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Internal and External Validity of Sluggish Cognitive Tempo and ADHD Inattention Dimensions with Teacher Ratings of Nepali Children

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Abstract

The objective was to evaluate the validity of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) symptoms in children from Nepal. Teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection dimensions in 366 children (50 % girls) in first through sixth grades (M age = 9.35, SD age = 1.96) on two separate occasions separated by 4-weeks. Seven of the eight SCT symptoms and all nine ADHD-IN symptoms showed convergent validity (substantial loadings on their respective factors) and discriminant validity (higher loadings on their respective factor than the alternative factor) at both time-points. Across all three separate analyses (assessment 1, assessment 2, and from assessment 1 to assessment 2), higher SCT scores were associated with lower ADHD-HI scores and higher depression, academic impairment, and social impairment scores after controlling for ADHD-IN while higher ADHD-IN scores were associated with higher ADHD-HI, ODD, academic impairment, and peer rejection scores after controlling for SCT. Also, as hypothesized, SCT scores were not related to ODD scores after controlling for ADHD-IN. The study provides the first evidence for the internal and external validity of the SCT dimension relative to the ADHD-IN dimension with teacher ratings of children from Nepal, thereby increasing the validity of the SCT construct beyond North America, Western Europe, South America, and South Korea.

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Notes

  1. Confirmatory factor analytic procedures were used to calculate the reliability coefficients (i.e., true score variance in each subscale, see Brown, 2015, pp. 305-321) along with the stability coefficient for the scales across the 4-week interval (Brown, 2015, pp. 221-233). The SCT, ADHD-IN, ADHD-HI, ODD, anxiety, depression, academic impairment, social impairment, and peer rejection nine-factor model also resulted in a good global fit at assessments one and two (assessment one: χ 2 (1448) = 2088, CFI = .945, TLI = .941, RMSEA = .035 (90 % CI .031, .038); assessment two: χ 2 (1448) = 2006, CFI = .964, TLI = .962, RMSEA = .032 (90 % CI .029, .036). In addition, the item factor loadings were substantial (all > .70 with most > .80) on their respective factors with the exception of three anxiety items at assessment one and four at assessment two (loadings from .32 to .61) and one peer rejection item at assessment two (loading of .63). The factors also showed discriminant validity with each other. Although these results should be considered preliminary due to the large number of items (56 manifest variables) relative to the small number of participants (366 children rated by 61 teachers), these findings do replicate and extend the factor analytic results from the first study with teacher ratings of Nepali children (Pendergast et al. 2014). These results are not reported in greater detail due to the large number of manifest variables relative to sample size. This was also the reason the correlational and regression analyses used manifest rather than latent variables. The CFA findings are available from the second author.

  2. Neither SCT nor ADHD-IN was significantly correlated with age (assessment one: r SCT = .06, SE SCT = .05, ns; r ADHD-IN = .05, SE ADHD-IN = .07, ns; assessment two: r SCT = .13, SE SCT = .07, ns; r ADHD-IN = .10, SE ADHD-IN = .09, ns). Boys had significantly higher ADHD-IN scores than girls at both assessments (assessment one: r = .18, SE = .05, p < .001; assessment two: r = .10, SE = .05, p < .05). In contrast, boys had significantly higher SCT scores than girls only at assessment one (assessment one: r = .12, SE = .04, p < .05; assessment two: r = .06, SE = .04, ns).

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Authors and Affiliations

  1. Children’s Mercy Hospital, Kansas City, MO, USA

    Girwan Khadka

  2. Department of Psychology, Washington State University, Pullman, WA, 99164-4820, USA

    G. Leonard Burns

  3. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Stephen P. Becker

Authors
  1. Girwan Khadka
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  2. G. Leonard Burns
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  3. Stephen P. Becker
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Correspondence to G. Leonard Burns.

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Girwan Khadka, G. Leonard Burns, and Stephen P. Becker declare that they have no conflict of interest.

Experiment Participants

The current study was conducted with the informed consent of all participants. Washington State University’s Department of Psychology (the University IRB ruled the study exempt from IRB review) approved the study's protocol along with the three elementary schools.

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Khadka, G., Burns, G.L. & Becker, S.P. Internal and External Validity of Sluggish Cognitive Tempo and ADHD Inattention Dimensions with Teacher Ratings of Nepali Children. J Psychopathol Behav Assess 38, 433–442 (2016). https://doi.org/10.1007/s10862-015-9534-6

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