Department of Psychiatry, Hennepin County Medical Center, 914 South 8th Street, Minneapolis, MN 55404, USA.
Clin Neuropsychol. 2010 Oct;24(7):1204-37. doi: 10.1080/13854046.2010.514290. Epub 2010 Sep 13.
This study examines the effectiveness of symptom validity measures to detect suspect effort in cognitive testing and invalid completion of ADHD behavior rating scales in 268 adults referred for ADHD assessment. Patients were diagnosed with ADHD based on cognitive testing, behavior rating scales, and clinical interview. Suspect effort was diagnosed by at least two of the following: failure on embedded and free-standing SVT measures, a score > 2 SD below the ADD population average on tests, failure on an ADHD behavior rating scale validity scale, or a major discrepancy between reported and observed ADHD behaviors. A total of 22% of patients engaged in symptom exaggeration. The Word Memory test immediate recall and consistency score (both 64%), TOVA omission errors (63%) and reaction time variability (54%), CAT-A infrequency scale (58%), and b Test (47%) had good sensitivity as well as at least 90% specificity. Clearly, such measures should be used to help avoid making false positive diagnoses of ADHD.
本研究旨在探讨症状有效性测量在认知测试中检测可疑努力以及在 268 名 ADHD 评估转介的成年人中无效完成 ADHD 行为评定量表中的有效性。患者根据认知测试、行为评定量表和临床访谈被诊断为 ADHD。可疑努力的诊断依据至少包括以下两项：嵌入式和独立 SVT 测量失败，在 ADD 人群平均水平以下的测试分数超过 2 个标准差， ADHD 行为评定量表有效性量表失败，或报告的 ADHD 行为与观察到的行为之间存在较大差异。共有 22%的患者存在症状夸大。单词记忆测试即时回忆和一致性分数（均为 64%）、TOVA 遗漏错误（63%）和反应时间变异性（54%）、CAT-A 不频繁量表（58%）和 b 测试（47%）具有良好的敏感性，特异性至少为 90%。显然，应该使用这些措施来帮助避免对 ADHD 做出错误的阳性诊断。
