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Pretending to Not Concentrate
Published in Alan R. Hirsch, Neurological Malingering, 2018
Angela Rekhi, Jasmine M. Campbell, Alan R. Hirsch
Self-report ADHD questionnaires are some of the easiest assessment tools for malingerers to use to simulate symptoms of ADHD. Quinn (2003) was one of the first to conduct an experiment in which college students were asked to feign ADHD symptoms on behavior checklists, and assessed their outcome in comparison to college students with diagnosed ADHD and a normal control group of college students without ADHD. Results indicated that the group asked to malinger performed similarly to the true ADHD group on the ADHD Behavior Checklist (Quinn, 2003). In another study by Fisher and Watkins (2008), it was established that 93% of college students with no diagnostic criteria for ADHD were successfully able to fake self-reported ADHD symptoms on the College ADHD Response Evaluation and 73% were successful on the ADHD Behavior Checklist. The results of the study effectively demonstrated that neither of these scales were of utility in ferreting out malingering from true ADHD (Fisher and Watkins, 2008). Multiple studies, thereafter, have used scales such as Conners’ Adult ADHD Rating Scales (CAARS), Wender Utah Rating Scale, and ADHD Rating Scale (ARS) in assessing the ease with which the symptoms can be faked. All were found to be inadequate in detecting feigned ADHD symptoms.
Adult Attention Deficit-Hyperactivity Disorder
Published in Thomas L. Schwartz, Practical Psychopharmacology, 2017
The key to diagnosis is confirming the longitudinal and impairing presence of a combination of (a) inattention, (b) hyperactivity, and/or (c) impulsivity that cannot be explained by another psychiatric disorder, substance misuse, personality disorder, or medical condition. During a routine interview, use of an initial screening question is warranted. If the patient answers positively, this should trigger the use of a full DSM-5 symptom interview or use of a validated, reliable ADHD rating scale. The use of the DSM-5 model may seem tedious or effortful in regard to memorization and the implementation of a rigorous systematic, symptom-based approach to adult ADHD diagnosis. Nevertheless, it does promote a very sensitive and specific validated way to make the diagnosis and apply accurate, efficacious treatments. Following this approach should allow the prescriber and patient to obtain the pharmacological outcomes that are reported in the literature. Use of rating scales for each psychiatric disorder will be discussed in later chapters as well. Scales generally allow the clinician to rely less on the DSM-5 clinical interview and more on patient-driven, self-reporting measures. Ideally, both approaches will be used.
Case 2: He doesn’t listen to me
Published in Barry Wright, Subodh Dave, Nisha Dogra, 100 Cases in Psychiatry, 2017
Barry Wright, Subodh Dave, Nisha Dogra
The clinical picture is strongly suggestive of ADHD. He reports at least five symptoms of inattention (avoiding mundane tasks, having difficulty finishing projects, losing belongings, being easily distractible and failing to listen to others in conversation). He developed symptoms of inattention, hyperactivity and impulsivity before the age of 12 and his symptoms are pervasive (seen both in his home and work environments). They have led to significant disturbance in socio-occupational functioning (negative feedback from colleagues; threat of separation from his wife). The diagnosis can be confirmed by obtaining corroborative history from parents or teachers. Self-rating scales such as Conners, Adult ADHD Rating Scale can be helpful. It would be important to check GP records in childhood for ADHD assessment, Child and Adolescent Mental Health Services (CAMHS) involvement or other relevant information such as school problems, minor injuries etc. This man’s symptoms cannot be better explained by another psychiatric or medical disorder or by substance misuse. Adult ADHD is the most appropriate diagnosis based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Bear in mind the possibility of feigned or exaggerated symptoms (e.g. for drug misuse). Symptoms of hyperactivity and impulsivity may subside in adulthood and in this case symptoms of inattention are prominent.
Influence of smartphone addiction and poor sleep quality on attention-deficit hyperactivity disorder symptoms in university students: a cross-sectional study
Published in Journal of American College Health, 2022
Soo Jin Kwon, Yoonjung Kim, Yeunhee Kwak
Further, ADHD symptoms significantly differed by academic achievement level, which is similar to previous findings showing that university students diagnosed with ADHD had a lower grade point average and a higher rate of being issued academic warnings compared with students without ADHD, and that a higher level of ADHD symptoms assessed with an ADHD rating scale was significantly associated with a lower grade point average.41,42 Students with Internet addiction are enticed by addictive devices and use them for extended periods, often until late at night, breaking the normal sleep-wake cycle, which can in turn cause them difficulty focusing in classes, resulting in lower grades.39 Among ADHD symptoms, inattention affects studying strategies, and inefficient studying strategies contribute to low academic achievement.42 Improving the academic achievement of university students with ADHD symptoms requires more than simply treating the ADHD symptoms. Students should be trained in learning strategies to develop their executive functioning skills such as study skills and academic adjustment as a way to effectively improve their academic achievement.43,44 Accordingly, training programs customized for student groups showing ADHD symptoms should be developed to support them to establish studying strategies and consistently execute them.
Adults referred to a national ADHD clinic in Iceland: clinical characteristics and follow-up status
Published in Nordic Journal of Psychiatry, 2021
Bára Sif Ómarsdóttir, Sigurlín Hrund Kjartansdóttir, Páll Magnússon, Halldóra Ólafsdóttir, Jón Friðrik Sigurðsson
Study I: All the participants were referred to the ADHD Clinic by their GP or other physicians, after having completed the ADHD Rating Scale for ADHD symptoms in childhood and adulthood, as well as the background questionnaire. The secretary of the ADHD clinic, who was trained and supervised for this task, phoned an informant or informants designated by the participant (in most cases family members), who completed the ADHD Rating Scale for childhood- and adulthood-ADHD symptoms of the participant. The participants who met screening criteria for ADHD (t-score 65 and above on the ADHD Rating Scale self-report and the informant report, both for childhood and adulthood), were admitted to a diagnostic interview, including questions about their developmental history, the K-SADS and the MINI, and were asked to fill in the self-report instruments. Figure 1 describes the procedure. Those who received ADHD diagnosis were offered medication according to clinical guidelines and were given psychoeducation about ADHD.
Predictive factors of success in neurofeedback training for children with ADHD
Published in Developmental Neurorehabilitation, 2019
Yasuko Okumura, Yosuke Kita, Mikimasa Omori, Kota Suzuki, Akira Yasumura, Ayako Fukuda, Masumi Inagaki
Table 2 summarizes the results of the ADHD rating scale and cognitive assessment. No significant effect was found for Inattention or Impulsivity/Hyperactivity scores (all ps > .02, all ηp2 values < .06), which indicated that the severity of these ADHD symptoms did not differ between groups, and there was no reduction after NF training. With regard to the SS of the DN-CAS Stroop Test, a marginally significant Group by Time interaction was revealed (F (1, 20) = 3.56, p = .074, ηp2 = .15), due to the higher pre-training SS in the learners than in the non-learners (F (1, 20) = 7.91, p = .011, ηp2 = .28). The group difference in post-training SS was not significant (F (1, 20) = 0.95, p = .34, ηp2 = .045).