Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.1.1. ADHD Group
2.1.2. Control Group
2.1.3. Simulation Group
2.2. Materials
2.2.1. Demographic Information
2.2.2. Self-Reported Symptoms of ADHD
2.2.3. Performance Validity
2.2.4. Neuropsychological Performance Assessment
2.3. Procedure
2.4. Data Analysis
3. Results
3.1. Neuropsychological Test Performance
3.2. CFADHD-Specific Cut-Off Scores
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | ADHD n = 57 1 | Control n = 60 1 | Simulation n = 151 1 | p-Value 2 |
---|---|---|---|---|
Age (years) | 32 (12) | 20 (1) | 19 (1) | <0.001 |
Gender (f/m) | 19 (33%)/ 38 (67%) | 43 (72%)/ 17 (28%) | 120 (79%)/ 31 (21%) | <0.001 |
Education (years) | 10 (1) | 13 (1) | 13 (1) | <0.001 |
ADHD Symptoms (childhood) | 41 (18) | 14 (9) | 13 (9) | <0.001 |
ADHD Symptoms (adulthood) | 34 (9) | 11 (7) | 10 (7) | <0.001 |
ADHD | Control | Simulation | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Raw Score | PR < 9 | Raw Score | PR < 9 | Raw Score | PR < 9 | ||||||||||
Test | Median | MAD | Min | Max | % | Median | MAD | Min | Max | % | Median | MAD | Min | Max | % |
TMT-A RT | 20.10 | 3.30 | 12.50 | 40.60 | 35.09 | 14.90 | 1.30 | 10.60 | 24.00 | 0.00 | 20.80 | 6.20 | 11.60 | 151.90 | 35.10 |
TMT-B RT | 32.80 | 7.50 | 15.30 | 96.60 | 21.05 | 20.80 | 3.95 | 13.00 | 43.10 | 0.00 | 33.00 | 9.80 | 13.60 | 529.00 | 19.21 |
WAFS RT | 368 | 63.00 | 150.00 | 694.00 | 19.30 | 326.50 | 53.00 | 200.00 | 524.00 | 8.33 | 406.00 | 62.00 | 71.00 | 710.00 | 30.46 |
WAFS RTSD | 1.25 | 0.08 | 1.12 | 9.33 | 29.82 | 1.21 | 0.05 | 1.11 | 2.80 | 20.00 | 1.36 | 0.06 | 1.14 | 11.86 | 73.51 |
WAFS OE | 0.00 | 0.00 | 0.00 | 16.00 | 24.56 | 0.00 | 0.00 | 0.00 | 9.00 | 8.33 | 3.00 | 3.00 | 0.00 | 17.00 | 67.55 |
WAFS CE | 3.00 | 1.00 | 0.00 | 49.00 | 15.79 | 2.00 | 1.00 | 0.00 | 10.00 | 10.00 | 10.00 | 5.00 | 0.00 | 87.00 | 77.48 |
NBV N | 11.00 | 2.00 | 1.00 | 15.00 | 22.81 | 14.00 | 1.00 | 5.00 | 15.00 | 1.67 | 9.00 | 2.00 | 0.00 | 15.00 | 20.53 |
5POINT N | 23.00 | 5.00 | 11.00 | 45.00 | 21.05 | 31.00 | 7.00 | 12.00 | 50.00 | 0.00 | 26.00 | 8.00 | 4.00 | 48.00 | 4.64 |
5POINT R | 1.00 | 1.00 | 0.00 | 22.00 | 3.51 | 1.00 | 1.00 | 0.00 | 14.00 | 6.67 | 2.00 | 1.00 | 0.00 | 27.00 | 7.28 |
SWITCH A | 0.11 | 2.11 | −8.00 | 34.00 | 15.79 | 0.02 | 0.02 | −0.05 | 0.13 | 5.00 | 0.03 | 0.04 | −0.17 | 10.00 | 11.26 |
SWITCH S | 0.24 | 0.15 | −0.40 | 1.54 | 10.53 | 0.19 | 0.10 | −0.24 | 0.49 | 3.33 | 0.10 | 0.11 | −0.45 | 0.72 | 6.62 |
WAFV RT | 464 | 65.00 | 355 | 662 | 17.54 | 418 | 51.50 | 247 | 652 | 6.67 | 548 | 69.00 | 69 | 751 | 32.45 |
WAFV RTSD | 1.26 | 0.05 | 1.17 | 1.43 | 12.28 | 1.25 | 0.05 | 1.12 | 3.86 | 11.67 | 1.31 | 0.07 | 0.00 | 18.68 | 35.76 |
WAFV OE | 2.00 | 2.00 | 0.00 | 18.00 | 26.32 | 1.00 | 1.00 | 0.00 | 11.00 | 10.00 | 9.00 | 4.00 | 0.00 | 25.00 | 82.12 |
WAFV CE | 2.00 | 1.00 | 0.00 | 17.00 | 24.56 | 1.00 | 1.00 | 0.00 | 8.00 | 13.33 | 7.00 | 4.00 | 0.00 | 298.00 | 76.82 |
INHIB RT | 0.28 | 0.03 | 0.20 | 0.51 | 7.02 | 0.26 | 0.03 | 0.21 | 0.41 | 1.67 | 0.31 | 0.05 | 0.21 | 0.56 | 25.17 |
INHIB RTSD | 0.10 | 0.03 | 0.05 | 3.25 | 21.05 | 0.08 | 0.02 | 0.04 | 0.33 | 3.33 | 0.15 | 0.05 | 0.04 | 1.83 | 51.66 |
INHIB OE | 4.00 | 3.00 | 0.00 | 33.00 | 28.07 | 2.00 | 2.00 | 0.00 | 46.00 | 15.00 | 15.00 | 10.00 | 0.00 | 121.00 | 65.56 |
INHIB CE | 12.00 | 4.00 | 1.00 | 35.00 | 19.30 | 12.00 | 3.00 | 1.00 | 32.00 | 8.33 | 19.00 | 5.00 | 2.00 | 43.00 | 43.05 |
STROOP RI | 0.18 | 0.10 | −0.03 | 0.88 | 31.58 | 0.12 | 0.04 | 0.00 | 0.51 | 8.33 | 0.22 | 0.12 | −0.71 | 2.31 | 33.11 |
STROOP NI | 0.11 | 0.08 | −0.12 | 0.85 | 10.53 | 0.11 | 0.04 | 0.00 | 1.16 | 0.00 | 0.10 | 0.06 | −0.29 | 1.00 | 13.25 |
Test | Indicator | Cut-off Score |
---|---|---|
TMT-A | RT | ≥27.1 |
TMT-B | RT | ≥54.6 |
WAFS | RT | ≥532 |
WAFS | RTSD | ≥1.43 |
WAFS | OE | ≥4 |
WAFS | CE | ≥8 |
NBV | N | ≤6 |
5POINT | N | ≤12 |
5POINT | R | ≥4 |
SWITCH | A | ≥11 |
SWITCH | S | ≥0.54 |
WAFV | RT | ≥636 |
WAFV | RTSD | ≥1.35 |
WAFV | OE | ≥7 |
WAFV | CE | ≥7 |
INHIB | RT | ≥0.364 |
INHIB | RTSD | ≥0.165 |
INHIB | OE | ≥18 |
INHIB | CE | ≥27 |
STROOP | RI | ≥0.448 |
STROOP | NI | ≥0.323 |
Base Rate | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
10% | 20% | 30% | 40% | 50% | ||||||||
Metric | Sensitivity | Specificity | PPV | NPV | PPV | NPV | PPV | NPV | PPV | NPV | PPV | NPV |
TMT-A RT | 35.10 | 91.23 | 30.78 | 92.67 | 50.01 | 84.90 | 63.17 | 76.63 | 72.73 | 67.83 | 80.01 | 58.43 |
TMT-B RT | 21.19 | 91.23 | 21.16 | 91.24 | 37.65 | 82.24 | 50.87 | 72.98 | 61.69 | 63.46 | 70.73 | 53.65 |
WAFS RT | 14.57 | 91.23 | 15.58 | 90.58 | 29.34 | 81.03 | 41.58 | 71.36 | 52.55 | 61.56 | 62.42 | 51.64 |
WAFS RTSD | 31.13 | 91.23 | 28.28 | 92.26 | 47.01 | 84.12 | 60.33 | 75.55 | 70.29 | 66.52 | 78.01 | 56.98 |
WAFS OE | 44.37 | 92.98 | 41.26 | 93.77 | 61.25 | 86.99 | 73.04 | 79.59 | 80.83 | 71.49 | 86.34 | 62.57 |
WAFS CE | 64.90 | 91.23 | 45.12 | 95.90 | 64.91 | 91.23 | 76.02 | 85.85 | 83.14 | 79.59 | 88.09 | 72.22 |
NBV N | 20.53 | 91.23 | 20.64 | 91.18 | 36.91 | 82.12 | 50.08 | 72.82 | 60.94 | 63.26 | 70.06 | 53.44 |
5POINT N | 5.96 | 96.49 | 15.88 | 90.23 | 29.81 | 80.41 | 42.13 | 70.54 | 53.11 | 60.62 | 62.94 | 50.64 |
5POINT R | 19.21 | 91.23 | 19.57 | 91.04 | 35.37 | 81.87 | 48.41 | 72.49 | 59.34 | 62.88 | 68.65 | 53.03 |
SWITCH A | 0.00 | 90.57 | 0.00 | 89.07 | 0.00 | 78.37 | 0.00 | 67.88 | 0.00 | 57.60 | 0.00 | 47.52 |
SWITCH S | 2.65 | 90.57 | 3.03 | 89.33 | 6.56 | 78.82 | 10.74 | 68.46 | 15.77 | 58.25 | 21.92 | 48.19 |
WAFV RT | 18.79 | 91.23 | 19.23 | 91.00 | 34.88 | 81.80 | 47.87 | 72.39 | 58.82 | 62.76 | 68.18 | 52.91 |
WAFV RTSD | 34.23 | 91.23 | 30.24 | 92.58 | 49.38 | 84.73 | 62.58 | 76.40 | 72.23 | 67.54 | 79.60 | 58.11 |
WAFV OE | 62.67 | 91.23 | 44.25 | 95.65 | 64.11 | 90.72 | 75.38 | 85.08 | 82.65 | 78.57 | 87.72 | 70.96 |
WAFV CE | 56.00 | 91.23 | 41.50 | 94.91 | 61.48 | 89.24 | 73.23 | 82.87 | 80.97 | 75.67 | 86.46 | 67.46 |
INHIB RT | 26.17 | 91.23 | 24.90 | 91.75 | 42.73 | 83.17 | 56.12 | 74.25 | 66.55 | 64.96 | 74.90 | 55.27 |
INHIB RTSD | 41.61 | 91.23 | 34.52 | 93.36 | 54.25 | 86.21 | 67.03 | 78.47 | 75.98 | 70.09 | 82.59 | 60.97 |
INHIB OE | 45.64 | 91.23 | 36.63 | 93.79 | 56.53 | 87.03 | 69.04 | 79.66 | 77.62 | 71.57 | 83.88 | 62.66 |
INHIB CE | 16.11 | 94.74 | 25.38 | 91.04 | 43.35 | 81.87 | 56.74 | 72.49 | 67.11 | 62.88 | 75.37 | 53.04 |
STROOP RI | 20.41 | 91.23 | 20.54 | 91.16 | 36.77 | 82.09 | 49.93 | 72.79 | 60.80 | 63.23 | 69.94 | 53.41 |
STROOP NI | 10.88 | 91.23 | 12.12 | 90.21 | 23.68 | 80.37 | 34.72 | 70.49 | 45.27 | 60.56 | 55.37 | 50.59 |
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Becke, M.; Tucha, L.; Butzbach, M.; Aschenbrenner, S.; Weisbrod, M.; Tucha, O.; Fuermaier, A.B.M. Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study. Int. J. Environ. Res. Public Health 2023, 20, 4070. https://doi.org/10.3390/ijerph20054070
Becke M, Tucha L, Butzbach M, Aschenbrenner S, Weisbrod M, Tucha O, Fuermaier ABM. Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study. International Journal of Environmental Research and Public Health. 2023; 20(5):4070. https://doi.org/10.3390/ijerph20054070
Chicago/Turabian StyleBecke, Miriam, Lara Tucha, Marah Butzbach, Steffen Aschenbrenner, Matthias Weisbrod, Oliver Tucha, and Anselm B. M. Fuermaier. 2023. "Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study" International Journal of Environmental Research and Public Health 20, no. 5: 4070. https://doi.org/10.3390/ijerph20054070