Validation of the Test of Attention Distraction in identifying non-credible performance in diagnosis-seeking...

Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in young adults is complicated by reliance on self-report, psychiatric comorbidity, and vulnerability to exaggerated or noncredible responding in assessment-seeking populations. The Test of Attentional Distraction (TOAD) is a computerized attention task developed to function as a domain-specific performance validity indicator. Archival data from 95 postsecondary students referred for comprehensive ADHD evaluation were examined using a multimethod battery that included clinical interview, collateral information, self-report ADHD measures, embedded ADHD-specific symptom validity indices, traditional performance validity tests (PVTs), continuous performance test (CPT) indices, and the TOAD. Thirty-one participants (32.6%) were classified as significant or high risk for suspect effort on the TOAD. TOAD failure was associated with substantially elevated ADHD symptom endorsement across nearly all Conners' Adult ADHD Rating Scales (CAARS) subscales and with ADHD-specific symptom validity indices, including Dissimulation and Infrequency scales. Associations with most traditional memory-based PVTs were limited. In contrast, TOAD indices demonstrated strong convergence with CPT-derived exaggeration indices and effectively discriminated individuals with extreme CPT profiles previously linked to noncredible ADHD presentation. Findings support the TOAD as a clinically useful, domain-specific performance validity indicator that provides incremental information beyond traditional PVTs in adult ADHD assessment.