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Are there distinct cognitive and motivational sub-groups of children with ADHD?

Published online by Cambridge University Press:  16 November 2017

Rikke Lambek ,
Edmund Sonuga-Barke ,
Rosemary Tannock ,
Anne Virring Sørensen ,
Dorte Damm  and
Per Hove Thomsen
Rikke Lambek*
Affiliation:
Aarhus University, Aarhus, Denmark
Edmund Sonuga-Barke
Affiliation:
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Kings College, London, United Kingdom & Ghent University, Ghent, Belgium
Rosemary Tannock
Affiliation:
University of Toronto & Hospital for Sick Children, Toronto, Canada
Anne Virring Sørensen
Affiliation:
Aarhus University Hospital, Aarhus, Denmark
Dorte Damm
Affiliation:
Aarhus University Hospital, Aarhus, Denmark
Per Hove Thomsen
Affiliation:
Aarhus University, Aarhus, Denmark Aarhus University Hospital, Aarhus, Denmark
*
Author for correspondence: Rikke Lambek, E-mail: rikkel@psy.au.dk
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Abstract

Background

Attention-deficit/hyperactivity disorder (ADHD) is proposed to be a neuropsychologically heterogeneous disorder that encompasses two distinct sub-groups, one with executive function (EF) deficits and one with delay aversion (DA). However, such claims have often been based on studies that have operationalized neuropsychological deficits using a categorical approach – using intuitive but rather arbitrary, clinical cut-offs. The current study applied an alternative empirical approach to sub-grouping in ADHD, latent profile analysis (LPA), and attempted to validate emerging subgroups through clinically relevant correlates.

Methods

One-hundred medication-naïve children with ADHD and 96 typically developing children (6–14 years) completed nine EF and three DA tasks as well as an odor identification test. Parents and teachers provided reports of the children's behavior (ADHD and EF). Models of the latent structure of scores on EF and DA tests were contrasted using confirmatory factor analysis (CFA). LPA was carried out based on factor scores from the CFA and sub-groups were compared in terms of odor identification and behavior.

Results

A model with one DA and two EF factors best fit the data. LPA resulted in four sub-groups that differed in terms of general level of neuropsychological performance (ranging from high to very low), odor identification, and behavior. The sub-groups did not differ in terms of the relative EF and DA performance. Results in the ADHD group were replicated in the control group.

Conclusions

While EF and DA appear to be dissociable constructs; they do not yield distinct sub-groups when sub-grouping is based on a statistical approach such as LPA.

Keywords

ADHDdelay aversionexecutive functionlatent profile analysis (LPA)
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 10 , July 2018 , pp. 1722 - 1730
Copyright
Copyright © Cambridge University Press 2017 

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