The effects of symptom information coaching on the feigning of adult ADHD.

Edmundson, Maryanne; Berry, David T. R.; Combs, Hannah L; Harp, Jordan P.; Williams, Ande; Rojas, Stephanie L.; Saleh, Ahmed K; Scott, April B.

doi:10.1037/pas0000478

Cited by 22 publications

(20 citation statements)

References 26 publications

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“…The resulting sum score showed utility in discerning genuine cases of ADHD from individuals who had failed an independent performance validity test (PVT; see "Methods" section for details). Subsequent cross-validations of this index have revealed variable, yet promising classification accuracy (Cook et al 2016(Cook et al , 2017Edmundson et al 2017;Fuermaier et al 2016a, b;Harrison and Armstrong 2016;Walls et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners’ adult ADHD rating scales

et al. 2021

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As attention-deficit/hyperactivity disorder (ADHD) is a feasible target for individuals aiming to procure stimulant medication or accommodations, there is a high clinical need for accurate assessment of adult ADHD. Proven falsifiability of commonly used diagnostic instruments is therefore of concern. The present study aimed to develop a new, ADHD-specific infrequency index to aid the detection of non-credible self-report. Disorder-specific adaptations of four detection strategies were embedded into the Conners’ Adult ADHD Rating Scales (CAARS) and tested for infrequency among credible neurotypical controls (n = 1001) and credible adults with ADHD (n = 100). The new index’ ability to detect instructed simulators (n = 242) and non-credible adults with ADHD (n = 22) was subsequently examined using ROC analyses. Applying a conservative cut-off score, the new index identified 30% of participants instructed to simulate ADHD while retaining a specificity of 98%. Items assessing supposed symptoms of ADHD proved most useful in distinguishing genuine patients with ADHD from simulators, whereas inquiries into unusual symptom combinations produced a small effect. The CAARS Infrequency Index (CII) outperformed the new infrequency index in terms of sensitivity (46%), but not overall classification accuracy as determined in ROC analyses. Neither the new infrequency index nor the CII detected non-credible adults diagnosed with ADHD with adequate accuracy. In contrast, both infrequency indices showed high classification accuracy when used to detect symptom over-report. Findings support the new indices’ utility as an adjunct measure in uncovering feigned ADHD, while underscoring the need to differentiate general over-reporting from specific forms of feigning.

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Section: Introductionmentioning

confidence: 99%

Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners’ adult ADHD rating scales

et al. 2021

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“…Prevalence rates of feigned ADHD are estimated to be as high as 48% (Tucha et al, 2015), leading to a consensus among experts regarding the need for its evaluation (Fuermaier, Fricke, de Vries, Tucha, & Tucha, 2019). Regrettably, despite unmistakable evidence that clinical judgment and examinee self-reports are inadequate for its detection, research and development of detection techniques focusing on feigned ADHD have not progressed at a sufficient rate (e.g., Edmundson et al, 2017; J. A. Suhr, Cook, & Morgan, 2017).…”

Section: Introductionmentioning

confidence: 99%

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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“…The CAARS-S: L in its original form includes eight clinical scales and one validity index (the Inconsistency Index). The Inconsistency Index (INC) assesses careless/random responding rather than over-reporting or feigning, although those seeking to dissimulate may employ careless/random responding in an attempt to feign ADHD deficits [12,[23][24][25]. The CAARS-S: L's lack of a feigning validity scale has rendered it vulnerable to feigned symptom reports.…”

Section: Introductionmentioning

confidence: 99%

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

Harp¹,

Walls²,

Berry³

et al. 2020

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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

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The effects of symptom information coaching on the feigning of adult ADHD.

Cited by 22 publications

References 26 publications

Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners’ adult ADHD rating scales

Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners’ adult ADHD rating scales

Detection of Feigned ADHD Using the MOXO-d-CPT

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

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