Cross-validating the Dot Counting Test Among an Adult ADHD Clinical Sample and Analyzing the Effect of ADHD Subtype and Comorbid Psychopathology

Abstract

This study cross-validated the dot counting test (DCT) as a performance validity test (PVT) in an adult attention-deficit/hyperactivity disorder (ADHD) clinical population and examined the effect of ADHD subtype and psychiatric comorbidity on accuracy for detecting invalidity. DCT performance was assessed among 210 consecutive adult ADHD referrals who underwent neuropsychological evaluation and were classified into valid ( n = 175) or invalid ( n = 35) groups based on seven independent criterion PVTs. The invalid group had significantly worse DCT performance than the valid group using both the standard and unrounded scoring procedure ([Formula: see text]). Classification accuracy was excellent, with 54.3% sensitivity/92% specificity at optimal cut-scores of ≥14 (rounded) and ≥13.38 (unrounded). Nonsignificant DCT performance differences emerged based on ADHD subtype or the presence/absence of comorbid psychopathology. The DCT functions well as a nonmemory-based PVT in an ethnoracially diverse ADHD population, supporting its clinical utility for detecting invalid neurocognitive performance during ADHD evaluations.

Cross-Validation of Multiple WAIS-IV Digit Span Embedded Performance Validity Indices Among a Large Sample of Adult Attention Deficit/Hyperactivity Disorder Clinical Referrals

“…All patients were administered a battery of seven freestanding and embedded PVTs that previously have been cross-validated in ADHD samples or ADHD-predominant mixed clinical samples, including the Dot Counting Test (Abramson et al, 2021; Boone et al, 2002); Rey 15-Item Test Recall/Recognition (Ashendorf et al, 2021), Rey Auditory Verbal Learning Test Effort Score (Pliskin et al, 2021), Brief Visuospatial Memory Test-Revised Recognition Discrimination (Bailey et al, 2018; Resch et al, 2020), Stroop Test Word Reading T-Score (White, Korinek, et al, 2020); Trail Making Test - Part A (White, Korinek, et al, 2020), and Verbal Fluency (F/A/S; White, Korinek, et al, 2020). Consistent with current empirical findings and neuropsychology practice standards, those with ≤1 criterion PVT failures were classified into the valid group and those with ≥2 failures were assigned to the invalid group (e.g., Critchfield et al, 2019; Jennette et al, 2021; Larrabee, 2014; Rhoads et al, 2021; Schroeder, Martin, Heinrichs, & Baade, 2019; Soble et al, 2020).…”

Symptom and performance validity in samples of adults at clinical evaluation of ADHD: a replication study using machine learning algorithms

“…When applying current standards of at least two SVT/ PVT failures indicating noncredible symptom report or performance, our base rates ranging from 9.7% to 27.3% fell largely in the range of earlier studies in this field of up to 20% invalid test performance as suggested by empirical research (Abramson et al, 2021;Phillips et al, 2022;P. S. Marshall et al, 2016) and estimated by clinically working neuropsychologists (Martin & Schroeder, 2020).…”

“…However, empirical evidence from more recent research and current practice standards claim the use of multiple independent PVTs to determine performance validity, and define invalid performance if at least two PVTs are failed (Jennette et al, 2021;Rhoads et al, 2021;Sherman et al, 2020;Soble et al, 2020;Sweet et al, 2021). Based on the stricter criterion of at least two PVT failures on a battery of several PVTs, recent research reported base rates of noncredible performance of 11-19% in the clinical evaluation of adult ADHD (Abramson et al, 2021;Phillips et al, 2022;P. S. Marshall et al, 2016).…”

Exploring Subfactors of Adult Cognitive Disengagement Syndrome and Impact on Neuropsychological Performance

“…All patients were administered two freestanding and three embedded PVTs throughout their test batteries, consistent with the number of PVTs typically used by neuropsychologists in clinical evaluations (Martin et al, 2015). Freestanding PVTs were the Dot Counting Test (Abramson et al, 2023) and the Rey 15-Item Test Recall + Recognition (Poynter et al, 2019). Embedded PVTs administered were the Reliable Digit Span from the (Khan et al, 2022).…”