a Department of Clinical and Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands.
b Department of Clinical Psychology and Neuropsychology , SRH Clinic Karlsbad-Langensteinbach , Karlsbad , Germany.
J Clin Exp Neuropsychol. 2018 Dec;40(10):971-986. doi: 10.1080/13803395.2018.1457139. Epub 2018 Apr 25.
Several approaches, ranging from self-ratings of symptoms and impairments to objective neuropsychological testing, have been utilized during clinical evaluation in order to assess symptom and performance validity of individuals with attention-deficit/hyperactivity disorder (ADHD) in adulthood. Motor activity has not been considered yet in this context, which is surprising given that hyperactivity is a prominent characteristic of ADHD. Hence, the goal of the present study was to explore the incremental value of motor activity when assessing the credibility of individuals with adult ADHD at clinical evaluation.
Forty-six patients diagnosed with ADHD took part in the study. A simulation design was performed, in which 152 healthy individuals were allocated to either a control condition (n = 36) or one of three simulation conditions (n = 116), the latter requesting participants to feign ADHD. All participants completed a self-rating scale of cognitive functioning and performed a computerized test for vigilance. Body movements were recorded during vigilance testing via a motion tracker attached to the back of the participant's chair.
Patients with ADHD reported significantly more pronounced cognitive complaints and performed significantly poorer on the vigilance test than control participants. Simulators of ADHD, as compared to genuine patients, showed excessively low performance on the vigilance test. However, neither self-ratings of cognitive functioning nor measures of motor activity were suitable to distinguish genuine from feigned ADHD. A hierarchical logistic regression model showed that motor activity had no incremental value in detecting feigned ADHD when vigilance test performance has already been considered.
Standard neuropsychological tests of vigilance may be useful to measure both performance and credibility of individuals with adult ADHD at clinical evaluation. In contrast, self-reports of symptoms and impairments, as well as measures of body movements, may not support the assessment of credibility in this context.
为了评估成年注意力缺陷多动障碍（ADHD）患者的症状和表现效度，临床评估中采用了多种方法，包括自陈症状和障碍程度，以及客观的神经心理学测试。然而，在这种情况下，尚未考虑到运动活动，这令人惊讶，因为多动是 ADHD 的一个突出特征。因此，本研究的目的是探讨在临床评估中评估成年 ADHD 患者可信度时，运动活动的增量价值。
46 名被诊断为 ADHD 的患者参加了这项研究。采用模拟设计，将 152 名健康个体分为对照组（n=36）或三个模拟组之一（n=116），后者要求参与者假装患有 ADHD。所有参与者都完成了认知功能自评量表，并进行了警觉性计算机测试。通过附在参与者椅子背面的运动跟踪器，在警觉性测试期间记录身体运动。
与对照组相比，ADHD 患者报告的认知问题明显更为严重，警觉性测试的表现明显更差。与真正的患者相比，ADHD 的模拟者在警觉性测试中的表现过低。然而，无论是认知功能自评量表还是运动活动测量都不适合区分真正的和假装的 ADHD。分层逻辑回归模型表明，当考虑到警觉性测试的表现时，运动活动在检测假装的 ADHD 方面没有增量价值。
标准的警觉性神经心理学测试可能有助于在临床评估中测量成年 ADHD 患者的表现和可信度。相比之下，在这种情况下，症状和障碍程度的自我报告以及身体运动的测量可能无法支持可信度的评估。
