(PS7-41) Identification of an Inattention and Hyperactivity/Impulsivity Subscale on the Eyberg Child Behavior Inventory: Easing Routine Outcome Monitoring for Clinicians

Abstract Text: Intro
About 8% of children meet diagnostic criteria for Oppositional Defiant Disorder (ODD) or other disruptive behavior disorders (Lavigne et al., 2009). Many children with ODD diagnoses have comorbid diagnoses of Attention-Deficit/Hyperactivity Disorder (ADHD; Harvey et al., 2016). In addition to broad measures of disruptive behaviors or other psychopathology (e.g., ECBI, CBCL, etc.; Achenbach, 1991; Eyberg & Pincus, 1999), clinicians treating comorbid ODD and ADHD often use scales that specifically measure inattention, hyperactivity, and impulsivity as a method of routine outcome monitoring (ROM) in treatment. However, given the inconvenience often associated with regularly administering a handful of different measures, many clinicians forgo ROM, which can inhibit effective treatment (Valdiviezo-Oña et al., 2025). Past research has identified subscales on the ECBI (i.e., oppositional defiant, conduct problems, and inattentive behavior; Hukkelberg, 2019), but these subscales do not uniquely capture hyperactivity/impulsivity and few clinicians use these subscales to inform treatment. In this study, we examined the psychometric properties of the ECBI with a clinical sample of children identified with ADHD to determine the presence of a combined inattention and hyperactivity/impulsivity subscale that could be used in addition to overall disruptive behavior scores.
Method
Participants were 128 parent-child dyads (73% children male, M = 4.8 years) enrolled in a randomized controlled trial testing Parent-Child Interaction Therapy (PCIT; Funderburk & Eyberg, 2011) for children with ADHD. Disruptive behaviors were measured using the ECBI (Eyberg & Pincus, 1999) and ADHD symptoms were measured using the CBCL ADHD Problems Subscale (Achenbach, 1991), Swanson, Norman, and Pelham-IV Inattention Subscale (SNAP-IV-I; Swanson et al., 2001), and SNAP-IV Hyperactivity/Impulsivity subscale. Social support, used as a discriminant validity test, was measured using the Multidimensional Scale of Perceived Social Support (MSPSS; Wilcox, 2010). We first used confirmatory factor analyses (CFA) to test for the presence of an inattention and hyperactivity/impulsivity subscale. Then, we calculated internal consistency reliability estimates as well as tests of validity with theoretically related measures.
Results
CFAs provided support for 7-item ADHD subscale (CFI = .928, SRMR = .049). The subscale had adequate reliability ( =. 84). Correlations indicated that the ECBI ADHD subscale was significantly linked to CBCL-ADHD, SNAP-IV-I, and SNAP-IV-HI (rs = .36, .65, .48, respectively; ps < .001). The subscale was not related to MSPSS (r = .03, p = .781), a theoretically unrelated construct.
Discussion
Psychometric tests supported the use of the ECBI ADHD subscale in a sample of children diagnosed with ADHD. Given how strongly each subscale was related to their full-measure counterparts, clinicians could save valuable intervention time by using both overall disruptive behavior scores in addition to ECBI subscale scores for children with comorbid ADHD and other disruptive behavior disorders. More research is needed to test these subscales in samples of children with other diagnoses (e.g., ASD, Conduct Disorder, etc.).