Subtypes versus severity differences in attention-deficit/hyperactivity disorder in the Northern Finnish Birth Cohort.
OBJECTIVE
To investigate whether behaviors of inattention, hyperactivity, and impulsivity among adolescents in Northern Finland reflect qualitatively distinct subtypes of ADHD, variants along a single continuum of severity, or of severity differences within subtypes.


METHODS
Latent class models, exploratory factor models, and factor mixture models were applied to questionnaire data of ADHD behaviors obtained from the Northern Finland Birth Cohort (NFBC). Latent class models correspond to qualitatively distinct subtypes, factor analysis corresponds to severity differences, and factor mixture analysis allows for both subtypes and severity differences within subtypes.


RESULTS
A comparison of the different models shows that models that distinguish between a low scoring majority class (unaffecteds) and a high scoring minority class (affecteds), and allow for two factors (inattentive, hyperactive-impulsive) with severity differences provide the best fit.


CONCLUSIONS
The analysis provides support that a high-scoring minority group (8.8% of males and 6.8% of females) likely reflects an ADHD group in the Northern Finland Birth Cohort, whereas the majority of the population falls into a low-scoring group of unaffecteds. Distinct factors composed of items of inattention and hyperactivity-impulsivity are evident for both sexes with considerable variability in severity within each class.
Lubke
Gitta H
GH
University of Notre Dame, Notre Dame, IN, USA.
Muthén
Bengt
B
Moilanen
Irma K
IK
McGough
James J
JJ
Loo
Sandra K
SK
Swanson
James M
JM
Yang
May H
MH
Taanila
Anja
A
Hurtig
Tuula
T
Järvelin
Marjo-Riitta
MR
Smalley
Susan L
SL
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D002391:Catchment Area, Health; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires