The relationship of malingering test failure to self-reported symptoms and neuropsychological findings in adults referred for ADHD evaluation

Abstract

Diagnosis of adult attention-deficit/hyperactivity disorder (ADHD) adults is difficult, as neither symptom report nor neuropsychological findings are specific to ADHD. Few studies address the possibility that noncredible performance influences both symptom report and neuropsychological findings. The present study utilized archival data from young adults referred for concerns about ADHD, divided into three groups: (1) those who failed a measure of noncredible performance (the Word Memory Test; WMT), (2) those who met diagnostic criteria for ADHD, and (3) controls with psychological symptoms but no ADHD. Results showed a 31% failure rate on the WMT. Those who failed the WMT showed clinical levels of self-reported ADHD symptoms and impaired neuropsychological performance. Neither self-report measures nor neuropsychological tests could distinguish ADHD from psychological controls, with the exception of self-reported current hyperactive/impulsive symptoms and Stroop interference. Results underscore the effect of noncredible performance on both self-report and cognitive measures in ADHD.

What Do We Really Know about ADHD in College Students?

“…In the same study, nearly 50 % of students evaluated for ADHD at a university-based psychological assessment clinic failed at least 1 index from the Word Memory Test [15], a test designed to detect lack of effort on neuropsychological assessments, and thus suggestive of malingering [13]. Similar findings were reported by Suhr et al [16].…”

Interactions among attention-deficit hyperactivity disorder (ADHD) and problem gambling in a probabilistic reward-learning task

“…The available literature on performance of ADHD patients using IGT measurements is conflicting. Our data is in line with those which showed improvement in bet selections over time among medicated and possibly unmedicated (although not statistically) ADHD patients [31][32][33][34]. In contrast, some other studies found affective decision-making deficits in ADHD patients using IGT scores [35][36][37].…”

Detection of malingered attention deficit hyperactivity disorder

“…The instructed malingerers were again successful in feigning the condition. Using a different design for their study, Suhr et al (2008) also found that the Conners' Adult ADHD Rating Scale is not useful in the assessment of symptom exaggeration. Both present and previous findings indicate that self-report rating scales are not sensitive enough for the purpose of detecting the malingering of ADHD.…”

“…The present study further explored the effects of coaching on the BADDS using a simulation design. So far, only a limited number of studies (Quinn 2003;Harrison et al 2007;Suhr et al 2008) have addressed the potential of rating scales for the detection of malingered ADHD. However, the BADDS has not been used before in the context of malingering.…”