The development of an embedded figures test for the detection of feigned attention deficit hyperactivity disorder in adulthood

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 t detect feigned ADHD Method An Embedded Figures Test (EFT) was developed for the detection of feigned ADHD i adulthood. EFT performance of 51 adults with ADHD was compared to the performance o 52 matched healthy individuals, as well as to 268 undergraduate students who were randoml allocated in a simulation design to one of four experimental conditions, i.e. a contro group, a naïve simulation group, a symptom-coached simulation group or a test-coache simulation group. Furthermore, an independent sample of 11 adults with ADHD as well as sample of 17 clinicians experienced in the work with adults with ADHD were assessed fo further validation of the EFT Result The EFT was relatively easy to perform for both patients with ADHD and healthy comparison as shown by low error rates and non-significant group differences. However, simulatio groups differed from patients with ADHD by significant and large effects. An EFT inde for the prediction of feigned ADHD was derived based on logistic regression coefficients Receiver Operating Characteristics (ROC) demonstrated good classification accuracy o feigned ADHD relative to ADHD (AUC = 94.8%), i.e. high sensitivity (88%) and specificit (90%) ConclusionsThis study supports the utility of the EFT for the detection of feigned adult ADHD.