51
|
Shura RD, Miskey HM, Williams VG, Jadidian A, Rowland JA. Informing Evidence-Based Assessment of ADHD in Veterans and Service Members. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Robert D. Shura
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina, and Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine
| | - Holly M. Miskey
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina, and Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine
| | - Vanessa G. Williams
- Patient Care Services Psychology, Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado
| | - Alex Jadidian
- Mental Health & Behavioral Sciences Service Line, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Jared A. Rowland
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina, and Department of Neurobiology and Anatomy, Wake Forest School of Medicine
| |
Collapse
|
52
|
Lippa SM. Performance validity testing in neuropsychology: a clinical guide, critical review, and update on a rapidly evolving literature. Clin Neuropsychol 2017; 32:391-421. [DOI: 10.1080/13854046.2017.1406146] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sara M. Lippa
- Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Bethesda, MD, USA
| |
Collapse
|
53
|
Mawjee K, Woltering S, Lai N, Gotlieb H, Kronitz R, Tannock R. Working Memory Training in ADHD: Controlling for Engagement, Motivation, and Expectancy of Improvement (Pilot Study). J Atten Disord 2017; 21:956-968. [PMID: 25501356 DOI: 10.1177/1087054714557356] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether a shortened-length session of CogMed Working Memory Training (CWMT) would be a suitable active control group and evaluate study protocol to aid in design refinements for a larger randomized controlled trial (RCT). METHOD Thirty-eight post-secondary students diagnosed with ADHD were randomized into 25 sessions of standard (45 min/session) or shortened (15 min/session) CWMT, or into a waitlist control group. RESULTS There was no significant difference in completion rate or training index score between the standard- and shortened-length groups indicating that both groups showed improvement and put forth good effort during training. CONCLUSION Preliminary findings suggest that shorter training sessions may induce similar levels of engagement, motivation, and expectancy of improvement in participants. We conclude that a larger scale RCT that utilizes shortened-length training as an active control group is warranted, but that a few modifications to the study protocol will be required.
Collapse
Affiliation(s)
| | - Steven Woltering
- 1 University of Toronto, Ontario, Canada.,2 Texas A&M University, Texas, USA
| | - Nathan Lai
- 1 University of Toronto, Ontario, Canada
| | | | - Reena Kronitz
- 3 Jewish Vocational Services Toronto, Ontario, Canada
| | - Rosemary Tannock
- 1 University of Toronto, Ontario, Canada.,4 Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
54
|
Harrison AG. Clinical, Ethical, and Forensic Implications of a Flexible Threshold for LD and ADHD in Postsecondary Settings. PSYCHOLOGICAL INJURY & LAW 2017. [DOI: 10.1007/s12207-017-9291-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
55
|
Detecting Feigned Attention-Deficit/Hyperactivity Disorder (ADHD): Current Methods and Future Directions. PSYCHOLOGICAL INJURY & LAW 2017. [DOI: 10.1007/s12207-017-9286-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
56
|
Bordoff B. The Challenges and Limitations of Diagnosing and Pharmacologically Treating ADHD in University Students. PSYCHOLOGICAL INJURY & LAW 2017. [DOI: 10.1007/s12207-017-9288-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
57
|
Cook C, Buelow MT, Lee E, Howell A, Morgan B, Patel K, Bryant AM, Menatti A, Suhr J. Malingered Attention Deficit/Hyperactivity Disorder on the Conners’ Adult ADHD Rating Scales: Do Reasons for Malingering Matter? JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2017. [DOI: 10.1177/0734282917696934] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Malingering is a significant assessment concern in adults undergoing evaluations for attention deficit/hyperactivity disorder (ADHD) and may occur for a number of reasons, including access to medication and/or accommodations. Therefore, it is important to investigate ways to determine accuracy of self-reported ADHD symptoms. The present study used a simulation design to examine the impact of reasons for malingering on the Conners’ Adult ADHD Rating Scales (CAARS) Symptom subscales and the CAARS infrequency index (CII). Participants ( N = 157) were randomly assigned to one of three conditions: best effort, malingering for stimulant medication, or malingering for extra time accommodations. The three groups were compared with 34 individuals reporting previous diagnosis of ADHD. Results showed that individuals in both malingering groups scored higher than controls on all CAARS subscales and CII. Individuals in the medication malingering group, but not the extra time malingering group, scored higher than the ADHD group on CII and several CAARS subscales whose content overtly reflects ADHD symptomatology. Findings emphasize the influence of malingering on self-reported ADHD symptoms and the need to assess for malingering in ADHD evaluation. Results also suggest that reason for malingering might differentially affect self-report of ADHD symptoms.
Collapse
|
58
|
Barnhart WR, Buelow MT. Assessing impulsivity: Relationships between behavioral and self-report measures in individuals with and without self-reported ADHD. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
59
|
Leppma M, Long D, Smith M, Lassiter C. Detecting Symptom Exaggeration in College Students Seeking ADHD Treatment: Performance Validity Assessment Using the NV-MSVT and IVA-Plus. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 25:210-218. [PMID: 28128974 DOI: 10.1080/23279095.2016.1277723] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The symptoms of ADHD are highly subjective, and there is ample empirical evidence that demonstrates the ease with which impairments in attention can be feigned on many commonly used subjective and objective measures of attention. We examined the combination of two assessment measures, NV-MSVT and IVA+, to screen for performance validity and ADHD symptoms in college students. Results indicated that the NV-MSVT was effective in differentiating between students with potential high impairment, such as ADHD, and possible malingerers. In addition, in vivo clinical data (N = 350) resulted in lower validity cut-off scores on the IVA+ than had been previously suggested. Clinical implications and future research are also discussed.
Collapse
Affiliation(s)
- Monica Leppma
- a Counseling, Rehabilitation Counseling, & Counseling Psychology , West Virginia University , Morgantown , West Virginia , USA
| | - Daniel Long
- b Student Mental Health Service Program , West Virginia University , Morgantown , West Virginia , USA
| | - Megan Smith
- c School of Public Health HSC , West Virginia University , Morgantown , West Virginia , USA
| | | |
Collapse
|
60
|
Sibley MH, Mitchell JT, Becker SP. Method of adult diagnosis influences estimated persistence of childhood ADHD: a systematic review of longitudinal studies. Lancet Psychiatry 2016; 3:1157-1165. [PMID: 27745869 DOI: 10.1016/s2215-0366(16)30190-0] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/14/2016] [Accepted: 07/15/2016] [Indexed: 11/30/2022]
Abstract
Several studies have questioned the stability of attention-deficit hyperactivity disorder (ADHD) from childhood to adulthood. This systematic review illustrates how variability in diagnostic methods influences adult ADHD persistence estimates. Systematic database searches identified studies reporting adult ADHD persistence rates that were published in English between Jan 1, 1992, and May 31, 2016. Study inclusion criteria were systematic childhood diagnosis of attention-deficit disorder, ADHD, or a research diagnostic protocol that matched DSM-III, DSM-III-R, or DSM-IV standards; mean childhood age of younger than 12·0 years with no participants older than 18·0 years; and mean adult age of 18·0 years or older with no participants younger than 17·0 years. Across 12 included samples, we identified 41 estimates of ADHD persistence, which ranged from 4·0% to 77·0%. Methods of diagnosing ADHD in adulthood varied widely with respect to source of information, diagnostic instruments (eg, rating scales, interviews), diagnostic symptom threshold, and whether impairment was required for diagnosis. Sole reliance on self reports and a strict threshold of six DSM symptoms led to very low persistence estimates. To minimise false-negative and false-positive classifications, recommended methods for determining adult persistence of ADHD include collecting self and informant ratings, requiring the presence of impairment, and using an age-appropriate symptom threshold. Very few persistence estimates utilised these methods, but those that did indicated persistence rates of 40-50%.
Collapse
Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry and Behavioral Health, Center for Children and Families, Florida International University, Miami, FL, USA.
| | - John T Mitchell
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
61
|
Sibley MH, Coxe S, Molina BSG. Refining Diagnostic Procedures for Adults With Symptoms of ADHD. Assessment 2016; 24:290-296. [PMID: 27866171 DOI: 10.1177/1073191116676890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a chronic disorder that afflicts individuals into adulthood. The field continues to refine diagnostic standards for ADHD in adults, complicated by the disorder's heterogeneous presentation, subjective symptoms, and overlap with other disorders. Two key diagnostic questions are from whom to collect diagnostic information and which symptoms should be contained on an adult diagnostic checklist. Using a trifactor model, Martel et al. examine these questions in a sample of adults with and without self-identified ADHD symptoms. In this response, we highlight the importance of their finding that self and informant symptom reports differ in a sample of adults who acknowledge ADHD symptoms. We also review issues that continue to face the field related to model specification, evaluating symptom utility, and sample composition, discussing how these issues influence conclusions that may be drawn from Martel et al. and similar investigations. We conclude that the article makes an important research contribution about the nature of self and informant ADHD symptom reports but emphasize that symptom checklist refinement must occur through a broad lens that considers work from a range of sample types and clinically informative analytic strategies.
Collapse
Affiliation(s)
| | - Stefany Coxe
- 1 Florida International University, Miami, FL, USA
| | | |
Collapse
|
62
|
Fuermaier ABM, Tucha O, Koerts J, Grabski M, Lange KW, Weisbrod M, Aschenbrenner S, Tucha L. The Development of an Embedded Figures Test for the Detection of Feigned Attention Deficit Hyperactivity Disorder in Adulthood. PLoS One 2016; 11:e0164297. [PMID: 27732620 PMCID: PMC5061314 DOI: 10.1371/journal.pone.0164297] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES It has been shown that an increasing number of adults deliberately feign attention deficit hyperactivity disorder (ADHD), which demonstrates the need for new tests designed to detect feigned ADHD. METHODS An Embedded Figures Test (EFT) was developed for the detection of feigned ADHD in adulthood. EFT performance of 51 adults with ADHD was compared to the performance of 52 matched healthy individuals, as well as to 268 undergraduate students who were randomly allocated in a simulation design to one of four experimental conditions, i.e. a control group, a naïve simulation group, a symptom-coached simulation group or a test-coached simulation group. Furthermore, an independent sample of 11 adults with ADHD as well as a sample of 17 clinicians experienced in the work with adults with ADHD were assessed for further validation of the EFT. RESULTS The EFT was relatively easy to perform for both patients with ADHD and healthy comparisons as shown by low error rates and non-significant group differences. However, simulation groups differed from patients with ADHD by significant and large effects. An EFT index for the prediction of feigned ADHD was derived based on logistic regression coefficients. Receiver Operating Characteristics (ROC) demonstrated good classification accuracy of feigned ADHD relative to ADHD (AUC = 94.8%), i.e. high sensitivity (88%) and specificity (90%). CONCLUSIONS This study supports the utility of the EFT for the detection of feigned adult ADHD.
Collapse
Affiliation(s)
- Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- * E-mail:
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Meryem Grabski
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Klaus W. Lange
- Department of Experimental Psychology, University of Regensburg, 93040 Regensburg, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
- Section for Experimental Psychopathology and Neurophysiology, Centre for Psychosocial Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| |
Collapse
|
63
|
Musso MW, Hill BD, Barker AA, Pella RD, Gouvier WD. Utility of the Personality Assessment Inventory for Detecting Malingered ADHD in College Students. J Atten Disord 2016; 20:763-74. [PMID: 25204276 DOI: 10.1177/1087054714548031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of the current study is to examine the utility of the Personality Assessment Inventory (PAI) for detecting feigned ADHD in college students. METHOD A sample of 238 undergraduate students was recruited and asked to simulate ADHD (ADHD simulators) or respond honestly (controls) on the PAI. Archival data (n = 541) from individuals diagnosed with clinical ADHD, no diagnosis, learning disorder, mood/anxiety, comorbid ADHD-mood/anxiety, or suspect effort were used. RESULTS Few individuals scored above the cutoffs on PAI validity scales. When alternative cutoff scores were examined, cutoffs of ≥77 on the Negative Impression Management (NIM) scale, ≥3 on the Malingering Index (MAL), and ≥1 on the Rogers Discriminant Function (RDF) yielded excellent specificity in all groups and sensitivities of .33, .30, and .20, respectively. CONCLUSION Individuals who were asked to simulate ADHD easily manipulate the PAI; however, alternative cutoff scores proposed for PAI validity indices may improve the detection of feigned ADHD symptoms.
Collapse
Affiliation(s)
| | | | | | - Russell D Pella
- University of Texas Health Sciences Center, San Antonio, TX, USA
| | | |
Collapse
|
64
|
DuPaul GJ, Pinho TD, Pollack BL, Gormley MJ, Laracy SD. First-Year College Students With ADHD and/or LD. JOURNAL OF LEARNING DISABILITIES 2016; 50:238-251. [PMID: 26712797 DOI: 10.1177/0022219415617164] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Students with attention-deficit/hyperactivity disorder (ADHD) and/or learning disabilities (LD) experience significant challenges in making the transition from high school to college. This study examined the ways first-year college students with ADHD, LD, ADHD+LD, and comparison peers differ in engagement, core self-evaluation, high school preparation behaviors, and goals/expectations. Participants were from the 2010 Cooperative Institutional Research Program Freshman Survey, including students with ADHD ( n = 5,511), LD ( n = 2,626), ADHD+LD ( n = 1,399), or neither disability ( n = 5,737). Controlling for SAT/ACT scores, family income, and parent education, students with ADHD, LD, or ADHD+LD differed from peers on self-ratings of academic and creative abilities and psychosocial functioning; school disengagement, substance use, and emotional difficulties during their last year of high school; reasons for attending college; and expectations for college activities. Several differences were found between disability groups. Implications for college support services and future research are discussed.
Collapse
Affiliation(s)
- George J DuPaul
- 1 College of Education, Lehigh University, Bethlehem, PA, USA
| | - Trevor D Pinho
- 1 College of Education, Lehigh University, Bethlehem, PA, USA
| | | | | | - Seth D Laracy
- 1 College of Education, Lehigh University, Bethlehem, PA, USA
| |
Collapse
|
65
|
Fazio RL, Denning JH, Denney RL. TOMM Trial 1 as a performance validity indicator in a criminal forensic sample. Clin Neuropsychol 2016; 31:251-267. [DOI: 10.1080/13854046.2016.1213316] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - John H. Denning
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Robert L. Denney
- Neuropsychological Associates of Southwest Missouri, Springfield, MO, USA
| |
Collapse
|
66
|
Cook CM, Bolinger E, Suhr J. Further Validation of the Conner's Adult Attention Deficit/Hyperactivity Rating Scale Infrequency Index (CII) for Detection of Non-Credible Report of Attention Deficit/Hyperactivity Disorder Symptoms. Arch Clin Neuropsychol 2016; 31:358-64. [DOI: 10.1093/arclin/acw015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 11/12/2022] Open
|
67
|
Harrison AG, Armstrong IT. Development of a symptom validity index to assist in identifying ADHD symptom exaggeration or feigning. Clin Neuropsychol 2016; 30:265-83. [DOI: 10.1080/13854046.2016.1154188] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
68
|
Dvorsky MR, Langberg JM, Molitor SJ, Bourchtein E. Clinical Utility and Predictive Validity of Parent and College Student Symptom Ratings in Predicting an ADHD Diagnosis. J Clin Psychol 2016; 72:401-18. [DOI: 10.1002/jclp.22268] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
69
|
Kimball EW, Wells RS, Ostiguy BJ, Manly CA, Lauterbach AA. Students with Disabilities in Higher Education: A Review of the Literature and an Agenda for Future Research. HIGHER EDUCATION: HANDBOOK OF THEORY AND RESEARCH 2016. [DOI: 10.1007/978-3-319-26829-3_3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
|
70
|
Perugi G, Vannucchi G. The use of stimulants and atomoxetine in adults with comorbid ADHD and bipolar disorder. Expert Opin Pharmacother 2015; 16:2193-204. [PMID: 26364896 DOI: 10.1517/14656566.2015.1079620] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Attention deficit/hyperactivity disorder (ADHD) persists into adulthood in about 50% of the affected children, with high rates of comorbidity with bipolar disorder (BD). Stimulants and atomoxetine (ATX) are effective treatments for ADHD, but their use in adults with comorbid BD (ADHD-BD) has not been extensively studied and may be problematic. AREAS COVERED The aim of the paper is to summarize the available literature regarding the use of these medications in ADHD-BD adult patients. Results of randomized-controlled and open-label trials, case reports, and case series are reviewed. We also reviewed data relative to some specific issues of this comorbidity in adults, especially substance use disorder, malingering, and stimulants misuse. EXPERT OPINION ADHD-BD may be associated with more severe symptoms, course, and worst outcome of both conditions. The frequent coexistence with alcohol and substance abuse may further complicate treatment management. Stimulants are the most effective medications for ADHD, but their use may be contraindicated in the presence of a comorbid drug abuse or in patients that simulate or exaggerate ADHD symptoms in order to obtain stimulants for diversion or abuse. ATX may be effective in the treatment of ADHD symptoms in BD patients, with a modestly increased risk of (hypo)manic switches and destabilization of the mood disorder when utilized in association with mood stabilizers. In the majority of the cases, a hierarchical approach is desirable, with mood stabilization preceding the treatment of ADHD symptoms. Although systematic trials on the use of stimulants and ATX in ADHD-BD comorbidity in adulthood are necessary, both treatments should be considered possible options to be carefully evaluated once the patient has been stabilized.
Collapse
Affiliation(s)
- Giulio Perugi
- a 1 University of Pisa, Psychiatry Unit, Department of Clinical and Experimental Medicine , Via Roma 67, Pisa, Italy +390 508 35414 ; +390 502 1581 ; .,b 2 Institute of Behavioral Sciences "G. De Lisio" , Pisa, Italy
| | - Giulia Vannucchi
- b 2 Institute of Behavioral Sciences "G. De Lisio" , Pisa, Italy
| |
Collapse
|
71
|
Chepenik LG. Difficult Patient Encounters: Medical Education and Modern Approaches. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2015. [DOI: 10.1007/s40138-015-0084-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
72
|
Lindstrom W, Nelson JM, Foels P. Postsecondary ADHD Documentation Requirements: Common Practices in the Context of Clinical Issues, Legal Standards, and Empirical Findings. J Atten Disord 2015; 19:655-65. [PMID: 24131894 DOI: 10.1177/1087054713506262] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the information postsecondary institutions require when determining disability service eligibility for students with reported ADHD. METHOD ADHD documentation requirements of 200 U.S. institutions were surveyed by reviewing guidelines posted on disability services websites. RESULTS Whereas virtually all institutions required documentation, findings revealed significant variability in requirements across institutions. Required variables most often included a qualified evaluator (80%), diagnostic statement (75%), and identification of substantial limitations (73%), but only 5 of 46 evaluated variables were required by at least 50% of institutions. Supportive data such as diagnostic criteria, standardized assessment results, and rationale for accommodations were rarely required. CONCLUSION The majority of institutions required little to verify ADHD as a disability. Furthermore, there was little agreement on what components are essential for verification. When integrated with research, a large portion of guidelines failed to address identified weaknesses in ADHD diagnosis and disability determination.
Collapse
|
73
|
Thomas M, Rostain A, Corso R, Babcock T, Madhoo M. ADHD in the College Setting: Current Perceptions and Future Vision. J Atten Disord 2015; 19:643-54. [PMID: 24743974 DOI: 10.1177/1087054714527789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess perceptions concerning ADHD among U.S. college healthcare providers. METHOD A 37-question survey was conducted from October 4 to December 2, 2010. Participants were contacted via mail or telephone and compensated for participation. RESULTS Thirty-eight percent of the respondents (physicians, n = 59; nurses, n = 138; directors, n = 101) viewed ADHD as a "problem"/"very much a problem" at their institution. Referrals for evaluation came from students (84%), psychologists/counselors (68%), or the institution (68%). Although 48% of respondents felt "comfortable"/"very comfortable" in their ability to recognize ADHD, 92% referred students for evaluation. Most respondents (>90%) agreed medication use may be warranted; 52% of respondents who treat ADHD or consult with a specialist (from 95% of physicians to 31% of directors) prescribed pharmacotherapy. CONCLUSION Although college healthcare providers recognize the importance of treating ADHD, their discomfort in diagnosing and treating ADHD represents a barrier to care for college students.
Collapse
Affiliation(s)
- Mark Thomas
- University of Alabama, Tuscaloosa, USA; Tuscaloosa Focus MD, Northport, AL; Clinical-affiliate assistant professor, University of Alabama, Tuscaloosa, AL, USA
| | | | | | | | | |
Collapse
|
74
|
Nguyen CT, Green D, Barr WB. Evaluation of the MMPI-2-RF for Detecting Over-reported Symptoms in a Civil Forensic and Disability Setting. Clin Neuropsychol 2015; 29:255-71. [DOI: 10.1080/13854046.2015.1033020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
75
|
De Los Reyes A, Aldao A. Introduction to the special issue: toward implementing physiological measures in clinical child and adolescent assessments. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 44:221-37. [PMID: 25664767 DOI: 10.1080/15374416.2014.891227] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The National Institute of Mental Health recently launched the Research Domain Criteria (RDoC). The RDoC is an initiative to improve classification of mental health concerns by promoting research on the brain mechanisms underlying these concerns, with the ultimate goal of developing interventions that target these brain mechanisms. A key focus of RDoC involves opening new lines of research examining patients' responses on biological measures. The RDoC presents unique challenges to mental health professionals who work with children and adolescents. Indeed, mental health professionals rarely integrate biological measures into clinical assessments. Thus, RDoC's ability to improve patient care rests, in part, on the development of strategies for implementing biological measures within mental health assessments. Further, mental health professionals already carry out comprehensive assessments that frequently yield inconsistent findings. These inconsistencies have historically posed challenges to interpreting research findings as well as assessment outcomes in practice settings. In this introductory article, we review key issues that informed the development of a special issue of articles demonstrating methods for implementing low-cost measures of physiological functioning in clinical child and adolescent assessments. We also outline a conceptual framework, informed by theoretical work on using and interpreting multiple informants' clinical reports (De Los Reyes, Thomas, Goodman, & Kundey, 2013 ), to guide hypothesis testing when using physiological measures within clinical child and adolescent assessments. This special issue and the conceptual model described in this article may open up new lines of research testing paradigms for implementing clinically feasible physiological measures in clinical child and adolescent assessments.
Collapse
|
76
|
Clemow DB, Walker DJ. The Potential for Misuse and Abuse of Medications in ADHD: A Review. Postgrad Med 2015; 126:64-81. [DOI: 10.3810/pgm.2014.09.2801] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
77
|
Huggins SP, Rooney ME, Chronis-Tuscano A. Risky sexual behavior among college students With ADHD: is the mother-child relationship protective? J Atten Disord 2015; 19:240-50. [PMID: 23048048 DOI: 10.1177/1087054712459560] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined the extent to which ADHD was associated with risky sexual behaviors (RSBs) in a sample of 92 undergraduates with (n = 44) and without (n = 48) ADHD. Mother-child relationship quality was examined as a potential moderator. METHOD We conducted comprehensive assessments for ADHD and comorbid conditions and collected measures of RSB and mother-child relationship quality. RESULTS Female students with ADHD were least likely to use condoms than males overall and females without ADHD. An interaction between ADHD and mother-child relationship quality accounted for significant variance in the number of past-year sexual partners, such that a high-quality relationship was protective only for students with ADHD. No other significant associations were found between ADHD and RSB. CONCLUSION Results suggest that female college students with ADHD are at risk for unprotected sex. Moreover, a positive mother-child relationship may be protective for college students with ADHD in relation to RSB.
Collapse
|
78
|
Mattingly G, Culpepper L, Babcock T, Arnold V. Aiming for remission in adults with attention-deficit/hyperactivity disorder: The primary care goal. Postgrad Med 2015; 127:323-9. [PMID: 25662296 DOI: 10.1080/00325481.2015.1012481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is often undiagnosed and undertreated in adults, resulting in wide-ranging problems and functional deficits in patients' lives. In addition, psychiatric comorbidities unrelated to symptom severity may be present. However, effective treatment that can alleviate symptoms and bring about meaningful improvements in functionality is available. Primary care providers can play a crucial role in recognizing and diagnosing ADHD, initiating and monitoring treatment, and obtaining consultations or arranging referrals when necessary, all with the goal of achieving and maintaining remission. Fulfillment of this role requires a practical understanding of the diverse clinical manifestations of ADHD in patients stratified by age and sex, and familiarity with current treatment guidelines. Although there is no absolute consensus on the criteria by which remission is defined, treatment response may be guided by objective ratings of global symptom severity and patients' self-reports of changes in their ability to cope with routine daily tasks, academic and vocational responsibilities, and social relationships. Although there has been much research into the genetic and neurophysiologic basis of ADHD, it is more important for primary care providers to appreciate that ADHD is a chronic condition requiring lifelong follow-up and that clinical presentation and response to treatment can vary widely among patients and over time in the same patients. Such variability makes the management of ADHD challenging, but the opportunity to bring about dramatic improvement in patients' lives makes it imperative for primary care providers to be competent in this area. This review provides primary care clinicians with a practical definition of remission in adults with ADHD, to emphasize that symptom reduction does not necessarily mean intact functionality, and to suggest a multidisciplinary approach aimed at achieving the greatest possible reduction of symptoms and normalization of functionality.
Collapse
Affiliation(s)
- Greg Mattingly
- Washington University School of Medicine , St. Charles, MO
| | | | | | | |
Collapse
|
79
|
Abstract
This chapter reviews methylphenidate misuse, abuse, dependence, diversion, and malingering associated with its use as a prescription medication for attention-deficit/hyperactivity disorder and the nonmedical use linked to its stimulant effects. Methylphenidate-induced regional elevations in brain dopamine appear to be integral to both efficacy in attention-deficit/hyperactivity disorder and potential for abuse, raising potential concerns for drug safety and prescription drug diversion costs associated with nonmedical use. Regardless, methylphenidate is an important treatment option, and detecting malingering for the purpose of illicit access to methylphenidate for subsequent misuse or diversion is a difficult challenge. Also discussed are the effects of methylphenidate in patients with comorbid substance use disorder and the potential linkage of methylphenidate use with subsequent substance abuse. The current data suggest that methylphenidate misuse and diversion are common health-care problems with a stimulant prescription drug diversion prevalence of approximately 5-10 % of high school students and 5-35 % of college students. The effectiveness and speed of action of methylphenidate are deemed desirable to enhance attention and focus performance for activities such as studying for exams, but methylphenidate is also misused recreationally. These data suggest a need for close screening and therapeutic monitoring of methylphenidate use in the treatment of attention-deficit/hyperactivity disorder.
Collapse
Affiliation(s)
- David B Clemow
- Senior Clinical Research Scientist, Lilly Corporate Center, 46285, Indianapolis, IN, USA.
| |
Collapse
|
80
|
Patrick RE, Horner MD. Psychological characteristics of individuals who put forth inadequate cognitive effort in a secondary gain context. Arch Clin Neuropsychol 2014; 29:754-66. [PMID: 25318597 DOI: 10.1093/arclin/acu054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The current study sought to characterize the psychological architecture of individuals who put forth inadequate effort. The Minnesota Multiphasic Personality Inventory, 2nd Edition-Restructured Form was used to identify dimensions of psychological functioning in a mixed outpatient sample of U.S. Veterans referred for neuropsychological evaluation as part of their clinical care. After accounting for external financial incentive and symptom overreporting, results showed that the inadequate effort group (n = 23, mean age = 42.48) scored higher than the adequate effort group (n = 29, mean age = 44.31) on neurologic complaints (NUC) and lower on behavioral/externalizing dysfunction (BXD), antisocial behaviors (RC4), and disconstraint (DISC-r). Lower scores on BXD, RC4, and DISC-r could indicate higher behavioral constraint-a psychological characteristic that has been linked to the pursuit of high-value future rewards. Alternatively, lower scores on these scales could have reflected a self-presentation strategy aimed at minimizing externalizing and RC4 in order to appear more psychological healthy. Implications of each of these interpretations are discussed.
Collapse
Affiliation(s)
- Regan E Patrick
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC 29401, USA
| | - Michael D Horner
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC 29401, USA
| |
Collapse
|
81
|
Harrison AG, Flaro L, Armstrong I. Rates of Effort Test Failure in Children With ADHD: An Exploratory Study. APPLIED NEUROPSYCHOLOGY-CHILD 2014; 4:197-210. [DOI: 10.1080/21622965.2013.850581] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
82
|
Williamson KD, Combs HL, Berry DTR, Harp JP, Mason LH, Edmundson M. Discriminating among ADHD alone, ADHD with a comorbid psychological disorder, and feigned ADHD in a college sample. Clin Neuropsychol 2014. [PMID: 25225947 DOI: 10.1080/13854046.2014.956674\] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Since the early 2000s concern has increased that college students might feign ADHD in pursuit of academic accommodations and stimulant medication. In response, several studies have validated tests for use in differentiating feigned from genuine ADHD. Although results have generally been positive, relatively few publications have addressed the possible impact of the presence of psychological disorders comorbid with ADHD. Because ADHD is thought to have accompanying conditions at rates of 50% and higher, it is important to determine if the additional psychological disorders might compromise the accuracy of feigning detection measures. The present study extended the findings of Jasinski et al. (2011) to examine the efficacy of various measures in the context of feigned versus genuine ADHD with comorbid psychological disorders in undergraduate students. Two clinical groups (ADHD only and ADHD + comorbid psychological disorder) were contrasted with two non-clinical groups (normal controls answering honestly and normal participants feigning ADHD). Extending previous research to individuals with ADHD and either an anxiety or learning disorder, performance validity tests such as the Test of Memory Malingering (TOMM), the Letter Memory Test (LMT), and the Nonverbal Medical Symptom Validity Test (NV-MSVT) were effective in differentiating both ADHD groups from normal participants feigning ADHD. However, the Digit Memory Test (DMT) underperformed in this study, as did embedded validity indices from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Woodcock Johnson Tests of Achievement-III (WJ-III).
Collapse
|
83
|
Williamson KD, Combs HL, Berry DTR, Harp JP, Mason LH, Edmundson M. Discriminating among ADHD alone, ADHD with a comorbid psychological disorder, and feigned ADHD in a college sample. Clin Neuropsychol 2014; 28:1182-96. [PMID: 25225947 DOI: 10.1080/13854046.2014.956674] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Since the early 2000s concern has increased that college students might feign ADHD in pursuit of academic accommodations and stimulant medication. In response, several studies have validated tests for use in differentiating feigned from genuine ADHD. Although results have generally been positive, relatively few publications have addressed the possible impact of the presence of psychological disorders comorbid with ADHD. Because ADHD is thought to have accompanying conditions at rates of 50% and higher, it is important to determine if the additional psychological disorders might compromise the accuracy of feigning detection measures. The present study extended the findings of Jasinski et al. (2011) to examine the efficacy of various measures in the context of feigned versus genuine ADHD with comorbid psychological disorders in undergraduate students. Two clinical groups (ADHD only and ADHD + comorbid psychological disorder) were contrasted with two non-clinical groups (normal controls answering honestly and normal participants feigning ADHD). Extending previous research to individuals with ADHD and either an anxiety or learning disorder, performance validity tests such as the Test of Memory Malingering (TOMM), the Letter Memory Test (LMT), and the Nonverbal Medical Symptom Validity Test (NV-MSVT) were effective in differentiating both ADHD groups from normal participants feigning ADHD. However, the Digit Memory Test (DMT) underperformed in this study, as did embedded validity indices from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Woodcock Johnson Tests of Achievement-III (WJ-III).
Collapse
|
84
|
Detection of feigned attention deficit hyperactivity disorder. J Neural Transm (Vienna) 2014; 122 Suppl 1:S123-34. [DOI: 10.1007/s00702-014-1274-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/12/2014] [Indexed: 11/30/2022]
|
85
|
Prevatt F, Young JL. Recognizing and Treating Attention-Deficit/Hyperactivity Disorder in College Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2014. [DOI: 10.1080/87568225.2014.914825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
86
|
Lovett BJ, Nelson JM, Lindstrom W. Documenting Hidden Disabilities in Higher Education. JOURNAL OF DISABILITY POLICY STUDIES 2014. [DOI: 10.1177/1044207314533383] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Once students with disabilities leave high school, they must take proactive steps to document their disabilities to educational institutions or employers when requesting accommodations. The Association on Higher Education and Disability (AHEAD) has been the principal organization offering suggestions on documentation requirements, and AHEAD’s recently revised guidance involves radical changes to the suggested requirements. AHEAD now recommends that students’ self-reports and disability services professionals’ impressions take precedence over external, objective records. This article reviews the relevant research to evaluate the evidence base for the revised guidance, finding it lacking in important ways as it applies to hidden disabilities (learning, cognitive, and psychiatric disabilities). The evidence supporting various sources of disability documentation is reviewed, and implications for policy and practice are discussed.
Collapse
|
87
|
Graf WD, Miller G, Nagel SK. Addressing the problem of ADHD medication as neuroenhancements. Expert Rev Neurother 2014; 14:569-81. [PMID: 24738763 DOI: 10.1586/14737175.2014.908707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The prevalence of attention deficit hyperactivity disorder (ADHD) diagnoses is rising. ADHD is closely linked to its treatment with medications such as methylphenidate and amphetamines, which have popular appeal as neuroenhancement drugs by persons without a neurological disorder. The three main reasons for the increase in ADHD medication demand, production, and consumption are a) the inclusion of milder ADHD diagnoses; b) the vast marketing of ADHD medications by the pharmaceutical industry; and c) the illegal diversion of controlled ADHD medication to consumers seeking stimulants as neuroenhancements. Rapidly rising rates of any neurological disorder - especially a behaviorly-defined disorder closely linked to potent medications currently prescribed to more than 5% of the population - deserves ongoing scrutiny. Major social and ethical problems arise from vague-symptom medicalization, neurological disorder trivialization, medication overuse, and controlled substances diversion to healthy persons for nonmedical purposes. We argue against the 'spectrumization' of ADHD in an effort to curtail further diagnosis creep.
Collapse
Affiliation(s)
- William D Graf
- Departments of Pediatrics and Neurology, Yale University, PO Box 208064, 333 Cedar Street, New Haven, CT 06510, USA
| | | | | |
Collapse
|
88
|
Musso MW, Gouvier WD. "Why is this so hard?" A review of detection of malingered ADHD in college students. J Atten Disord 2014; 18:186-201. [PMID: 22582347 DOI: 10.1177/1087054712441970] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this article is to review studies that have investigated malingered ADHD in college students and offer recommendations for assessing effort in clinical evaluations of ADHD in college students. METHOD This article identified and summarized nineteen peer-reviewed, empirical studies published between 2002 and 2011 that investigated malingered ADHD in college students. RESULTS Few of the measures examined proved useful for detecting malingered ADHD. Most self-report questionnaires were not sensitive to malingering. While there is some variability in the usefulness of neuropsychological test failure, profiles between malingerers and individuals with ADHD are too similar to confidently detect malingered ADHD. Failure of three or more symptom validity tests proved most useful at detecting malingered ADHD. CONCLUSION This review suggests that there is substantial need for measures designed specifically for detecting malingered ADHD. Simulators are able to produce plausible profiles on most tools used to diagnose ADHD.
Collapse
|
89
|
Haavik J, Halmøy A, Lundervold AJ, Fasmer OB. Clinical assessment and diagnosis of adults with attention-deficit/hyperactivity disorder. Expert Rev Neurother 2014; 10:1569-80. [DOI: 10.1586/ern.10.149] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
90
|
Langberg JM, Dvorsky MR, Becker SP, Molitor SJ. The impact of daytime sleepiness on the school performance of college students with attention deficit hyperactivity disorder (ADHD): a prospective longitudinal study. J Sleep Res 2013; 23:318-25. [PMID: 24372786 DOI: 10.1111/jsr.12121] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 11/20/2013] [Indexed: 01/10/2023]
Abstract
This prospective longitudinal study evaluated the impact of daytime sleepiness on the school performance of 62 college students diagnosed comprehensively with attention deficit hyperactivity disorder. The primary goal of the study was to determine if self-reported daytime sleepiness rated at the beginning of the academic year could predict academic and overall functioning at the end of the academic year while also considering potentially important covariates, including symptoms of inattention, hyperactivity and impulsivity, medication status and whether or not students lived at home or on-campus. Self-reported daytime sleepiness predicted longitudinally school maladjustment, overall functional impairment and the number of D and F grades (i.e. poor and failing) students received in courses above and beyond both self- and parent-report of symptoms, but did not predict overall grade point average. Living at home served as a protective factor and was associated with less school maladjustment and overall impairment. Gender was the only significant predictor in the overall grade point average model, with female gender associated with higher overall grades. The implications of these findings for monitoring and treatment of sleep disturbances in college students with attention deficit hyperactivity disorder are discussed.
Collapse
|
91
|
Cassuto H, Ben-Simon A, Berger I. Using environmental distractors in the diagnosis of ADHD. Front Hum Neurosci 2013; 7:805. [PMID: 24319423 PMCID: PMC3837230 DOI: 10.3389/fnhum.2013.00805] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/06/2013] [Indexed: 11/26/2022] Open
Abstract
This study examined the effect of the incorporation of environmental distractors in computerized continuous performance test (CPT) on the ability of the test in distinguishing ADHD from non-ADHD children. It was hypothesized that children with ADHD would display more distractibility than controls while performing CPT as measured by omission errors in the presence of pure visual, pure auditory, and a combination of visual and auditory distracting stimuli. Participants were 663 children aged 7–12 years, of them 345 diagnosed with ADHD and 318 without ADHD. Results showed that ADHD children demonstrated more omission errors than their healthy peers in all CPT conditions (no distractors, pure visual or auditory distractors and combined distractors). However, ADHD and non-ADHD children differed in their reaction to distracting stimuli; while all types of distracting stimuli increased the rate of omission errors in ADHD children, only combined visual and auditory distractors increased it in non-ADHD children. Given the low ecological validity of many CPT, these findings suggest that incorporating distractors in CPT improves the ability to distinguish ADHD from non-ADHD children.
Collapse
Affiliation(s)
- Hanoch Cassuto
- Pediatric Neurology Clinic, Leumit and Clalit HMO Jerusalem, Israel
| | | | | |
Collapse
|
92
|
Harrison AG, Lovett BJ, Gordon M. Documenting Disabilities in Postsecondary Settings. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2013. [DOI: 10.1177/0829573513508527] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increasing numbers of students with learning disability and attention deficit/hyperactivity disorder (ADHD) diagnoses are applying for accommodations in postsecondary education and employment settings. However, students’ documentation of these conditions is often substandard. One possible reason for this is that clinicians have failed to apply proper criteria when determining disability status. We surveyed 119 clinicians who diagnosed these conditions in students applying for accommodations to determine clinician levels of knowledge about appropriate diagnostic and legal standards. We found weak clinician knowledge on certain key issues, including the meaning of functional impairment and understanding of the different laws governing academic accommodation of children versus adults. The average respondent’s score on a 30-item true/false questionnaire was only 69% correct. Implications of these results for practice and future research are discussed.
Collapse
|
93
|
Rios J, Morey LC. Detecting Feigned ADHD in Later Adolescence: An Examination of Three PAI–A Negative Distortion Indicators. J Pers Assess 2013; 95:594-9. [DOI: 10.1080/00223891.2013.821071] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
94
|
Abstract
As prescriptions for stimulant medication to treat ADHD have increased, so have concerns about the nonmedical use and diversion of stimulant medication, especially among college students. There is also growing concern about young adults feigning ADHD in order to receive a prescription for stimulant medication. This paper summarizes recent research on the nonmedical use and diversion of stimulant medication with a focus on the prevalence of these behaviors, motivations for nonmedical use, factors associated with nonmedical use, and the consequences of such use. Research on the medical misuse of prescribed medication and malingering to obtain a diagnosis of ADHD is also discussed.
Collapse
Affiliation(s)
- David L Rabiner
- Department of Psychology & Neuroscience and the Center for Child and Family Policy, Duke University, Durham, NC, USA.
| |
Collapse
|
95
|
Levinson J, McKinney KA. Consuming an edge: ADHD, stimulant use, and psy culture at the corporate university. Transcult Psychiatry 2013; 50:371-96. [PMID: 23788569 DOI: 10.1177/1363461513490720] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We examine "psy" on the college campus. Psy refers to ways of knowing and acting on ourselves that shape everyday life psychologically. We suggest that there is an "elective affinity" between psy and the neoliberal management strategies that now dominate the "corporate university." We describe ways that psy organizes college life by drawing on the history of college health services; interviews about mental health and services at a university in Canada; and historical, social, and media accounts of student mental health and pharmaceutical drug use-both prescribed and not-on campus in the US and Canada. By the 1990s, for the first time, many students were arriving at college as already experienced consumers of psy with diagnoses and prescriptions. We approach this and the increased use of medication as an aspect of the psy-campus. We focus on stimulants, using ADHD to illustrate the blurring line between treatment and enhancement. Students who use stimulants-with or without prescription-do so in the same way: instrumentally in relation to academic demands. The blurred line between academic stress and psychiatric distress is further illustrated by "clinic notes," an institutionalized practice that enables all students to act on academic pressure as a matter of mental health. We describe the links between psy and institutional branding and marketing to illustrate the role of mental health and wellness services in the corporate university.
Collapse
Affiliation(s)
- Jack Levinson
- Department of Sociology, The City College of New York, New York, NY 10031, USA.
| | | |
Collapse
|
96
|
Schatz P, Glatts C. "Sandbagging" Baseline Test Performance on ImPACT, Without Detection, Is More Difficult than It Appears. Arch Clin Neuropsychol 2013; 28:236-44. [DOI: 10.1093/arclin/act009] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Philip Schatz
- Department of Psychology, Saint Joseph's University, Philadelphia, PA 19131, USA.
| | | |
Collapse
|
97
|
Sibley MH, Pelham WE, Molina BSG, Gnagy EM, Waxmonsky JG, Waschbusch DA, Derefinko KJ, Wymbs BT, Garefino AC, Babinski DE, Kuriyan AB. When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol 2012; 80:1052-1061. [PMID: 22774792 PMCID: PMC3919146 DOI: 10.1037/a0029098] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined several questions about the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in young adults using data from a childhood-diagnosed sample of 200 individuals with ADHD (age M = 20.20 years) and 121 demographically similar non-ADHD controls (total N = 321). METHOD We examined the use of self- versus informant ratings of current and childhood functioning and evaluated the diagnostic utility of adult-specific items versus items from the Diagnostic and Statistical Manual of Mental Disorders (DSM). RESULTS Results indicated that although a majority of young adults with a childhood diagnosis of ADHD continued to experience elevated ADHD symptoms (75%) and clinically significant impairment (60%), only 9.6%-19.7% of the childhood ADHD group continued to meet DSM-IV-TR (DSM, 4th ed., text rev.) criteria for ADHD in young adulthood. Parent report was more diagnostically sensitive than self-report. Young adults with ADHD tended to underreport current symptoms, while young adults without ADHD tended to overreport symptoms. There was no significant incremental benefit beyond parent report alone to combining self-report with parent report. Non-DSM-based, adult-specific symptoms of ADHD were significantly correlated with functional impairment and endorsed at slightly higher rates than the DSM-IV-TR symptoms. However, DSM-IV-TR items tended to be more predictive of diagnostic group membership than the non-DSM adult-specific items due to elevated control group item endorsement. CONCLUSIONS Implications for the assessment and treatment of ADHD in young adults are discussed (i.e., collecting informant reports, lowering the diagnostic threshold, emphasizing impairment, and cautiously interpreting retrospective reports).
Collapse
|
98
|
Abstract
Research on ADHD in college students began in the 1990s and has been steadily increasing in recent years. Because young adults with ADHD who attend college have experienced greater academic success during high school than many peers with the disorder, which is likely to be associated with better overall functioning, the degree to which they experience similar patterns of adjustment difficulties was not initially known. Accumulating research suggests that college students with ADHD experience less academic success and greater psychological and emotional difficulties than other students and use alcohol and drugs at higher rates. However, conclusions to be drawn from this research are limited by the use of small samples that may not be representative of the wider population of students with ADHD, and a lack of diagnostic rigor in identifying students with ADHD to be included in such research. Studies of the effectiveness of psychosocial treatments, medication treatment, and academic accommodations are extremely limited or nonexistent. Issues particularly germane to college students include feigning ADHD and the misuse and diversion of stimulant medication. Given that at least 25 % of college students with disabilities are diagnosed with ADHD, methodologically sound investigations are clearly needed in order to better understand the impact of ADHD on college students' adjustment and to develop and implement interventions that can enhance students' success.
Collapse
Affiliation(s)
| | - David L. Rabiner
- Department of Psychology and Neuroscience and Center for Child and Family Policy, Duke University, Durham, NC 27708 USA
| |
Collapse
|
99
|
Denning JH. The Efficiency and Accuracy of The Test of Memory Malingering Trial 1, Errors on the First 10 Items of The Test of Memory Malingering, and Five Embedded Measures in Predicting Invalid Test Performance. Arch Clin Neuropsychol 2012; 27:417-32. [DOI: 10.1093/arclin/acs044] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
100
|
Jasinski LJ, Harp JP, Berry DTR, Shandera-Ochsner AL, Mason LH, Ranseen JD. Using symptom validity tests to detect malingered ADHD in college students. Clin Neuropsychol 2011; 25:1415-28. [PMID: 22084858 DOI: 10.1080/13854046.2011.630024] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Recently there has been growing concern that college students may feign symptoms of ADHD in order to obtain academic accommodations and stimulant medication. Unfortunately research has only begun to validate detection tools for malingered ADHD. The present study cross-validated the results of Sollman, Ranseen, and Berry (2010) on the efficacy of several symptom validity tests for detection of simulated ADHD among college students. Undergraduates with a history of diagnosed ADHD were randomly assigned either to respond honestly or exaggerate symptoms, and were compared to undergraduates with no history of ADHD or other psychiatric disorders who were also randomly assigned to respond honestly or feign symptoms of ADHD. Similar to Sollman et al. (2010) and other recent research on feigned ADHD, several symptom validity tests, including the Test of Memory Malingering (TOMM), Letter Memory Test (LMT), Digit Memory Test (DMT), Nonverbal Medical Symptom Validity Test (NV-MSVT), and the b Test were reasonably successful at discriminating feigned and genuine ADHD. When considered as a group, the criterion of failure of 2 or more of these SVTs had a sensitivity of. 475 and a specificity of 1.00.
Collapse
Affiliation(s)
- Lindsey J Jasinski
- Department of Psychology, University of Kentucky, Lexington, KY 40506, USA
| | | | | | | | | | | |
Collapse
|