Detection of feigned ADHD in college students

Area of Science:

• Neuroscience
• Psychiatry
• Psychology

Background:

• Young adults often have incentives to seek attention-deficit/hyperactivity disorder (ADHD) diagnoses.
• Internet accessibility to ADHD information may lead to symptom-educated students prior to evaluation.
• This can result in false-positive diagnoses, especially when motivation to feign symptoms is present.

Purpose of the Study:

• To evaluate the diagnostic utility of ADHD symptom checklists, neurocognitive tests, and symptom validity tests (SVTs).
• To compare the performance of financially motivated undergraduates coached on ADHD with diagnosed ADHD students and controls.

Main Methods:

• Compared 31 undergraduates motivated to feign ADHD with 29 ADHD undergraduates (medication washout) and 14 controls.
• Utilized ADHD symptom checklists (e.g., ADHD Rating Scale), neurocognitive tests (e.g., Conners's CPT-II), and SVTs (e.g., TOMM, Digit Memory Test).

Main Results:

• Malingerers produced ADHD-consistent profiles; symptom checklists were highly susceptible to faking.
• Conners's Continuous Performance Test-II results were linked to motivation rather than ADHD.
• Cognitive SVTs, particularly the Test of Memory Malingering (TOMM), showed promising results in detecting feigning.

Conclusions:

• Symptom validity tests (SVTs) demonstrated high specificity for ADHD and moderate sensitivity to faking.
• Combining multiple SVT failures maintained high specificity, indicating their utility in ADHD diagnosis.
• A comprehensive evaluation including history, cognitive/emotional functioning, and consideration of exaggerated symptomatology is crucial for accurate ADHD diagnosis.