Faking ADHD? Symptom Validity Testing and Its Relation to Self-Reported, Observer-Reported Symptoms, and Neuropsychological Measures of Attention in Adults With ADHD

Hirsch, Oliver; Christiansen, Hanna

doi:10.1177/1087054715596577

Cited by 32 publications

(40 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of the present study confirm previous research showing that self-reported impairment scales are susceptible to noncredible responses in the clinical evaluation of adult ADHD and agree with the statement of Bryant and colleagues that 'the assessment for the validity of self-report and performance should be included in all evaluations, including assessments for ADHD' (Bryant et al, 2017;Heilbronner et al, 2009). The use of measures of both performance and symptom validity appears particularly relevant given the findings of only weak associations between both types of measures in the clinical evaluation of adults with ADHD (Hirsch & Christiansen, 2015). With regard to patients' self-reports, previous studies as well as the present data revealed an over-reporting response bias of noncredible individuals relative to genuine patients with ADHD Harrison & Armstrong, 2016;Suhr, Buelow, & Riddle, 2011).…”

Section: Discussionsupporting

confidence: 75%

Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD

Fuermaier

Tucha

Koerts

et al. 2017

The Clinical Neuropsychologist

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 75%

Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD

Fuermaier

Tucha

Koerts

et al. 2017

The Clinical Neuropsychologist

View full text Add to dashboard Cite

show abstract

“…In keeping with previous research findings indicating the vulnerability of the CAARS-S: L to feigning, the scores from the FGN group in this study were statistically comparable to those of the ADHD group on all but one of the clinical scales [12,20]. The FGN group produced a higher Impulsivity/Emotional Lability scale score, likely reflecting the association between greater endorsement of these symptoms and feigned ADHD [44]. In response to the demonstrated vulnerability of the CAARS-S: L to feigning, which was supported by this study, the Infrequency Index (CII) was created as the first fake bad scale for the measure [27].…”

Section: Discussionsupporting

confidence: 89%

Conners’ Adult ADHD Rating Scale Infrequency Index Validation and Pilot Comparison of Administration Formats

Harp¹,

Walls²,

Berry³

et al. 2020

PDR

View full text Add to dashboard Cite

One major obstacle to the accurate diagnosis of ADHD in college students is malingering, although many symptom self-report measures used in the diagnostic process do not contain validity scales to identify feigners. The Infrequency Index (CII) for the Conners’ Adult ADHD Rating Scale–Self-Report: Long Version (CAARS-S: L) was developed in response to this concern, although further validation of this index is needed. Another topic of interest in ADHD malingering research is the increasing use of online assessments. However, little is known about how ADHD is malingered in an online format, particularly on the CAARS-S: L. The current study utilized a coached simulation design to examine the feigning detection accuracy of the CII and provide initial results on the effect of administration format (paper vs. online) on CAARS-S: L profiles. Data from 139 students were analyzed. Students with ADHD and students instructed to feign the disorder produced statistically comparable elevations on seven of eight CAARS-S: L clinical scales. Clinical scale elevations were generally comparable between paper and online forms, although some differences in the clinical and simulated ADHD groups suggest the need for further research. The CII demonstrated modest sensitivity (0.36) and adequate specificity (0.85) at the recommended cut score across administration formats. Specificity reached desirable levels (>= .90) at a raised cut score. These values were similar across administration formats. Results support the use of the CII and online CAARS-S: L form

show abstract

“…Marshall et al (Marshall et al, 2016) found that 27%, Suhr et al (Suhr, Hammers, Dobbins-Buckland, Zimak, & Hughes, 2008) found that 31%, and Nelson and Lovett (2019) found that 53% of young adults undergoing comprehensive ADHD assessment made an invalid symptom presentation. Similarly, in a significantly older adult population, 32% made such an invalid presentation (Hirsch & Christiansen, 2018).…”

Section: Diagnostic Issuesmentioning

confidence: 99%

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults: A qualitative review of the utility of assessment measures and recommendations for improving the diagnostic process

Marshall

Hoelzle

Nikolas

2019

The Clinical Neuropsychologist

View full text Add to dashboard Cite

Objective: Identify assessment measures that augment the clinical interview and improve the diagnostic accuracy of adult ADHD assessment. Method: The sometimes limited research literatures concerning the diagnostic efficacies of the clinical interview, standard and novel ADHD behavior rating scales, performance and symptom validity testing, and cognitive tests are critically reviewed. Results: Based on this qualitative review, both clinical interviews alone and ADHD behavior rating scales alone have adequate sensitivity but poor specificity in diagnosing ADHD. Response validity and symptom validity tests have reasonably good sensitivity and very good specificity in detecting invalid symptom presentation. Cognitive test batteries have inadequate sensitivity and specificity in identifying ADHD. Using cognitive tests in conjunction with behavior rating scales significantly improves the specificity of an assessment battery. Executive function behavior rating scales and functional impairment rating scales are unlikely to improve the diagnostic accuracy of ADHD assessment. Conclusions: Based on this review, key clinical interview questions, behavior rating scales, symptom validity tests, and cognitive tests that have promise to enhance current assessment practices are recommended. These are the authors' personal opinions, not consensus standards, or guidelines promulgated by any organization. These measures are incorporated in a practical, somewhat abbreviated, battery that has the potential to improve clinicians' ability to diagnose adult ADHD.

show abstract

Faking ADHD? Symptom Validity Testing and Its Relation to Self-Reported, Observer-Reported Symptoms, and Neuropsychological Measures of Attention in Adults With ADHD

Abstract: We found no strong indicators for negative response bias in ADHD patients who failed a symptom validity test. New measures and approaches to detect feigned ADHD should be developed.

Cited by 32 publications

References 41 publications

Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD

Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD

Conners’ Adult ADHD Rating Scale Infrequency Index Validation and Pilot Comparison of Administration Formats

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults: A qualitative review of the utility of assessment measures and recommendations for improving the diagnostic process

Contact Info

Product

Resources

About