RESUMO
Introducción: El método politético, recogido en el Manual Diagnóstico y Estadístico de los Trastornos Mentales-IV, es el que se plantea tradicionalmente para el diagnóstico de los trastornos por déficit de atención e hiperactividad (TDAH). Sin embargo, es probable que este procedimiento, que conlleva establecer cualquier combinación de 6 ítems, no sea el más adecuado para establecer un diagnóstico de TDAH y que las diferentes combinaciones de ítems tengan desigual peso. Objetivo: Determinar qué combinaciones de ítems de las escalas de inatención e hiperactividad-impulsividad de DuPaul, para padres y maestros, son las más efectivas a la hora de diagnosticar o descartar un TDAH. Resultados: No todas las combinaciones de ítems de padres y maestros obtuvieron el mismo valor predictivo. Todas ellas ofrecieron altos grados de especificidad, pero bajos grados de sensibilidad; es decir, las combinaciones resultaron más efectivas y confiables para descartar este tipo de trastornos que a la hora de diagnosticarlos. Discusión: El método que implica establecer combinaciones de los ítems mejores predictores del TDAH ofreció superiores resultados que los del método politético. No obstante, se requieren futuros estudios con muestras que posean tasas base más elevadas para obtener datos más fiables. Asimismo, sería conveniente emplear un método alternativo para la selección de los sujetos participantes que permita comprobar, posteriormente, la eficacia diagnóstica pura de los diferentes ítems de las escalas de clasificación de los TDAH (AU)
Introduction: The polythetic method used in the DSM is the one proposed traditionally for the diagnosis of Attention Disorders with or without Hyperactivity (ADHD). However, it is possible that the approach which aggregates any combination of 6 items wont be the optimal method to establish a diagnosis of ADHD, and that the different combinations may not be the same as regards to their ability to predict ADHD. Aim: Determine which combinations of items of DuPaul's inattention and hyperactivity-impulsivity scales (from parent and teacher versions), are the most effective to predict or rule out a diagnosis of ADHD. Results: Not every combination of items from parents and teachers obtained the same predictive value. All of them offered high levels of specificity, but had low sensivity; that is to say, the combinations were more effective and reliable for ruling out the disorder than predicting it. Conclusions: Data show that not every combination of ADHD items has the same predictive value and, therefore, the well-known polythetic method is disputable. The highest predictive value combinations, limitations of the study, and future lines of investigation are analyzed (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Psicometria/instrumentação , Manual Diagnóstico e Estatístico de Transtornos Mentais , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Estudos Prospectivos , Relações Pais-FilhoRESUMO
INTRODUCTION: The polythetic method used in the DSM is the one proposed traditionally for the diagnosis of Attention Disorders with or without Hyperactivity (ADHD). However, it is possible that the approach which aggregates any combination of 6 items won't be the optimal method to establish a diagnosis of ADHD, and that the different combinations may not be the same as regards to their ability to predict ADHD. AIM: Determine which combinations of items of DuPaul's inattention and hyperactivity-impulsivity scales (from parent and teacher versions), are the most effective to predict or rule out a diagnosis of ADHD. RESULTS: Not every combination of items from parents and teachers obtained the same predictive value. All of them offered high levels of specificity, but had low sensivity; that is to say, the combinations were more effective and reliable for ruling out the disorder than predicting it. CONCLUSIONS: Data show that not every combination of ADHD items has the same predictive value and, therefore, the well-known polythetic method is disputable. The highest predictive value combinations, limitations of the study, and future lines of investigation are analyzed.