Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD

Fuermaier, Anselm B. M.; Tucha, Oliver; Koerts, Janneke; Butzbach, Marah; Weisbrod, Matthias; Aschenbrenner, Steffen; Tucha, Lara

doi:10.1080/13854046.2017.1406143

Cited by 15 publications

(16 citation statements)

References 20 publications

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“…Bryant et al (2018) had similar findings with respect to the World Health Organization Disability Schedule (WHODAS, World Health Organization, 2012), another commonly used measure of functional impairment. Finally, individuals instructed to feign ADHD could not be differentiated from genuine patients diagnosed with ADHD in their reports on the Weiss Functional Impairment Rating Scale (Fuermaier et al, 2018).…”

Section: Additional Assessment Measures That Might Improve the Adult mentioning

confidence: 99%

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults: A qualitative review of the utility of assessment measures and recommendations for improving the diagnostic process

Marshall

Hoelzle

Nikolas

2019

The Clinical Neuropsychologist

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Objective: Identify assessment measures that augment the clinical interview and improve the diagnostic accuracy of adult ADHD assessment. Method: The sometimes limited research literatures concerning the diagnostic efficacies of the clinical interview, standard and novel ADHD behavior rating scales, performance and symptom validity testing, and cognitive tests are critically reviewed. Results: Based on this qualitative review, both clinical interviews alone and ADHD behavior rating scales alone have adequate sensitivity but poor specificity in diagnosing ADHD. Response validity and symptom validity tests have reasonably good sensitivity and very good specificity in detecting invalid symptom presentation. Cognitive test batteries have inadequate sensitivity and specificity in identifying ADHD. Using cognitive tests in conjunction with behavior rating scales significantly improves the specificity of an assessment battery. Executive function behavior rating scales and functional impairment rating scales are unlikely to improve the diagnostic accuracy of ADHD assessment. Conclusions: Based on this review, key clinical interview questions, behavior rating scales, symptom validity tests, and cognitive tests that have promise to enhance current assessment practices are recommended. These are the authors' personal opinions, not consensus standards, or guidelines promulgated by any organization. These measures are incorporated in a practical, somewhat abbreviated, battery that has the potential to improve clinicians' ability to diagnose adult ADHD.

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Section: Additional Assessment Measures That Might Improve the Adult mentioning

confidence: 99%

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults: A qualitative review of the utility of assessment measures and recommendations for improving the diagnostic process

Marshall

Hoelzle

Nikolas

2019

The Clinical Neuropsychologist

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“…Scoring provided a mean scale score for each of the nine situations (or less if situations were not applicable for individual participants). It must be noted that self-report scales, including those measuring attention, are susceptible to noncredible responses and the importance of the assessment of symptom validity has been stressed consistently in original articles, consensus reports, and statement papers (Bush et al, 2005;Fuermaier et al, 2018;Heilbronner, Sweet, Morgan, Larrabee, & Millis, 2009;Tucha, Fuermaier, Koerts, Groen, & Thome, 2015). Therefore, to ensure validity of responses, six validity items were included to the questionnaire, representing one set of simple mathematical calculations (3 items, e.g., "10 þ 20 =?")…”

Section: Methodsmentioning

confidence: 99%

“…First, while the majority of respondents (n ¼ 1,874) completed and passed six items assessing the validity of their responses, a smaller proportion of participants (n ¼ 457) did not complete any validity measures. Self-report scales, including those measuring attention, are susceptible to noncredible responses and the importance of the assessment of symptom validity has been stressed consistently in original articles, consensus reports, and statement papers (Bush et al, 2005;Fuermaier et al, 2018;Heilbronner, Sweet, Morgan, Larrabee, & Millis, 2009;Tucha, Fuermaier, Koerts, Groen, & Thome, 2015). The absence of neurological and psychiatric disorders that may influence the self-evaluation of attention capacities were determined based on self-report and were not assessed in an objective expert assessment.…”

Section: Limitationsmentioning

confidence: 99%

Everyday Life Attention Scale (ELAS): Normative data of n = 1,874 Dutch participants

Fuermaier

Groen

Tucha

et al. 2019

Applied Neuropsychology: Adult

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The Everyday Life Attention Scale (ELAS) is a sensitive and reliable self-report questionnaire assessing attentional capacities of respondents in nine different situations of daily life. The ELAS has the potential to add relevant information to the clinical evaluation of attention deficits, to guide treatment planning, as well as to evaluate treatment outcome. The present study provides normative data of 1,874 Dutch speaking participants, ranging from 18 to 76 years of age, with mixed levels of education and a roughly equal distribution in gender. Normative data are calculated based on multiple linear regression models for each of the nine ELAS situations. In this article, the ELAS questionnaire as well as norm data are offered free of use. Use of normative ELAS data as presented in this study enables its use in clinical practice and research. Potential applications of the ELAS and future directions are discussed.

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“…This left a total of 222 healthy individuals included in the study (Control group n = 117; Simulation group n = 105). This sample was gathered in the context of a larger research project, which randomly assigned healthy individuals to one of several groups (Fuermaier et al 2016(Fuermaier et al , 2018. For the purpose of this study, only the control group and naïve simulation group were examined.…”

Section: Healthy Individualsmentioning

confidence: 99%

“…Finally, it investigated the relationship between ADHD symptomology and perception accuracythat is, an individual's proximity to ADHD symptoms without having a diagnosis of ADHD. Data used to measure the resilience of the CAARS (Fuermaier et al 2016;Fuermaier et al 2018) and WFIRS (Fuermaier et al 2018) against feigned ADHD were repurposed for this study.…”

Section: Introductionmentioning

confidence: 99%

Public perceptions of adult ADHD: Indications of stigma?

et al. 2020

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Stigmatization represents a major barrier to treatment seeking across mental disorders. Despite this, stigma research on individual mental disorders remains in its infancy. Attention-deficit hyperactivity disorder (ADHD) in adults also represents an under-researched area—being far less studied than its child counterpart. This study examined the current state of public perceptions towards adult ADHD. A simulation group consisting of 105 participants performed the Weiss Functional Impairment Rating Scale (WFIRS) and Conners’ Adult ADHD Rating Scales (CAARS) as though they had ADHD. These scores were compared to a group consisting of 98 individuals with adult ADHD and a group of 117 healthy individuals both groups being instructed to complete the WFIRS and CAARS to the best of their abilities. Simulators were found to overestimate impairments in adult ADHD (to a large effect) in the domains of hyperactivity, DSM-IV hyperactivity-impulsivity, DSM-IV total, work, school, (to a medium effect) in family and social, and (to a negligible-small effect) in inattention, impulsivity, DSM-IV inattention, and life skills when compared to the ADHD group, and in all domains (to a large effect) when compared to the control group. Current and retrospective ADHD symptoms were found to be associated with more accurate perceptions in a number of domains. Evidence for the presence of perceptions considered to be stigmatizing was found, with largest effects present in the domains of hyperactivity, impulsivity, impairments at work, school, and engagement in risky behaviour.

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Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD

Abstract: The present study confirms the conclusion that self-reported impairments are susceptible to noncredible responses and should be used with caution in the clinical evaluation of adult ADHD.

Cited by 15 publications

References 20 publications

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults: A qualitative review of the utility of assessment measures and recommendations for improving the diagnostic process

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults: A qualitative review of the utility of assessment measures and recommendations for improving the diagnostic process

Everyday Life Attention Scale (ELAS): Normative data of n = 1,874 Dutch participants

Public perceptions of adult ADHD: Indications of stigma?

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