Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study

Miriam Becke; Lara Tucha; Marah Butzbach; Steffen Aschenbrenner; Matthias Weisbrod; Oliver Tucha; Anselm B M Fuermaier

doi:10.3390/ijerph20054070

Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study

Miriam Becke, Lara Tucha, Marah Butzbach, Steffen Aschenbrenner, Matthias Weisbrod, Oliver Tucha, Anselm B M Fuermaier^*

^*Corresponding author for this work

Clinical Neuropsychology

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery to 57 adults with ADHD, 60 neurotypical controls, and 151 instructed simulators, we examined each test's utility in detecting noncredible performance. Cut-off scores were derived for all available outcome variables. Although all ensured at least 90% specificity in the ADHD Group, sensitivity differed significantly between tests, ranging from 0% to 64.9%. Tests of selective attention, vigilance, and inhibition were most useful in detecting the instructed simulation of adult ADHD, whereas figural fluency and task switching lacked sensitivity. Five or more test variables demonstrating results in the second to fourth percentile were rare among cases of genuine adult ADHD but identified approximately 58% of instructed simulators.

Original language	English
Article number	4070
Number of pages	20
Journal	International Journal of Environmental Research and Public Health
Volume	20
Issue number	5
DOIs	https://doi.org/10.3390/ijerph20054070
Publication status	Published - 24-Feb-2023

Keywords

Adult
Humans
Attention Deficit Disorder with Hyperactivity/psychology
Malingering/diagnosis
Neuropsychological Tests
Wakefulness
Mentoring
Reproducibility of Results

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Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue StudyFinal publisher's version, 0.98 MBLicence: CC BY

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title = "Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study",

abstract = "The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery to 57 adults with ADHD, 60 neurotypical controls, and 151 instructed simulators, we examined each test's utility in detecting noncredible performance. Cut-off scores were derived for all available outcome variables. Although all ensured at least 90% specificity in the ADHD Group, sensitivity differed significantly between tests, ranging from 0% to 64.9%. Tests of selective attention, vigilance, and inhibition were most useful in detecting the instructed simulation of adult ADHD, whereas figural fluency and task switching lacked sensitivity. Five or more test variables demonstrating results in the second to fourth percentile were rare among cases of genuine adult ADHD but identified approximately 58% of instructed simulators.",

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AU - Butzbach, Marah

AU - Aschenbrenner, Steffen

AU - Weisbrod, Matthias

AU - Tucha, Oliver

AU - Fuermaier, Anselm B M

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KW - Malingering/diagnosis

KW - Neuropsychological Tests

KW - Wakefulness

KW - Mentoring

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Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study

Abstract

Keywords

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