Précision des échelles Achenbach dans le dépistage du trouble déficitaire de l'attention / hyperactivité dans une clinique publique de santé mentale

Aperçu: G.M.

Des rapports sur les aidants naturels, les enseignants et les jeunes du Système d'évaluation empirique d'Achenbach (ASEBA) ont été obtenus pour 299 enfants et 321 adolescents.

Chez les enfants, les problèmes d'attention déclarés par les aidants naturels ont surpassé toutes les autres sous-échelles de l'aidant et les mesures de l'enseignant.

Dans l'échantillon plus âgé, les problèmes d'attention déclarés par les soignants et les enseignants  ont été les plus efficaces pour identifier le TDAH. L'inclusion des rapports des aidants et des enseignants a augmenté de manière significative la prédiction du diagnostic de TDAH, contrairement à l'auto-évaluation des jeunes.

J Am Acad Child Adolesc Psychiatry. 2017 May;56(5):401-409. doi: 10.1016/j.jaac.2017.02.007. Epub 2017 Mar 6.

Accuracy of Achenbach Scales in the Screening of Attention-Deficit/Hyperactivity Disorder in a Community Mental Health Clinic

Raiker JS¹, Freeman AJ², Perez-Algorta G³, Frazier TW⁴, Findling RL⁵, Youngstrom EA⁶.

Author information

1

Florida International University, Miami.

2

University of Nevada, Las Vegas. Electronic address: andrew.freeman@unlv.edu

3

Lancaster University, Lancashire, UK.

4

Center for Autism at the Cleveland Clinic Lerner College of Medicine, Cleveland.

5

Johns Hopkins University, Baltimore.

6

University of North Carolina at Chapel Hill.

Abstract

OBJECTIVE:

To use receiver-operating characteristics analysis to identify multilevel diagnostic likelihood ratios and provide a framework for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in children (5-10 years old) and adolescents (11-18 years old) in an outpatient setting.

METHOD:

Caregiver, teacher, and youth reports from the Achenbach System of Empirically Based Assessment (ASEBA) were obtained for 299 children and 321 adolescents with multiple imputation of missing data. The reference standard was diagnosis of ADHD based on case history and a semistructured diagnostic interview masked to the ASEBA measurements.

RESULTS:

In children, caregiver-reported Attention Problems (area under the curve [AUC] = 0.74) outperformed all other subscales of the caregiver and teacher measures (AUCs ≤ 0.72). In the older sample, caregiver- and teacher-reported Attention Problems (caregiver AUC = 0.73; teacher AUC = 0.61) were best at identifying ADHD. Inclusion of caregiver and teacher reports significantly (p < .001 for all comparisons) increased prediction of ADHD diagnosis, whereas youth self-report did not.

CONCLUSION:

Caregiver-reported Attention Problems were more useful than teacher-reports and self-report in identifying ADHD. Combining caregiver and teacher reports improved identification. Multilevel likelihood ratios are provided to facilitate routine clinical use.

Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

PMID: 28433089  

DOI: 10.1016/j.jaac.2017.02.007