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Yıl:2005; Cilt: 8; Sayı: 1>> Özet
TAM METİN
Klinik Psikiyatri Dergisi; 2005;8(1):5-17
Dikkat Eksikliği Hiperaktivite Bozukluğunun Değerlendirilmesinde Wechsler Çocuklar için Zeka Ölçeği Geliştirilmiş Formunun Yeri
EE Bakar, Ş Soysal, N Kiriş, A Şahin, S Karakaş
Hacettepe Üniv. İhsan Doğramacı Çocuk Hast. Çocuk Nörolojisi Ana BD., Ankara, Türkiye
Amaç: Bu çalışmada, kontrollü koşullar altında, yeteri sayıdaki DEHB olgusu ve bunlarla eşleşmiş sağlıklı denekten elde edilen WISC-R puanları analiz edilmektedir. Çalışma çok-merkezli bir proje olarak gerçekleştirilmiş bulunmaktadır. Yöntem ve Gereçler: Klinik örneklemi DSM-IV kriterlerine göre DEHB tanısı alan, 6-16 yaş grubunda 105 erkek olgu oluşturmuştur. Kontrol grubunu ise DEHB grubuyla eşleşmiş 90 denek oluşturmuştur. WISC-R bu testi uygulama eğitimi almış üç psikolog tarafından, deneklere bireysel olarak uygulanmıştır. Bulgular: Temel bileşenler analizi sağlıklı çocuklarda faktör örüntüsünün sözel, performans ve şifre faktörlerini ayrı ayrı içerdiğini; DEHB'li çocuklarda ise bu örüntünün bozulduğunu ortaya koymuştur. Çok değişkenli varyans analizi grup etkisinin anlamlı olduğunu (Wilks lambda<.01) göstermiştir. Bu analizlerde anlamlı olarak etkilenen Genel Bilgi, Aritmetik, Küplerle Desen ve Şifre Alttest puanları ile yapılan lojistik regresyon analizi sonucunda, yordamada yer alan tek alttest olan Şifre'nin; toplam yordama değeri %63.08 gibi düşük bir değer olmuştur. Bu bulgular WISC-R puanlarının 90 sağlıklı denekten 40'ını DEHB grubuna; 105 DEHB hastasından 32'sini ise sağlıklı gruba koyduğunu göstermektedir. Tartışma: WISC-R puanları için şansa yakın düzeyde elde edilmiş olan isabet oranlarıyla konulan tanıların tıbbi değerinin olabileceğini düşünebilmek mümkün değildir. Bu bulgular, DEHB'de WISC-R'ın yerinin dikkatlice değerlendirilmesi gerektiğini ortaya koymuştur.
The Place of Wechsler Intelligence Scale for Children-Revised in Assessment of Attention Deficit Hyperactivity Disorder
Objective: The present study analyzed WISC-R scores that were obtained from a sufficient number of ADHD patients and matched control subjects under controlled conditions. This study was realized as a multi-center project. Methods: The clinical sample consisted of 105 male patients (age range: 6-16 [year]s). The control group consisted of 90 male subjects who were matched with the ADHD sample. WISC-R was individually administered to the subjects by three testors who had the relevant training for WISC-R administration. Results: Principal component analysis showed that the factor structure of the control group included separate factors for verbal subtest scores, performance subtest scores and coding score. The factor sructure of the ADHD group was disorganized. Multivariate analysis of variance showed that the group variable (ADHD, control) was significant. The significantly affected scores that included General Information, Arithmetic, Block Design and Coding subtests were subjected to logistic regression analysis. The only score that the regression model included was Digit Symbol. The accuracy of prediction for the total model was a low value, 63.08%. These results showed that WISC-R scores misclassified 40 of 90 healthy subjects as DEHB and 32 of 105 DEHB patients as healthy. Discussion: Clinical diagnosis that are made with hit rates such as those obtained using WISC-R scores may, most probably, not have any clinical value. The findings of the present study show that the place of WISC-R in assessing DEHB patients should be carefully reconsidered.

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