The current project outlines the development of the Attention-Deficit/Hyperactivity Disorder (ADHD) Symptom Infrequency Scale (ASIS), a stand-alone measure designed to identify individuals feigning or exaggerating symptoms to receive a diagnosis of ADHD. Over the course of 3 studies, valid data was collected from 402 participants assigned to control, simulator, ADHD diagnosed, or possible undiagnosed ADHD groups. Group assignment was based on self-reported history of ADHD diagnosis including information about the credentials of diagnosing professional and methods used. The ASIS includes an Infrequency Scale (INF) designed to detect rarely reported symptoms of ADHD and several clinical scales designed to measure genuine symptoms. The final version of the ASIS demonstrated high internal consistency for the INF (␣ ϭ .96) and the ADHD Total scales (␣ϭ .96). Convergent validity for the ADHD Total was established through a strong correlation with Barkley Adult ADHD Rating Scale-IV (r ϭ .92). Initial validation of the INF yielded high discriminability between groups (d ϭ 2.76; 95% confidence interval [2.17, 3.36]). The final INF scale demonstrated strong sensitivity (.79 -.86) and excellent specificity (.89). Using our study's malingering base rate of 29%, positive and negative predictive values were strong (.71-.79 and .92-.93, respectively). Additional information is provided for a range of base rates. Current results suggest that the ASIS has potential as a reliable and valid measure of ADHD that is sensitive to malingering when compared to a sample of individuals self-reporting a history of ADHD diagnosis.
Public Significance StatementThe present studies describe and validate a new self-report measure designed to detect exaggerated or feigned symptoms of ADHD in adults, known as the ADHD Symptom Infrequency Scale (ASIS). In these studies, the ASIS appeared to detect feigned symptoms better than similar measures, and could be used in ADHD evaluations to protect adults from the risks associated with false diagnosis. While the results of this study are promising, further research on the ASIS will be necessary.
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