Middle Eastern Journal of Disability Studies
مجله مطالعات ناتوانی
MEJDS
Medical Sciences
http://jdisabilstud.org
1
admin
2322-2840
2322-2840
10.29252/mejds
14
8888
13
fa
jalali
1398
12
1
gregorian
2020
3
1
10
شماره سال ۱۳۹۹
online
1
fulltext
fa
توان تشخیصی مقیاسهای درجهبندی والدین در تفکیک کودکان مبتلا به اختلال نارسایی توجه/فزونکنشی از کودکان فاقد این اختلال
The Diagnostic Accuracy of Parent Rating Scales in Discriminating Children with and Without Attention-Deficit/Hyperactivity Disorder
روانشناسی
Psychology
مقاله پژوهشی اصیل
Original Research Article
<p style="font-style: normal; text-align: justify;"><span style="font-size:12px;"><span style="font-family:Tahoma;"><strong>زمینه و هدف: </strong>اختلال نارسایی توجه/فزونکنشی یکی از شایعترین اختلالات عصبیرفتاری در دوران کودکی است که هنوز هیچ روش یا منبع اطلاعاتی واحدی برای تشخیص دقیق این اختلال شناسایی نشده است. هدف پژوهش حاضر بررسی توان تشخیصی مقیاسهای درجهبندی والدین در تفکیک کودکان مبتلا به این اختلال از کودکان فاقد آن بود.<strong><span dir="LTR"><span style="font-size:8.0pt;"></span></span></strong><br>
<strong>روشبررسی: </strong>تحقیق حاضر از نوع توصیفی و روانسنجی بود. جامعهٔ آماری را دانشآموزان پسر ابتدایی شهر مشهد در سال تحصیلی ۹۴-۱۳۹۳ تشکیل دادند. نمونه شامل بیست کودک بهنجار و بیست کودک مبتلا به اختلال نارسایی توجه/فزونکنشی بود که با روش نمونهگیری دردسترس انتخاب شدند. برای جمعآوری دادهها از فرم کوتاه و تجدیدنظرشدهٔ مقیاس درجهبندی والدین کانرز (کانرز و همکاران، ۱۹۹۷) و فرم کوتاه مقیاس اسنپ-۴ ویژۀ والدین (سوانسون و همکاران، ۲۰۰۱) در دو مرحله با فاصلهٔ چهار هفته استفاده شد. دادهها ازطریق میانگین و انحراف معیار، آلفای کرونباخ، همبستگی پیرسون، آزمون تحلیل واریانس چندمتغیری و تحلیل راک در سطح معناداری ۰٫۰۵ با استفاده از نرمافزار <span dir="LTR">SPSS</span> نسخهٔ ۲۵ تحلیل شد.<br>
<strong>یافتهها: </strong>نتایج پژوهش حاضر نشان داد، نسخهٔ والدین مقیاسهای کانرز و اسنپ-۴ میتواند بهطور معناداری کودکان نارساتوجه/فزونکنش را از کودکان فاقد این اختلال متمایز کند (۰٫۰۰۱><span dir="LTR">(<em>p</em></span>؛ همچنین برای تمام خردهمقیاسهای این دو مقیاس، اندازههای حساسیت با مقادیر بیشتر از ۰٫۷۰ و ویژگی بیشتر از ۰٫۷۰ است.<br>
<strong> نتیجهگیری:</strong> براساس یافتههای این پژوهش خصوصیات روانسنجی مقیاسهای کانرز و اسنپ تأیید میشود؛ بنابراین از این دو مقیاس میتوان بهعنوان ابزارهایی مطلوب در تشخیص اختلال <span dir="LTR">ADHD</span> استفاده کرد</span></span></p>
<p style="font-style: normal; text-align: justify;"><span style="font-family:Tahoma;"><span style="font-size:12px;"><strong>Background & Objectives: </strong>Attention–Deficit Hyperactivity/Disorder (ADHD) remains a highly controversial psychological condition due to its complex nature and co-occurrence with several comorbid disorders; thus, it makes differential diagnosis especially difficult (if not impossible). The overdiagnosis of ADHD and subsequently the over-prescription of psychostimulants to these children are the most essential parts of ADHD controversy. There exists no accurate diagnostic method to help professionals to establish a correct diagnosis of ADHD; therefore, they have been recommended to use multiple methods and information sources, such as interviews with parents and teachers, behavioral rating scales, direct observation techniques, and neuropsychological tests to ensure the correct diagnosis. This study aimed to investigate the diagnostic power of behavioral rating scales responded by parents in diagnosing ADHD as well as their other psychometric properties.<br>
<strong>Methods:</strong> This was a descriptive and methodological study. The statistical population included all male students in Mashhad City, Iran, in the 2014–2015 academic year. The study sample consisted of 40 students selected by convenience sampling method. To gather the quantitative data, we <em>observed</em> students in <em>classroom</em> settings and interviewed their teachers and parents. Of these boys, 20 were healthy and 20 had received ADHD diagnosis by a physician before participating in our study. We administered a short three–subscale form of the Wechsler Intelligence Scale for Children–Revised (Wechsler, 1974) to all these 40 children to ensure they have no intellectual disability. Besides, the study groups were matched concerning intelligence quotient. Then, we trained blind interviewers to administer semi–structured interviews with the children’s parents to verify their initial ADHD diagnoses; they also requested the parents to rate their children’s classroom behaviors using the Conners Parent Rating Scale–Revised (CPRS–R) (Conners, 1997) and the Swanson, Nolan, and Pelham–4 Rating Scale (SNAP–IV) (Swanson et al., 2001) two times with a <em>one–month interval</em>. We also used the Receiver Operating Characteristic (ROC) analysis to calculate the sensitivity and specificity as well as False Positive Rate (FPR) and False Negative Rate (FNR) for these scales. Additionally, we used Cronbach’s alpha coefficient and Pearson correlation coefficient methods to evaluate the internal consistency and test-retest reliability of both rating scales in SPSS. The significance level of the tests was set at 0.05.</span></span></p>
<p style="font-style: normal; text-align: justify;"><span style="font-family:Tahoma;"><span style="font-size:12px;"><strong>Results:</strong> Multivariate Analysis of Variance (MANOVA) followed by one–way Analysis of Variance (ANOVA) and posthoc tests data indicated that all subscales of CPRS–R and SNAP–IV could significantly distinguish between ADHD and non–ADHD children. Cronbach’s alpha coefficient for the total 18 items of SNAP–IV, as well as predominantly inattentive (first 9 items) and predominantly hyperactive/impulsive (second 9 items) subscales of it, were measured as 0.99, 0.97, and 0.98, respectively, indicating excellent internal consistencies. Test-retest reliabilities for the total 18 items and predominantly inattentive (first 9 items) and predominantly hyperactive/impulsive (second 9 items) subscales of SNAP–IV were 0.72, 0.77, and 0.68, respectively, indicating acceptable test-retest reliabilities for it. For CPRS–R, Cronbach’s alpha coefficients were obtained as 0.95, 0.89, and 0.88, 0.90 for cognitive (6 items), hyperactive (6 items), oppositional (6 items), and total (9 items) subscales, respectively. Test-retest reliabilities for cognitive, hyperactive, oppositional, and total subscales were computed as 0.94, 0.74, and 0.77, 0.86 respectively. ROC analyses also presented an excellent to acceptable sensitivity and specificity for all the subscales of the CPRS–R, and SNAP–IV rating scales. All sensitivities ranged between 0.70 and 0.85, all specificities raged between 0.70 and 0.90; the AUC values of SNAP–IV and CPRS–R lied between 0.80 and 0.89, which indicated their excellent diagnostic power with low FPR and FNR rates. </span></span></p>
<p style="font-style: normal; text-align: justify;"><span style="font-family:Tahoma;"><span style="font-size:12px;"><strong>Conclusion:</strong> Our results suggested that the diagnostic accuracy of the Persian versions of the CPRS–R, and SNAP–IV subscales were excellent to acceptable. The CPRS–R and SNAP–IV indicated excellent diagnostic accuracy in this study; however, using them in isolation is not recommended.</span></span></p>
اختلال نارسایی توجه/فزونکنشی, توان تشخیصی, فرم والدین مقیاس درجهبندی مقیاس کانرز, فرم والدین مقیاس درجهبندی اسنپ-۴.
Attention–deficit/hyperactivity disorder, Diagnostic accuracy, Conners Parent Rating Scale (CPRS), Swanson, Nolan, and Pelham Rating Scale–Parent Form (SNAP–IV).
231
231
http://jdisabilstud.org/browse.php?a_code=A-10-780-2&slc_lang=fa&sid=1
Vahideh
Momeniyan
وحیده
مومنیان
va.momeniyan@gmail.com
100319475328460051908
100319475328460051908
No
Semnan University
دانشگاه سمنان
Morteza
Nazifee
مرتضی
نظیفی
mnazifee@gmail.com
100319475328460051909
100319475328460051909
Yes
University of Bojnord
دانشگاه بجنورد
Siavash
Talepasand
سیاوش
طالع پسند
stalepasand@semnan.ac.ir
100319475328460051910
100319475328460051910
No
Semnan University
دانشگاه سمنان