Identifying Feigned ADHD in College Students: Comparing the Multidimensional ADHD Rating Scale to Established Validity Measures

Abstract

Objective: There is increased concern for malingering in ADHD evaluations due to presence of incentives such as accommodations and medications. Although several validity tests are available to classify malingering in non-ADHD populations, there is no test with proven effectiveness to detect feigned ADHD. This study investigated the ability of the MARS Symptom Validity Index 4 (MARS SV-index 4) and two published validity tests (the Word Memory Test [WMT] and Clinical Assessment of Attention Deficit-Adult [CAT-A] Infrequency scale) to detect malingered ADHD. Method: The participants consisted of 68 young adults, 34 with ADHD. Participants completed the MARS, CAT-A, and WMT validity measures. Results: The MARS SV index-4 demonstrated higher sensitivity rates for simulated malingering (61.8%) at close to optimal specificity (88.2%) compared to two published tests (which had sensitivity <42% at specificity >90%). Conclusion: The MARS shows good ability to detect feigned ADHD and appears to be useful for adult ADHD assessments.

A review of behavioural rating scales for the assessment of Attention Deficit/Hyperactivity Disorder among adults in research

“…For the detection of feigning, the infrequency scale of the MARS showed a very high specificity of 92%, a moderate-to-high sensitivity of 65%, very high PPV of 92%, and moderate-to-high NPV of 65% (Potts et al, 2021). In another study using a similar sample, the infrequency scale of the MARS and found a specificity of 88%, a moderate-to-high sensitivity of 62%, and moderate-to-high PPV of 63-88% and NPV of 69-87% for the detection of feigning (Potts et al, 2022). Finally, a recent study by Harrison et al (2022) examined the validity of two new indicators proposed by Aita et al (2018) for identifying feigned ADHD using the Personality Assessment Inventory (PAI).…”

“…Conversely, as opposed to measures embedded within existing rating scales, some authors have created stand-alone measures that assess ADHD directly while accounting for the existence of feigned symptoms. In spite of the fact that the MARS has shown promise in previous studies (Potts et al, 2021(Potts et al, , 2022, its efficacy has not yet been tested on clinical groups, which may have led to inflated results, as explained earlier. On the contrary, the ASIS has exhibited good psychometric properties in its initial validation study (Courrégé et al, 2019) and these findings have already been replicated with a sample of patients reporting symptoms of depression and anxiety (Skeel et al, 2022).…”

Validating Embedded Validity Indicators of Feigned ADHD-Associated Cognitive Impairment Using the MOXO-d-CPT

“…They may also be targeted by examinees attempting to precure academic accommodations, reasoning that evidence of cognitive impairment may increase their chances of success (Lovett & Nelson, 2021; Weis et al, 2021). For these reasons, there is a growing interest in detection of ADHD-associated cognitive impairment using CPTs (e.g., Pollock et al, 2021; Potts et al, 2022).…”