ABSTRACT

Given the functional impairments associated with Attention Deficit/Hyperactivity Disorder (AD/HD), a valid diagnosis is important. However, particularly when carried out in adulthood, the diagnostic process can be challenging and is complicated by conclusive evidence that a proportion of individuals referred for evaluation of AD/HD exaggerate or feign their symptoms. Relatively few methods, however, exist to identify such feigning. While continuous performance tests (CPTs) may provide useful information regarding performance validity, the question remains as to whether there are consistent patterns of exaggeration demonstrated by those feigning AD/HD. Thus, this study used cluster analysis to determine whether valid and reliable performance clusters would emerge based on CPT performance. Using archival data from a university-based AD/HD screening clinic, we investigated the performance of 305 adults on the Test of Variables of Attention (TOVA). Three profiles emerged, including one cluster who demonstrated exceptionally low performance on the TOVA, exceptionally high reports of AD/HD symptomology, and higher rates of failure on symptom and performance validity tests. The implication from our analysis is that this group most likely represents individuals who were exaggerating or magnifying their difficulties. The results reaffirm previous research showing that performance profiles on a continuous performance test can be used as an indicator of credible performance.

摘要

鉴于与注意力缺陷/多动障碍 (AD/HD) 相关的功能障碍，有效的诊断很重要。然而，特别是在成年期进行时，诊断过程可能具有挑战性，并且由于确凿的证据表明一部分被转介用于 AD/HD 评估的个体夸大或假装他们的症状而变得复杂。然而，识别这种假装的方法相对较少。虽然连续性能测试 (CPT) 可能提供有关性能有效性的有用信息，但问题仍然是假装 AD/HD 的人是否表现出一致的夸大模式。因此，本研究使用聚类分析来确定基于 CPT 性能是否会出现有效和可靠的性能聚类。使用来自大学 AD/HD 筛查诊所的档案数据，我们调查了 305 名成年人在注意力变量测试 (TOVA) 中的表现。出现了三个配置文件，其中一个集群在 TOVA 上表现出异常低的性能、异常高的 AD/HD 症状报告以及更高的症状和性能有效性测试失败率。我们分析的含义是，这个群体很可能代表了夸大或放大他们的困难的个人。结果再次证实了之前的研究表明，连续性能测试的性能配置文件可以用作可信性能的指标。包括一个在 TOVA 上表现出异常低性能的集群，异常高的 AD/HD 症状报告，以及在症状和性能有效性测试中更高的失败率。我们分析的含义是，这个群体很可能代表了夸大或放大他们的困难的个人。结果再次证实了之前的研究表明，连续性能测试的性能配置文件可以用作可信性能的指标。包括一个在 TOVA 上表现出异常低性能的集群，异常高的 AD/HD 症状报告，以及在症状和性能有效性测试中更高的失败率。我们分析的含义是，这个群体很可能代表了夸大或放大他们的困难的个人。结果再次证实了之前的研究表明，连续性能测试的性能配置文件可以用作可信性能的指标。