Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study

Miriam Becke, Lara Tucha, Marah Butzbach, Steffen Aschenbrenner, Matthias Weisbrod, Oliver Tucha and Anselm B. M. Fuermaier ()
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Miriam Becke: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
Lara Tucha: Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
Marah Butzbach: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
Steffen Aschenbrenner: Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
Matthias Weisbrod: Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
Oliver Tucha: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
Anselm B. M. Fuermaier: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands

IJERPH, 2023, vol. 20, issue 5, 1-20

Abstract: The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery to 57 adults with ADHD, 60 neurotypical controls, and 151 instructed simulators, we examined each test’s utility in detecting noncredible performance. Cut-off scores were derived for all available outcome variables. Although all ensured at least 90% specificity in the ADHD Group, sensitivity differed significantly between tests, ranging from 0% to 64.9%. Tests of selective attention, vigilance, and inhibition were most useful in detecting the instructed simulation of adult ADHD, whereas figural fluency and task switching lacked sensitivity. Five or more test variables demonstrating results in the second to fourth percentile were rare among cases of genuine adult ADHD but identified approximately 58% of instructed simulators.

Keywords: attention-deficit/hyperactivity disorder; neuropsychological assessment; performance validity; symptom validity; noncredible performance; feigning (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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