a Department of Clinical and Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands.
b Department of Psychiatry and Psychotherapy , SRH Clinic Karlsbad-Langensteinbach , Karlsbad-Langensteinbach , Germany.
Clin Neuropsychol. 2018 May;32(4):671-680. doi: 10.1080/13854046.2017.1406143. Epub 2017 Nov 23.
A growing body of research questions the reliance of symptom self-reports in the clinical evaluation of attention-deficit/hyperactivity disorder (ADHD) in adulthood. A recent study suggested that also impairment reports are vulnerable to noncredible responses, as derived from a simulation design using a global functional impairment scale. The present study aims to add evidence to this issue, by using an ADHD specific impairment scale in a simulation design on large samples.
Impairment ratings on the Weiss Functional Impairment Rating Scale (WFIRS) of 62 patients with ADHD were compared to 142 healthy individuals who were instructed to show normal behavior. Furthermore, impairment ratings of patients with ADHD were compared to ratings of 330 healthy individuals who were randomly assigned to one of four simulation conditions that were instructed to complete the scale as if they had ADHD.
Patients with ADHD reported higher levels of impairment than the healthy control group in all domains of life. Furthermore, individuals instructed to feign ADHD indicated higher levels of impairments in most domains of life compared to control participants and genuine patients with ADHD. The group differences between individuals feigning ADHD and individuals with genuine ADHD, however, were only small to moderate. Further analyses revealed that the WFRIS was not useful to successfully differentiate genuine from feigned ADHD.
The present study confirms the conclusion that self-reported impairments are susceptible to noncredible responses and should be used with caution in the clinical evaluation of adult ADHD.
越来越多的研究对在成人注意缺陷多动障碍（ADHD）的临床评估中依赖症状自我报告提出了质疑。最近的一项研究表明，即使是损害报告也容易受到不可信反应的影响，这是通过使用全球功能障碍量表的模拟设计得出的。本研究旨在通过在大型样本中使用 ADHD 特定的损害量表进行模拟设计来进一步证明这一问题。
将 62 名 ADHD 患者的 Weiss 功能障碍评定量表（WFIRS）的损害评分与 142 名被指示表现正常行为的健康个体进行比较。此外，将 ADHD 患者的损害评分与 330 名被随机分配到四个模拟条件之一的健康个体的评分进行比较，这些模拟条件被指示按 ADHD 患者的方式完成量表。
与健康对照组相比，ADHD 患者在所有生活领域的损害评分均较高。此外，与对照组参与者和真正的 ADHD 患者相比，被指示假装 ADHD 的个体在大多数生活领域的损害评分更高。然而，假装 ADHD 的个体与真正的 ADHD 患者之间的群体差异仅为小到中度。进一步的分析表明，WFRIS 无法成功地区分真正的和假装的 ADHD。
本研究证实了自我报告的损害易受不可信反应影响的结论，因此在成人 ADHD 的临床评估中应谨慎使用。
