Further examination of embedded performance validity indicators for the Conners’ Continuous Performance Test and Brief Test of Attention in a large outpatient clinical sample

Sharland, Michael J.; Waring, Stephen C.; Johnson, Brian P.; Taran, Allise; Rusin, Travis A; Pattock, Andrew M.; Palcher, Jeanette A

doi:10.1080/13854046.2017.1332240

Cited by 14 publications

(11 citation statements)

References 42 publications

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“…As such knowledge may be instrumental in the ability to feign the cognitive impairment associated with the disorder, researchers are encouraged to include a comprehensive prior knowledge questionnaire in future studies (e.g., the Adult Knowledge of Attention Deficit Disorder Scale [AKADDS] used by Edmundson et al, 2017). Finally, it would be of interest to explore the utility of the MOXO-d-CPT in detecting feigned cognitive impairment in neuropsychiatric populations other than ADHD (as done using other CPTs; Erdodi, Lichtenstein, Rai, & Flaro, 2017; Erdodi et al, 2018; Sharland et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, several of these studies have limitations that include lack of a clinical ADHD patient group (Leark et al, 2002), inclusion of participants who did not yet have definitive ADHD diagnoses (Leppma et al, 2018), or reliance on previously provided diagnoses (i.e., possibly contaminating the ADHD group with malingerers, for example, Sollman et al, 2010). Finally, a substantial number of studies were conducted on neuropsychiatric disorders other than ADHD, thus making conclusions regarding the detection of feigned ADHD difficult (e.g., Erdodi, Pelletier, & Roth, 2018; Sharland et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Detection of Feigned ADHD Using the MOXO-d-CPT

et al. 2019

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Objective: The objective of this study was to assess the MOXO-d-CPT utility in detecting feigned ADHD and establish cutoffs with adequate specificity and sensitivity. Method: The study had two phases. First, using a prospective design, healthy adults who simulated ADHD were compared with healthy controls and ADHD patients who performed the tasks to the best of their ability ( n = 47 per group). Participants performed the MOXO-d-CPT and an established performance validity test (PVT). Second, the MOXO-d-CPT classification accuracy, employed in Phase 1, was retrospectively compared with archival data of 47 ADHD patients and age-matched healthy controls. Results: Simulators performed significantly worse on all MOXO-d-CPT indices than healthy controls and ADHD patients. Three MOXO-d-CPT indices (attention, hyperactivity, impulsivity) and a scale combining these indices showed adequate discriminative capacity. Conclusion: The MOXO-d-CPT showed promise for the detection of feigned ADHD and, pending replication, can be employed for this aim in clinical practice and ADHD research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection of Feigned ADHD Using the MOXO-d-CPT

et al. 2019

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“…S. Ord et al, 2010). These studies largely support the use of several individual and composite indicators from the CPT-II as EVIs in those with a traumatic brain injury (TBI; Lange et al, 2013) and in mixed clinical samples (e.g., Sharland et al, 2018). For example, the use of CPT-II Error indices such as OMI (Busse & Whiteside, 2012; J.…”

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confidence: 69%

Settling the Score: Can CPT-3 Embedded Validity Indicators Distinguish Between Credible and Non-Credible Responders Referred for ADHD and/or SLD?

et al. 2022

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Objective: The purpose of the present study was to further investigate the clinical utility of individual and composite indicators within the CPT-3 as embedded validity indicators (EVIs) given the discrepant findings of previous investigations. Methods: A total of 201 adults undergoing psychoeducational evaluation for ADHD and/or Specific Learning Disorder (SLD) were divided into credible ( n = 159) and non-credible ( n = 42) groups based on five criterion measures. Results: Receiver operating characteristic curves (ROC) revealed that 5/9 individual indicators and 2/4 composite indicators met minimally acceptable classification accuracy of ≥0.70 (AUC = 0.43–0.78). Individual (0.16–0.45) and composite indicators (0.23–0.35) demonstrated low sensitivity when using cutoffs that maintained specificity ≥90%. Conclusion: Given the lack of stability across studies, further research is needed before recommending any specific cutoff be used in clinical practice with individuals seeking psychoeducational assessment.

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“…These patients were otherwise typical and belong within the DSWPD spectrum. However, these extreme scores could also indicate a potential threat to performance validity (Sharland et al., ). To substantiate our main results, we therefore also provide separate cognitive domain estimates and background variables for the more typically performing DSWPD individuals (Appendix ).…”

Section: Methodsmentioning

confidence: 99%

“…These five patients were otherwise typical, belong within the DSWPD spectrum, and they were kept in the main analysis. However, an excessive amount of omission errors could potentially indicate a threat to performance validity, caused by factors unrelated to attention such as aggravation or lack of motivation (Sharland et al, 2018). Hit RT STE was also 30% higher in the low-omission sub-group (4.8 ms) compared with controls (3.5 ms; post hoc Student's t-test, p = 0.02) during forced early morning, although the three-way interaction for Hit RT STE was just short of statistical significance (Supporting information Table S1; p = 0.06).…”

Section: Appendix Supplemen Tary Analysis In the Low-omission Subgroupmentioning

confidence: 99%

Cognitive performance in DSWPD patients upon awakening from habitual sleep compared with forced conventional sleep

Solheim

Olsen

Kallestad

et al. 2018

Journal of Sleep Research

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Difficult early morning awakening is one of the defining symptoms of delayed sleep-wake phase disorder. It is accompanied by low cognitive arousal and drowsiness resulting in difficulty concentrating and focusing attention upon awakening. We designed the current study to quantitate cognitive performance (i.e. omissions, commissions, reaction time [average and variability]) and cognitive domains (i.e. focused attention, sustained attention, impulsivity and vigilance) with Conners' Continuous Performance Test II during both habitual and conventional (00:00-07:00 hr) sleep-wake schedule in young adult patients with delayed sleep-wake phase disorder (n = 20, mean age = 24.8 years, SD = 3.0) and controls (n = 16, mean age = 24.4 years, SD = 3.4). Conners' Continuous Performance Test II was administered after awakening and in the afternoon during both habitual and conventional conditions. In-laboratory polysomnography was performed for 2 nights. We assessed sleep, tiredness, chronotype and depression using questionnaires. Saliva was sampled for dim light melatonin onset measurements. Repeated-measures ANOVAs were applied for the Conners' Continuous Performance Test II measures with group (patient/control), time (afternoon/morning) and condition (habitual/conventional schedule) as fixed factors. Patients with delayed sleep-wake phase disorder had reduced reaction times, especially in the morning, greater response speed variability, and made more omission and commission errors compared with controls. Patients with delayed sleep-wake phase disorder also had reduced focused attention, especially upon forced early awakening. The short total sleep time of patients with delayed sleep-wake phase disorder could not statistically explain this outcome. In conclusion, we observed a state-dependent reduced ability to focus attention upon early morning awakening in patients with delayed sleep-wake phase disorder. Patients also had more omissions, longer reaction time and increased RT variability after habitual sleep, suggesting a possible small cognitive trait dysfunction in delayed sleep-wake phase disorder.

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Further examination of embedded performance validity indicators for the Conners’ Continuous Performance Test and Brief Test of Attention in a large outpatient clinical sample

Abstract: Overall, these findings corroborate previous findings, extending them to a large clinical sample. BTA and CPT-II are useful embedded performance validity indicators within a clinical battery but should not be used in isolation without other performance validity indicators.

Cited by 14 publications

References 42 publications

Detection of Feigned ADHD Using the MOXO-d-CPT

Detection of Feigned ADHD Using the MOXO-d-CPT

Settling the Score: Can CPT-3 Embedded Validity Indicators Distinguish Between Credible and Non-Credible Responders Referred for ADHD and/or SLD?

Cognitive performance in DSWPD patients upon awakening from habitual sleep compared with forced conventional sleep

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