Author

Karen Kosky

Date of Award

8-2019

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

David J. LaPorte

Second Advisor

William Meil

Third Advisor

Stephanie Davis

Fourth Advisor

Glen Getz

Abstract

Certain individuals presenting for diagnostic evaluations attempt to feign or exaggerate symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in an attempt to secure prescriptions for stimulant medications or desirable academic accommodations. Differentiating these individuals from those with bona fide impairment is important and challenging for clinicians. This study sought to assess the impact of pseudo-malingerers utilizing information available on the Internet on the utility of established symptom and performance validity measures, as well as to assess the potential of other scores on commonly administered neuropsychological measures for validity assessment. Undergraduate students were recruited for this between-groups experimental design. Participants were divided into one of four groups: two groups of malingering simulators (a coached group and a non-coached group), a comparison group, and a group of students with a diagnosis of ADHD (N=68). Participants completed a battery including a stand-alone (Word Choice subtest of Advanced Clinical Solutions) and embedded measure (Reliable Digit Span) of effort, the Conner’s Adult ADHD Rating Scale (CAARS), the Wisconsin Card Sorting Test (WCST), and a Continuous Performance Test (CPT). Results indicated the stand-alone measure of effort had moderate sensitivity and high specificity for identifying malingerers. Experimental groups did not differ in performance on the embedded effort measure, and the self-report measure was easily feigned by malingerers. Few significant differences between groups existed on the WCST and CPT scores. The clinical implications of these findings, recommendations for clinicians, and recommendations for future research endeavors are discussed.

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