

Objective

In an attempt to validate the current DSM-IV criteria for attention-deficit/hyperactivity disorder (ADHD) in females and to determine whether symptoms are continuously distributed or categorically discrete, the authors performed factor and latent class analysis on ADHD symptom data from a large general population of adolescent female twins (1,629 pairs).

Method

A structured diagnostic assessment of DSM-IV ADHD was completed with at least one parent of 1,629 pairs by telephone. ADHD symptoms from 1,549 pairs were subjected to latent class and factor analysis.

Results

Latent class and factor analyses were consistent with the presence of separate continuous domains of inattention (ATT), hyperactivity-impulsivity (H-I), and combined ATT with H-I problems. Severe latent classes corresponding to the predominantly inattentive, predominantly hyperactive-impulsive, and combined types were identified with lifetime prevalence estimates of 4.0%, 2.2%, and 3.7%, respectively. Membership in the severe ATT class predicted academic problems, family problems, and referral to health care providers. Membership in the H-I and combined classes also predicted impaired social relationships.

Conclusions

These results suggest that DSM-IV ADHD subtypes can be thought of as existing on separate continua of inattention, hyperactivity-impulsivity, and combined type problems. Membership in any of the three severe ADHD latent classes did not preclude academic excellence, but it was associated with different types of impairment and health care-seeking behavior. These data have implications in the areas of diagnosis, classification, treatment, and research.

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: This work was supported by NIMH grant MH01265 and by NIAAA grants AA09022, AA07728, and NIMH MH 52813. We acknowledge the assistance of Dr. Vicki Howell, Missouri Division of Vital Statistics, in the ascertainment of this sample, and of Ms. Elizabeth Sparrow in the diagnostic review of some of these data.

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ARTICLESLatent Class and Factor Analysis of DSM-IV ADHD: A Twin Study of Female Adolescents

ABSTRACT

Objective

Method

Results

Conclusions

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Psyhiatry

J Psychiatr Res

Empirically Based Taxonomy: How to Use Syndromes and Profile Types Derived from the CBCL/4–18, TRF, and YSR

Diagnostic and Statistical Manual of Mental Disorders

Behavior and academic achievement in hyperactivity subgroups and learning-disabled boys

Am J Dis Child

Convergence of the Child Behavior Checklist with structured interview-based psychiatric diagnoses of ADHD children with and without comorbidity

J Child Psychol Psychiatry

Further evidence for family genetic risk factors in attention deficit hyperactivity disorder (ADHD): patterns of comorbidity in probands and relatives in psychiatrically and pediatrically referred samples

Arch Gen Psychiatry

Familial association between attention deficit disorder and anxiety disorders

Am J Psychiatry

Evidence of familial association between attention deficit disorder and major affective disorders

Arch Gen Psychiatry

High rate of affective disorders in probands with attention deficit disorder and in their relatives: a controlled family study

Am J Psychiatry

Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders

Am J Psychiatry

Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico

Arch Gen Psychiatry

Genetics of hyperactivity

J Child Psychol Psychiatry

Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: a receiver-operating characteristic analysis

J Consult Clin Psychol

Unrestricted and Restricted Maximum Likelihood Latent Structure Analysis: A Manual for Users

Association of attention deficit disorder and the dopamine transporter gene

Am J Hum Genet

Psychiatric disorders in pediatric primary care

Arch Gen Psychiatry

DSM-III major depressive disorders in the community: a latent class analysis of data from the NIMH Epidemiologic Catchment Area programme

Br J Psychiatry

Genes, Culture and Personality: An Empirical Approach

Analyzing twin resemblance in multisymptom data: genetic applications of a latent class model for symptoms of conduct disorder in juvenile boys

Behav Genet

ARTICLES
Latent Class and Factor Analysis of DSM-IV ADHD: A Twin Study of Female Adolescents