Intentional inattention: Detecting feigned attention-deficit/hyperactivity disorder on the Personality Assessment Inventory.

Abstract

Given the increasing number of college students seeking Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses as well as the potential secondary gains associated with this disorder (e.g., access to stimulant medication, academic accommodations), the detection of malingered symptom presentations in this population is a major concern. The present study examined the ability of validity indicators on the widely used Personality Assessment Inventory (PAI; Morey, 1991) to distinguish between individuals experiencing genuine ADHD symptoms and individuals instructed to present with ADHD symptomatology for secondary gain. Sixty-six participants who successfully simulated ADHD (based on elevations on the Conners' Adult ADHD Rating Scale; Conners, Erhardt, & Sparrow, 1998) were compared with a sample of undergraduate students meeting diagnostic criteria for ADHD (N = 22) and an archival sample of adults who received an ADHD diagnosis at a university psychology clinic following a comprehensive psychological evaluation (N = 41). Successful simulators obtained significantly higher scores on all relevant PAI validity indicators compared with the clinical and archival comparison samples, with the Rogers Discriminant Function demonstrating the highest predictive accuracy (AUC = .86). Traditional cut scores on the Negative Impression (NIM) validity scale used to designate probable malingering, however, were not sensitive to simulated ADHD symptoms, although they did demonstrate excellent specificity. The PAI may be informative as an indicator of potentially exaggerated or malingered symptom presentation, but alternative cut scores for symptom validity indicators may be necessary to maximize its utility in these particular types of psychological evaluations. (PsycINFO Database Record

Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners’ adult ADHD rating scales

“…Growing recognition of adult manifestations of attentiondeficit/hyperactivity disorder (ADHD) (Kessler et al 2005a, b;Kessler et al 2006;Simon et al 2009;Wender et al 2001) has drawn attention to diagnostic challenges inherent in the disorder's clinical evaluation. As evidence of ADHD being an appealing and feasible target for exaggeration or feigning of symptom report has accumulated over the past years, the importance of identifying suspect effort within the diagnostic process has been underscored repeatedly (Fuermaier et al 2016a, b;Fuermaier et al 2017a, b;Harrison and Armstrong 2016;Harrison et al 2007;Jachimowicz and Geiselman 2004;Lee Booksh et al 2010;Marshall et al 2016;Quinn 2003;Smith et al 2017;Walls et al 2017). However, this growing base of empirical evidence supporting the use of validity tests in the diagnostic work-up of ADHD does not appear to have found widespread application in clinical settings yet.…”

A Place for Psychological Testing in the Assessment of Adult ADHD

“…In regards to personality inventories, the use of either the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath, 2012) or the Personality Assessment Inventory (Blais et al, 2010) is recommended. These personality inventories not only provide added information about plausible alternative diagnoses, they additionally demonstrate strong incremental validity for the assessment of adult ADHD and provide an initial symptom validity assessment of the patient's reported symptoms (Smith et al, 2017;Watson and Liljequist, 2018).…”

Brain Relatively Inert Network: Taking Adult Attention Deficit Hyperactivity Disorder as an Example

“…Due to misunderstandings and lack of knowledge about this disease, many people with ADHD are misdiagnosed and often fail to receive effective treatment ( Kooij et al, 2010 ). At the same time, the falsifiability based on the diagnostic scales is also very worrying ( Smith et al, 2017 ; Becke et al, 2021 ). Therefore, the diagnosis of adult ADHD is more difficult compared with childhood ADHD.…”