This study examined the utility of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) validity scales for detecting feigning and exaggeration of attention-deficit/hyperactive disorder (ADHD) among college students. Under a simulation study design, participants with and without ADHD were assigned to perform honestly or to feign or exaggerate deficits related to ADHD while completing self-report symptom inventories. Participants instructed to feign produced symptom profiles similar to honest clinical profiles and more severe than honest nonclinical profiles. Participants with ADHD instructed to exaggerate produced less severe profiles than those instructed to feign and more severe profiles than clinical controls. MMPI-2-RF scale Fp-r showed potential for use in malingered ADHD detection at a revised cut score, which was significantly lower than the cut score suggested in the test manual; use of the revised cut score will require further validation. Scales F-r, Fs, and FBS-r did not classify well, but should be assessed in future studies of malingered ADHD. Detection of exaggeration was consistently poorer than detection of feigning.

United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/ OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI + PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI + PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI + PTSD on the same variables. Additionally, the mTBI + PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI + PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment.

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