Language: Spanish
References: 13
Page: 63-68
PDF size: 104.28 Kb.

ABSTRACT

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders worldwide. The early detection of this disorder requires the use of screening instruments adapted to the cultural needs of the population. The Attention Deficit Hyperactivity Disorder Questionnaire for Latin American School Age Children and Adolescents (ADHD-LQSA) is a screening instrument designed in Latin American Spanish for the evaluation of probably cases of ADHD in children and adolescents. The design of the instrument was performed by an expert panel, integrated by psychiatrists, child and adolescent psychiatrists, child-neurologists, and neuropsychologists, during the first Latin American Consensus for ADHD in Mexico City in June 17-18, 2007. The ítems of the instrument were developed taking in to account the criteria used for ADHD in the Diagnostic and Statistical Manual for Mental Disorders, IV edition (DSM-IV) of the American Psychiatric Association. They were meant to be responded by the father or the mother in a Likert-type scale way; the main criteria for the detection of inattention, hyperactivity and impulsivity were included, as well as a poor psychomotor coordination ítem. The aim of this investigation was to establish the internal, construct, concurrent, convergent and divergent validities, and the temporal reliability of the ADHD-LQSA.
Material and methods: The sample was integrated with 985 subjects from nine countries of North, Central and South America. From the total 40.9% came from an epidemiological source and 65.4% were male. The mean age of those evaluated was 9.72 (± 3.06) years and the mean school years were 3.68 (± 2.82). The whole sample answered the ADHD-QLSA and the internal consistence and factorial analysis were performed with this evaluation. The clinical sample was integrated by 582 subjects and all of them received a clinical evaluation by one of the investigators who filled up an ADHD checklist for DSM-V criteria and established the diagnosis correlated with the total score of the ADHDQLSA to obtain the concurrent validity. In a subsample, 85 subjects answered also three different instruments: one for ADHD, one for anxiety and one for depression in order to establish the convergent and divergent validities; these same subjects answered again 15 days after the first application of the ADHD-QLSA.
Results: The Cronbach alfa value was 0.96. The factorial analysis that included all the subjects showed three factors: inattention, hyperactivity/impulsivity and tempo cognitivo lento; the Eigen value and the variance percentage were 13.89; 49.6%; 2.62; 9.3% and 1.07, 3.8% respectively. In the concurrent validity, we found that 16 out of the 28 ítems showed a significant correlation with the DSM-IV diagnostic criteria. The correlation of the total score of the ADHD-QLSA with the diagnosis of ADHD was r=0.45 (p=0.001). These 16 ítems were included in a second factorial analysis that showed two main factors: hyperactivity/impulsivity and inattention; the Eigen value and the percentage of the variance for each one was 9.56; 53.1%, and 2.07, 11.5%, respectively. The convergent validity with the ADHD instrument was r=0.89 (p‹.0001); the divergent correlation with the anxiety and depressive instruments were: r=0.31 (p=0.003) and r=0.19 (p=0.074), respectively. In the temporal reliability analysis, the intraclass correlation coefficient was 0.9697 (IC=95%; range 0.95-0.98).
Discussion: Inattention and hyperactivity/impulsivity factors explained 60% of the total variance; these same results had been observed in other Latin American studies. We must point out that a third factor explained almost 4% of the variance; this factor was named «tempo cognitivo lento», because it was integrated by the following ítems: low psychomotor coordination, oversights, lose of objects and seems not to be listening when talking. In this Latin American population, parents rated with higher scores the inattention than the hyperactivity/impulsivity manifestations; the inattentive factor explained by itself49.6% of the variance. We found a high convergent validity with another ADHD instrument and, as expected, a low correlation with the anxiety and depressive instruments. The temporal reliability was performed only in clinical population. In conclusion, the ADHD-QLSA showed good validity and reliability values in this investigation.

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