Simple identification of complex ADHD subtypes using current symptom counts
Open accessAbstract
Objective New attention-deficit/hyperactivity disorder (ADHD) subtypes identified through latent class analysis have been recently proposed. Here, we assess the accuracy of simple rules based on symptom counts for the assignment of youths to clinically relevant population-derived ADHD subtypes: severe inattentive (SI) and severe combined (SC).Method Data from 9,675 twins and siblings from Missouri and Australia aged 7 to 19 years were analyzed using continuous and categorical models of ADHD symptoms using principal components analysis and subtyping by DSM-IV and by latent class criteria. Cut points were derived for classifying SI and SC subtypes by positive predictive value, negative predictive value, percent positive agreement, and Matthew coefficient of agreement.Results Principal components analysis suggested two underlying factors: total number of symptoms and symptom type, with SI and SC latent class subtypes clearly mapping to distinct areas on a plot of these factors. Having six or more total symptoms and fewer than three hyperactive-impulsive symptoms accurately predicts the latent class SI subtype. The latent class SC subtype was best identified by 11 or more total symptoms and 4 or more hyperactive-impulsive. The DSM-IV ADHD subtype criteria accurately identified the SC subtype but only poorly for the SI subtype.Conclusions Symptom counts criteria allow the simple and accurate identification of subjects with severe ADHD subtypes defined by latent class analysis. Such simple symptom counts corresponding to screening cut points selected latent class-derived SI subtype subjects with greater precision than DSM-IV criteria.
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LCA has been successfully applied in separate ASD and ADHD research fields and has disclosed clinically relevant, more homogeneous subtypes of both disorders.
“This approach has already been successfully ap-plied in the separate research fields of ASD and ADHD, and has with greater precision disclosed clinically relevant, more homogeneous subtypes of both disorders.[17][18][19]”
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Cites
Mendelson, G. (1995) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679509064964 · Cited by 2,592 · see citing works
Assessing the accuracy of prediction algorithms for classification: an overview
Baldi, P., Brunak, S., Chauvin, Y., Andersen, C. A. F., & Nielsen, H. (2000) · Bioinformatics · doi:10.1093/bioinformatics/16.5.412 · Cited by 2,111 · see citing works
McCutcheon, A. L. (1987) · Sage eBooks · doi:10.4135/9781412984713 · Cited by 2,082 · see citing works
Bucholz, K. K., Cadoret, R. J., Cloninger, C. R., Dinwiddie, S. H., HESSELBROCK, V. M., Nürnberger, J. I., Reich, T., Schmidt, I., & Schuckit, M. A. (1994) · Journal of Studies on Alcohol · doi:10.15288/jsa.1994.55.149 · Cited by 1,758 · see citing works
Epidemiology: Beyond the Basics
Szklo, M., & Nieto, F. J. (1999) · Cited by 1,455 · see citing works
Epidemiology: Beyond the Basics
Szklo, M. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.8.821 · Cited by 1,320 · see citing works
DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.11.1673 · Cited by 935 · see citing works
Autistic traits in a population-based ADHD twin sample
Reiersen, A. M., Constantino, J. N., Volk, H. E., & Todd, R. D. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2006.01720.x · Cited by 352 · see citing works
Self-citationMcBurnett, K., Pfiffner, L. J., & Frick, P. J. (2001) · Research on Child and Adolescent Psychopathology · doi:10.1023/a:1010377530749 · Cited by 308 · see citing works
DSM-IV Field Trials for the Disruptive Behavior Disorders: Symptom Utility Estimates
Frick, P. J., LAHEY, B. B., Applegate, B. E., KERDYK, L., Ollendick, T. H., Hynd, G. W., Garfinkel, B. D., Greenhill, L. L., Biederman, J., Barkley, R. A., et al. (1994) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199405000-00011 · Cited by 263 · see citing works
Latent Class and Factor Analysis of DSM-IV ADHD: A Twin Study of Female Adolescents
Hudziak, J. J., Heath, A. C., Madden, P. A. F., Reich, W., Bucholz, K. K., Slutske, W. S., Bierut, L. J., Neuman, R. J., & Todd, R. D. (1998) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199808000-00015 · Cited by 247 · see citing works
Self-citationLévy, F., & Hay, D. A. (2001) · doi:10.4324/9781315782959 · Cited by 169 · see citing works
Self-citationTodd, R. D., Rasmussen, E. R., Neuman, R. J., Reich, W., Hudziak, J. J., Bucholz, K. K., Madden, P. A. F., & Heath, A. C. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.11.1891 · Cited by 164 · see citing works
Self-citationEvaluation of ADHD Typology in Three Contrasting Samples: A Latent Class Approach
Neuman, R. J., Todd, R. D., Heath, A. C., Reich, W., Hudziak, J. J., Bucholz, K. K., Madden, P. A. F., Begleiter, H., Bernice Porjesz, A., Samuel Kuperman, C., et al. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199901000-00016 · Cited by 162 · see citing works
Self-citationHeath, A. C., Madden, P. A. F., Grant, J., McLaughlin, T., Todorov, A. T., & Bucholz, K. K. (1999) · Twin Research · doi:10.1375/136905299320566013 · Cited by 139 · see citing works
Self-citationCo-occurrence of motor problems and autistic symptoms in attention-deficit/hyperactivity disorder
REIERSEN, A. M., CONSTANTINO, J. N., & TODD, R. D. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31816bff88 · Cited by 123 · see citing works
Self-citation(2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_300321 · Cited by 117 · see citing works
Rasmussen, E., Neuman, R. J., Heath, A. C., Lévy, F., Hay, D. A., & Todd, R. D. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00248.x · Cited by 114 · see citing works
Self-citationRasmussen, E. R., Neuman, R. J., Heath, A. C., Lévy, F., Hay, D. A., & Todd, R. D. (2002) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00229 · Cited by 105 · see citing works
Self-citationTodd, R. D., Sitdhiraksa, N., Reich, W., Ji, T. H.-C., Joyner, C. A., Heath, A. C., & Neuman, R. J. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200207000-00014 · Cited by 103 · see citing works
Self-citationA Systematic Evaluation of ADHD and Comorbid Psychopathology in a Population-Based Twin Sample
Volk, H. E., Neuman, R. J., & Todd, R. D. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000166173.72815.83 · Cited by 88 · see citing works
Self-citationNeuman, R. J., Sitdhiraksa, N., Reich, W., Ji, T. H.-C., Joyner, C. A., Sun, L.-W., & Todd, R. D. (2005) · Twin Research and Human Genetics · doi:10.1375/twin.8.4.392 · Cited by 81 · see citing works
Self-citationReliability and Stability of a Semistructured DSM-IV Interview Designed for Family Studies
Todd, R. D., Joyner, C. A., Heath, A. C., Neuman, R. J., & Reich, W. (2003) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200312000-00013 · Cited by 73 · see citing works
Self-citationTodd, R. D., Huang, H., & Henderson, C. A. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01892.x · Cited by 63 · see citing works
Self-citationTodd, R. D., Rasmussen, E., Wood, C., Lévy, F., & Hay, D. A. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200405000-00012 · Cited by 60 · see citing works
Self-citationVolk, H. E., Henderson, C. A., Neuman, R. J., & Todd, R. D. (2006) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30299 · Cited by 53 · see citing works
Self-citationHeath, A., Madden, P., Grant, J., et al. (1999) · Twin Research · doi:10.1375/twin.2.2.145 · Cited by 44 · see citing works
Reformulating Attention-Deficit/Hyperactivity Disorder According to Signal Detection Theory
MOTA, V. L., & Schachar, R. J. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200009000-00014 · Cited by 42 · see citing works
The Latent Class Structure of ADHD Is Stable Across Informants
Althoff, R. R., Copeland, W. E., Stanger, C., Derks, E. M., Todd, R. D., Neuman, R. J., Van Beijsterveldt, T. C. E. M., Boomsma, D. I., & Hudziak, J. J. (2006) · Twin Research and Human Genetics · doi:10.1375/twin.9.4.507 · Cited by 38 · see citing works
Self-citationHay, D. A., McStephen, M., Lévy, F., & Pearsall-Jones, J. G. (2002) · Twin Research · doi:10.1375/136905202320906039 · Cited by 38 · see citing works
Self-citationFaraone, S. V., Biederman, J., SPRICH-BUCKMINSTER, S., Chen, W. J., & Tsuang, M. T. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199301000-00024 · Cited by 37 · see citing works
The diagnostic genetics of ADHD symptoms and subtypes
Lévy, F., McStephen, M., & Hay, D. A. (2021) · Psychology Press eBooks · doi:10.4324/9781315782959-3 · Cited by 11 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [1]American Psychiatric A Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) 1994 American Psychiatric Association Washington, D.C.
- [23]Rasmussen ER Neuman RJ Heath AC Levy F Hay DA Todd RD Replication of the latent class structure of Attention-Deficit/Hyperactivity Disorder (ADHD) subtypes in a sample of Australian twins. Journal of Child Psychology and Psychiatry and Allied Disciplines 2002 43 1018 28 12455923
Cited by
Sorted by citations
van der Meer, J. M. J., Oerlemans, A. M., van Steijn, D. J., Lappenschaar, M. G. A., de Sonneville, L. M. J., Buitelaar, J. K., & Rommelse, N. N. J. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.08.024 · Cited by 303 · see citing works
Frick, P. J., & Nigg, J. T. (2012) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032511-143150 · Cited by 290 · see citing works
Karalunas, S. L., Gustafsson, H., Fair, D. A., Musser, E. D., & Nigg, J. T. (2018) · Psychological Assessment · doi:10.1037/pas0000664 · Cited by 138 · see citing works
Mazaheri, A., Fassbender, C., Coffey‐Corina, S., Hartanto, T. A., Schweitzer, J. B., & Mangun, G. R. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.08.023 · Cited by 105 · see citing works
DuPaul, G. J., Morgan, P. L., Farkas, G., Hillemeier, M. M., & Maczuga, S. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-016-0126-z · Cited by 71 · see citing works
Goth-Owens, T. L., Martinez-Torteya, C., Martel, M. M., & Nigg, J. T. (2010) · Child Neuropsychology · doi:10.1080/09297049.2010.485126 · Cited by 69 · see citing works
Cognitive Control and Attentional Selection in Adolescents with ADHD Versus ADD
Carr, L., Henderson, J., & Nigg, J. T. (2010) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2010.517168 · Cited by 61 · see citing works
Initial Examination of the BRIEF2 in Clinically Referred Children With and Without ADHD Symptoms
Jacobson, L. A., Pritchard, A. E., Koriakin, T. A., Jones, K. E., & Mahone, E. M. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716663632 · Cited by 40 · see citing works
van der Meer, J. M. J., Lappenschaar, M. G. A., Hartman, C. A., Greven, C. U., Buitelaar, J. K., & Rommelse, N. N. J. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714533194 · Cited by 37 · see citing works
DSM-V and the future diagnosis of attention-deficit/hyperactivity disorder
Swanson, J. M., Wigal, T. L., & Lakes, K. D. (2009) · Current Psychiatry Reports · doi:10.1007/s11920-009-0060-7 · Cited by 38 · see citing works
Association between DRD4 genotype and Autistic Symptoms in DSM-IV ADHD.
Reiersen, A. M., & Todorov, A. A. (2011) · PubMed Central · Cited by 34 · see citing works
Self-citationDiagnostic Profiles Among Urban Adolescents With Unmet Treatment Needs
Hogue, A., & Dauber, S. E. (2011) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426611407500 · Cited by 34 · see citing works
Altered structural connectivity is related to attention deficit/hyperactivity subtypes: A DTI study
Ercan, E. S., Süren, S., Bacanlı, A., Yazıcı, K. U., Çallı, C., Ardıç, Ü. A., Jafari, D. A., Kosova, B., Özyurt, O., Aydın, C., et al. (2016) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2016.04.002 · Cited by 33 · see citing works
Lack of Association of Handedness With Inattention and Hyperactivity Symptoms in ADHD
Ghanizadeh, A. J. (2012) · Journal of Attention Disorders · doi:10.1177/1087054711429789 · Cited by 32 · see citing works
Parents reported oral sensory sensitivity processing and food preference in ADHD
Ghanizadeh, A. J. (2011) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2011.01830.x · Cited by 26 · see citing works
Katsuki, D., Yamashita, H., Yamane, K., Kanba, S., & Yoshida, K. (2020) · Child Psychiatry & Human Development · doi:10.1007/s10578-020-00977-8 · Cited by 26 · see citing works
Ercan, E. S., Süren, S., Bacanlı, A., Yazıcı, K. U., Çallı, C., Özyurt, O., Jafari, D. A., Kosova, B., Franco, A. R., & Rohde, L. A. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-015-0731-3 · Cited by 26 · see citing works
Do Hyperactive Symptoms Matter in ADHD-I Restricted Phenotype?
Schmitz, M. D., Ludwig, H. T., & Rohde, L. A. (2010) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2010.517170 · Cited by 23 · see citing works
Adolescent and Caregiver Reports of ADHD Symptoms Among Inner-City Youth
Hogue, A., Dauber, S. E., Lichvar, E., & Spiewak, G. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712443160 · Cited by 21 · see citing works
Smith, L. C., Tamm, L., Hughes, C. W., & Bernstein, I. H. (2012) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-012-0091-5 · Cited by 21 · see citing works
The latent classes of subclinical ADHD symptoms: Convergences of multiple informant reports
Kóbor, A., Takács, Á., Urbán, R., & Csépe, V. (2012) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2012.04.008 · Cited by 16 · see citing works
Wu, Z.-M., Wang, P., Liu, J., Liu, L., Cao, X., Sun, L., Yang, L., Cao, Q., Wang, Y., & Yang, B. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1099882 · Cited by 14 · see citing works
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Artificial Intelligence in Pediatrics: Important Clinical Signs in Newborn Syndromes
Braaten, Ø. (1996) · Computers and Biomedical Research · doi:10.1006/cbmr.1996.0013 · Cited by 10 · see citing works
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Krakowski, A. D., Szatmári, P., Crosbie, J., Schachar, R. J., Duku, E., Georgiades, S., & Anagnostou, E. A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.654120 · Cited by 10 · see citing works
Ghanizadeh, A. J. (2010) · Psychiatry Investigation · doi:10.4306/pi.2010.7.2.116 · Cited by 7 · see citing works
Andretta, J. R., Woodland, M. H., Ramirez, A. M., & Barnes, M. E. (2013) · Journal of Forensic Psychiatry and Psychology · doi:10.1080/14789949.2013.823218 · Cited by 6 · see citing works
Improving accuracy of ADHD subtype diagnoses with the ADHD symptom rating scale
Rogers, E., Graves, S., Freeman, A. J., Paul, M. G., Etcoff, L., & Allen, D. (2022) · Child Neuropsychology: A Journal of Normal and Abnormal Development in Childhood and Adolescence · doi:10.1080/09297049.2022.2044768 · Cited by 5 · see citing works
Parental Abuse Towards Their Children with ADHD in Iran
Ghanizadeh, A. J., Yazdanshenas, P., Nasab, M. M., Firoozabadi, A., & Farrashbandi, H. (2014) · Journal of Family Violence · doi:10.1007/s10896-014-9585-6 · Cited by 4 · see citing works
Durak, S. F., Tahıllıoğlu, A., Songür, Ç. Y., Çoban, M., Varol, B., & Ercan, E. S. (2025) · Applied Neuropsychology Child · doi:10.1080/21622965.2025.2493812 · Cited by 2 · see citing works
ADHD: New Approaches to Subtyping and Nosology
Nigg, J. T. (2015) · The ADHD Report · doi:10.1521/adhd.2015.23.2.6 · Cited by 2 · see citing works
Tempo cognitivo lento: una revisión actualizada
Ustárroz, J. T., Ruiz-García, B., Luna-Lario, P., & Goñi, P. H. (2015) · Revista de Neurología · doi:10.33588/rn.6107.2015327 · Cited by 2 · see citing works
Synapsin Polymorphisms Could Be Correlated with Stroop Simple Reaction Time Scores
Büber, A., Başay, B. K., Başay, Ö., Ozturk, O., Alaçam, H., Yazıcı, K. U., Bacanlı, A., Ay, M. E., Erdal, M. E., Herken, H., et al. (2016) · American Journal of Molecular Biology · doi:10.4236/ajmb.2016.61003 · Cited by 1 · see citing works
Tempo cognitivo lento (sluggish cognitive tempo) ¿Un subtipo de TDAH o una entidad diferente?
Torres, F. J. U. (2010) · Archivos de Investigación Materno Infantil
Browne, D. T., & Andrade, B. F. (2016) · Vulnerable Children and Youth Studies · doi:10.1080/17450128.2016.1160172
Artificial intelligence applied to medical genetics
Braaten, Ø. (2011) · NORA - Norwegian Open Research Archives
Exploración de los factores generales y específicos en la estructura del TDAH
de Miguel, J. F. (2019) · doi:10.35376/10324/35133
van der Meer, J. M. J. (2014) · Radboud Repository (Radboud University)
- Authors
- Volk, H. E., Todorov, A. A., Hay, D. A., & Todd, R. D.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Volk, Heather E.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 48
- Issue
- 4
- Pages
- 441-450
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC5763481
- OpenAlex
- W2009351653
- Cited by
- 39
- References
- 31
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 5 · 2015: 3 · 2014: 3 · 2013: 2 · 2012: 6
- FWCI
- 3.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eSpace (Curtin University) (submittedVersion)
- Funders
- National Institute of Mental Health (F31MH074272, R01MH052813, R01MH083823, MH074272, MH-52813, L40 MH078286, MH083823)
- National Institute of Environmental Health Sciences (T32ES013678, ES013678)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, ADHD subtypes, symptom count, latent class analysis, DSM-IV diagnostic criteria, hyperactive-impulsive symptoms, inattentive symptoms, youth, twins and siblings
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Severity of Illness Index, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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