Utilidad del Children's Embedded Figures Test en el Trastorno por Déficit de Atención con Hiperactividad

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Abstract

El estudio analiza diferencias entre casos de Trastorno por Déficit de Atención con Hiperactividad (TDAH) y controles en su modo global / analítico de procesar la información, buscando el mejor modelo basado en el Children's Embedded Figures Test (CEFT) que permita predecir TDAH y analizando la validez de la prueba para el diagnóstico del trastorno. Se estudia una muestra de 100 casos de TDAH (criterios DSM-IV) y 100 controles, entre 7 y 11 años, evaluados mediante el CEFT. Los controles fueron reclutados de forma aleatoria y emparejados según edad, sexo y zona sociodemográfica con los casos. Los casos presentan un estilo cognitivo medio significativamente mas dependiente de campo (d = 1.36), reflejando un modo de procesamiento mas global que los controles en todas las edades. El modelo de regresión logística que mejor predice TDAH está formado por edad, sexo y CEFT. La formulación derivada del modelo presenta sensibilidad del 80% y especifidad del 84%, tomando como prueba de referencia criterios DSM-IV para TDAH. Concluimos valorando que el CEFT presenta utilidad y adecuada validez de criterio para TDAH.

Translated abstract

Objectives: To assess the differences among patients with Attention Deficit Hyperactivity Disorder (ADHD) and control subjects, in relation to their global/analytical way of processing information and to find the best model based in Children´s Embedded Figures Test (CEFT) which permits prediction and diagnosis of ADHD, and analyzing the validity of the test for the diagnostic of the disease. Method: We study 100 ADHD cases (DSM-IV criteria) and 100 controls, ranging between 7 and 11 years of age, analyzed with CEFT. Controls were randomly recruited and matched by age, gender and sociodemography area with cases. Results: Cases show an average cognitive style significantly more field dependent (d = 1.36), reflecting a more global way of processing information than controls at all ages. The logistic regression model that best predicts ADHD is constituted by age, gender and CEFT direct marks and the derived formula from the model shows an 80% of sensitivity and a 84% specificity for ADHD, taking as gold standard the DSM-IV criteria. Conclusion: CEFT test shows utility and of appropriate validity for diagnosing ADHD.

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Most cited references 31

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A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder.

Rhonda Martinussen, Jill Alison Hayden, Sheilah Hogg-Johnson … (2005)

To determine the empirical evidence for deficits in working memory (WM) processes in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Exploratory meta-analytic procedures were used to investigate whether children with ADHD exhibit WM impairments. Twenty-six empirical research studies published from 1997 to December, 2003 (subsequent to a previous review) met our inclusion criteria. WM measures were categorized according to both modality (verbal, spatial) and type of processing required (storage versus storage/manipulation). Children with ADHD exhibited deficits in multiple components of WM that were independent of comorbidity with language learning disorders and weaknesses in general intellectual ability. Overall effect sizes for spatial storage (effect size = 0.85, CI = 0.62 - 1.08) and spatial central executive WM (effect size = 1.06, confidence interval = 0.72-1.39) were greater than those obtained for verbal storage (effect size = 0.47, confidence interval = 0.36-0.59) and verbal central executive WM (effect size = 0.43, confidence interval = 0.24-0.62). Evidence of WM impairments in children with ADHD supports recent theoretical models implicating WM processes in ADHD. Future research is needed to more clearly delineate the nature, severity, and specificity of the impairments to ADHD.