Utility of the Structured Interview of Reported Symptoms (SIRS-2) in detecting feigned adult attention-deficit/hyperactivity disorder

Becke, Miriam; Fuermaier, Anselm B. M.; Buehren, Jannes; Weisbrod, Matthias; Aschenbrenner, Steffen; Tucha, Oliver; Tucha, Lara

doi:10.1080/13803395.2019.1621268

Cited by 6 publications

(3 citation statements)

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“…Adaptation of detection strategies previously described by Rogers (2018) may be useful additions or alternatives to the reliance on erroneous stereotypes, according to the authors. They suggest that inquiries into symptom combinations, which are rarely reported jointly by genuine patients, may present another basis on which to formulate ADHD-specific items for validity tests; a recommendation supported by findings published recently (Becke et al 2019).…”

Section: Introductionmentioning

confidence: 87%

“…Diagnoses of ADHD were secured through a comprehensive clinical work-up and confirmed by at least two experienced clinicians. The diagnostic process included a psychiatric interview, which enquired both past and present symptoms of ADHD in accordance with the DSM criteria (American Psychiatric Association 2013; Barkley and Murphy 1998). Additionally, participants scored above the recommended cut-offs on two standardized self-report rating scales, which tapped symptoms of ADHD across the same time span (WURS-K and ASR) (Adler et al 2006;Kessler et al 2005a, b;Ward et al 1993).…”

Section: Participantsmentioning

confidence: 99%

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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

et al. 2021

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As attention-deficit/hyperactivity disorder (ADHD) is a feasible target for individuals aiming to procure stimulant medication or accommodations, there is a high clinical need for accurate assessment of adult ADHD. Proven falsifiability of commonly used diagnostic instruments is therefore of concern. The present study aimed to develop a new, ADHD-specific infrequency index to aid the detection of non-credible self-report. Disorder-specific adaptations of four detection strategies were embedded into the Conners’ Adult ADHD Rating Scales (CAARS) and tested for infrequency among credible neurotypical controls (n = 1001) and credible adults with ADHD (n = 100). The new index’ ability to detect instructed simulators (n = 242) and non-credible adults with ADHD (n = 22) was subsequently examined using ROC analyses. Applying a conservative cut-off score, the new index identified 30% of participants instructed to simulate ADHD while retaining a specificity of 98%. Items assessing supposed symptoms of ADHD proved most useful in distinguishing genuine patients with ADHD from simulators, whereas inquiries into unusual symptom combinations produced a small effect. The CAARS Infrequency Index (CII) outperformed the new infrequency index in terms of sensitivity (46%), but not overall classification accuracy as determined in ROC analyses. Neither the new infrequency index nor the CII detected non-credible adults diagnosed with ADHD with adequate accuracy. In contrast, both infrequency indices showed high classification accuracy when used to detect symptom over-report. Findings support the new indices’ utility as an adjunct measure in uncovering feigned ADHD, while underscoring the need to differentiate general over-reporting from specific forms of feigning.

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Section: Introductionmentioning

confidence: 87%

Section: Participantsmentioning

confidence: 99%

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

et al. 2021

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“…While the CII, EI, and Ds-ADHD utilize items drawn from existing instruments, the INF and the ACI each contain disorder-specific items written specifically for the purpose of detecting noncredible self-report in the clinical assessment of ADHD. The ACI's items were developed as ADHD-specific adaptations of detection strategies described by Rogers (Becke et al, 2019;Rogers, 2018). Initial validation studies showed comparable classification accuracy for the Ds-ADHD and INF, whereas the performance of the ACI was comparable to the CII's classification accuracy.…”

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confidence: 99%

Joint Consideration of Validity Indicators Embedded in Conners’ Adult ADHD Rating Scales (CAARS)

Becke

Tucha

Weisbrod

et al. 2022

Psychol. Inj. and Law

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A decade of research has both illustrated the need for accurate clinical assessment of adult ADHD and brought forward a series of validity indicators assisting this diagnostic process. Several of these indicators have been embedded into Conners’ Adult ADHD Rating Scales (CAARS). As their different theoretical underpinnings offer the opportunity of possible synergy effects, the present study sought to examine whether the item- or index-wise combination of multiple validity indicators benefits classification accuracy. A sample of controls (n = 856) and adults with ADHD (n = 72) answered the CAARS, including the ADHD Credibility Index (ACI) honestly, while a group of instructed simulators (n = 135) completed the instrument as though they had ADHD. First, original CAARS items, which are part of the CAARS Infrequency Index (CII), and items drawn from the ACI were combined into a new CII-ACI-Compound Index. Secondly, existing validity indicators, including suspect T-score elevations and the CII, were considered in combination. Both approaches were evaluated in terms of sensitivity and specificity. The combination of four CII and five ACI items into the CII-ACI-Compound Index yielded a sensitivity between 41 and 51% and an estimated specificity above 87%. Suspect T-score elevations on all three DSM scales emerged as another potentially useful validity indicator with a sensitivity of 45 to 46% and a specificity > 90%. Deeming examinees non-credible whenever two or more validity indicators showed suspect results ensured low false-positive rates (< 10%), but reduced sensitivity significantly. Classifying respondents as non-credible as soon as any given indicator fell into the suspect range resulted in frequent false positives (> 11% of misclassified adults with ADHD). Depending on whether high specificity or high sensitivity is prioritized, such combined considerations offer valuable additions to individual validity indicators. High sensitivity provided by “either/or” combinations could prove useful in screening settings, whereas high stakes settings could benefit from “and” combinations.

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Assessment and treatment of substance use in adults with ADHD: a psychological approach

Young

Woodhouse

2020

J Neural Transm

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Utility of the Structured Interview of Reported Symptoms (SIRS-2) in detecting feigned adult attention-deficit/hyperactivity disorder

Cited by 6 publications

References 70 publications

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

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

Joint Consideration of Validity Indicators Embedded in Conners’ Adult ADHD Rating Scales (CAARS)

Assessment and treatment of substance use in adults with ADHD: a psychological approach

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