The Iowa Gambling Task (IGT) was created to assess real-world decision making in a laboratory setting and has been applied to various clinical populations (i.e., substance abuse, schizophrenia, pathological gamblers) outside those with orbitofrontal cortex damage, for whom it was originally developed. The current review provides a critical examination of lesion, functional neuroimaging, developmental, and clinical studies in order to examine the construct validity of the IGT. The preponderance of evidence provides support for the use of the IGT to detect decision making deficits in clinical populations, in the context of a more comprehensive evaluation. The review includes a discussion of three critical issues affecting the validity of the IGT, as it has recently become available as a clinical instrument: the lack of a concise definition as to what aspect of decision making the IGT measures, the lack of data regarding reliability of the IGT, and the influence of personality and state mood on IGT performance.

These findings support the hypothesis that the self-reported cognitive impact of fibromyalgia is also found in objective neuropsychological measures. Routine screening for cognitive dysfunction in those with fibromyalgia may be warranted in addition to assessment of the traditional fibromyalgia symptoms.

There is a clinical need for measurement of noncredible self-reporting of symptoms of attention deficit hyperactivity disorder (ADHD) in adults presenting for ADHD evaluation. The present study describes the development of initial validity data for an Infrequency Index for the Conner's Adult Attention Deficit/Hyperactivity Rating Scale (CII). Items for the CII were obtained from a large sample of nontreatment seeking university students, including individuals with a selfreported history of ADHD diagnosis. Items endorsed infrequently in the sample, including those with ADHD diagnoses, were identified and summed to create the CII. Initial validation data were gathered from a sample of individuals seeking clinical evaluation for ADHD. The CII was strongly related to noncredibly high symptom report and was also related to noncredible performance on cognitive measures. Results provide initial support for the CII's use in assessing noncredible overreporting on the Conner's Adult Attention-Deficit/Hyperactivity Rating Scale.Keywords attention deficit hyperactivity disorder, differential diagnosis, validity measurement Diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood is often based on clinical interview and completion of self-report scales that assess for current and childhood symptoms consistent with the disorder. However, there are several problems with reliance on self-report for ADHD diagnosis, including the high base rate of endorsement of "ADHD" symptoms in both general and clinical populations and the face validity of ADHD symptoms, which makes them vulnerable to noncredible responding.Both current and childhood ADHD symptoms are endorsed with at high rates in the general population, making it difficult to rely on self-reported symptoms for ADHD diagnosis (DuPaul et al.

Researchers and clinicians frequently use behavioral measures to assess decision making. The most common task that is marketed to clinicians is the Iowa Gambling Task (IGT), thought to assess risky decision making. How does performance on the IGT relate to performance on other common measures of decision making? The present study sought to examine relationships between the IGT, the Balloon Analogue Risk Task (BART), and the Columbia Card Task (CCT). Participants were 390 undergraduate students who completed the IGT, BART, and either the "hot" or "cold" CCT. Principal components factor analysis on the IGT, BART, and CCT-cold (n = 112) indicated that the IGT measures a different component of decision making than the BART, and the CCT-cold weakly correlated with early IGT trials. Results of the exploratory factor analysis on the IGT, BART, and CCT-hot (n = 108) revealed a similar picture: the IGT and BART assessed different types of decision making, and the BART and CCT-hot were weakly correlated. A confirmatory factor analysis (n = 170) indicated that a 3-factor model without the CCT-cold (Factor 1: later IGT trials; Factor 2: BART; and Factor 3: early IGT trials) was a better fitting model than one that included the CCT-cold and early IGT trials on the same factor. Collectively, the present results suggest that the IGT, BART, and CCT all measure unique, nonoverlapping decision making processes. Further research is needed to more fully understand the neuropsychological construct of decision making.

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