Detection of Malingered ADHD Using the MMPI-2-RF

Abstract

This study examined the utility of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) validity scales for detecting feigning and exaggeration of attention-deficit/hyperactive disorder (ADHD) among college students. Under a simulation study design, participants with and without ADHD were assigned to perform honestly or to feign or exaggerate deficits related to ADHD while completing self-report symptom inventories. Participants instructed to feign produced symptom profiles similar to honest clinical profiles and more severe than honest nonclinical profiles. Participants with ADHD instructed to exaggerate produced less severe profiles than those instructed to feign and more severe profiles than clinical controls. MMPI-2-RF scale Fp-r showed potential for use in malingered ADHD detection at a revised cut score, which was significantly lower than the cut score suggested in the test manual; use of the revised cut score will require further validation. Scales F-r, Fs, and FBS-r did not classify well, but should be assessed in future studies of malingered ADHD. Detection of exaggeration was consistently poorer than detection of feigning.

A Place for Psychological Testing in the Assessment of Adult ADHD

“…Given these findings, we recommend cognitive testing as an optional component of the formal ADHD assessment. Cognitive testing is best used in complicated and ambiguous cases, such as a patient with multiple diagnoses, or a diagnosis (Harp et al, 2011). There are several research studies on feigned ADHD profiles (Sibley et al, 2016).…”

Development of the Subtle ADHD Malingering Screener

“…A more precise determination of this base rate is difficult, however, given that malingering ADHD symptoms in a medical setting can be accomplished fairly easily (Fisher & Watkins, 2008; Harp, Jasinski, Shandera-Ochsner, Mason, & Berry, 2011; Jachimowicz & Geiselman, 2004; Quinn, 2003). This has been attributed partly to taxonomic difficulty in accurately categorizing symptoms and causes of the disorder, and partly to the fact that most physicians are not adequately equipped to identify cases of malingering (Harrison, 2006; National Center on Addiction and Substance Abuse at Columbia University, 2005).…”

Conners’ Adult ADHD Rating Scale Infrequency Index Validation and Pilot Comparison of Administration Formats

“…Experts in the area suggest that feigning deficits is more likely to occur in 'high-stakes' psychological evaluations, such as those that could lead to external benefits for the examinee [4]. ADHD evaluations can be considered 'high-stakes' in that diagnosed college students may be eligible to receive academic accommodations, such as additional testing time, access to a private testing room, and/or stimulant medication [5]. Access to controlled stimulant medications, such as Adderall or Ritalin, can be particularly appealing to college students.…”

“…As previously mentioned, multiple studies have found few or no statistically significant differences on the CAARS-S: L clinical scales when comparing feigning and diagnosed ADHD groups [5,20,26]. Though the CAARS-S: L manual warns that clinical scale scores greater than 80 could indicate feigning, it also states that such elevations could indicate extreme yet truthful symptomology [22].…”