INS NYC 2024 Program

Poster	Poster Session 10 Program Schedule 02/17/2024 09:00 am - 10:15 am Room: Shubert Complex (Posters 1-60) Poster Session 10: Neurodevelopmental \| Congenital Conditions Final Abstract #22 Clinical Validation of an ADHD Dissimulation Scale (Ds-ADHD-r) on the MMPI-3 Katie Califano, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States Timothy Arentsen, Semmes Murphey Clinic, Memphis, United States Marcy Adler, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States Jennifer Seeley McGee, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States Brad Roper, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States Category: ADHD/Attentional Functions Keyword 1: symptom validity Keyword 2: performance validity Objective: The MMPI assesses invalid response styles, especially potential symptom over-reporting and inconsistencies in reporting. Evaluations include additional validity indicators, such as performance validity tests (PVTs) and symptom validity tests (SVTs). However, there is a need to capture credible Attention-Deficit / Hyperactivity symptomatology. Robinson and Rogers (2018) developed a 10-item Dissimulation ADHD validity scale (Ds-ADHD) for the MMPI-2-RF to measure erroneous stereotypes of ADHD, which found to be effective in distinguishing credible and noncredible ADHD diagnoses. For this current study, the Ds-ADHD scale was converted to a 9-item, experimental Dissimulation ADHD validity scale (Ds-ADHD-r) for the MMPI-3. The utility was examined when a mixed sample of U.S. Military Veterans was divided into credible vs. noncredible groups according to either PVT- or SVT-based definitions. Participants and Methods: 173 Veterans (M_age= 36.18, SD_age = 11.10, M_edu = 14.01, SD_edu = 2.11, 88% male, 81% White, 17% Black) completed a neuropsychological evaluation with a question about ADHD diagnosis. The evaluation included 2-9 PVTs, CAARS, and an internally consistent MMPI-2-RF. The proposed MMPI-3 Ds-ADHD-r scale was calculated to differentiate credible or noncredible performance on cognitive measures. “True” responses (i.e., erroneous stereotypes) were coded as 1 and “false” answers were coded as 2, creating a 9- to 18-point scale, with lower scores associated with a higher likelihood of feigned ADHD presentation. For PVT-based grouping, the credible group was determined if participants completed at least two PVTs and passed all PVTs (n=146). The noncredible group was determined by participants failing two or more PVTs (n=27). For SVT-based grouping, the credible group yielded a consistent CAARS-S:L profile (n=134), defined by a cut score of <21 in the Infrequency Index (CII). The noncredible SVT group (n=53) was classified as ≥ 21 on CII. Group assignment was clinically confirmed. Results: The Ds-ADHD-r scores resulted in a significant difference between credible and noncredible performance groups for both the PVT (t = -2.85, p = .007; Cohen’s d = -0.60) and the SVT (t = -4.51, p < .001; Cohen’s d = -.74) groups. Veterans in the noncredible PVT group endorsed more erroneous stereotypes of ADHD (M = 12.00, SD = 2.08) than those in the credible PVT group (M = 13.24, SD = 2.09). A ROC analysis specified an AUC of .66 (95% CI = .55 to .78). The Ds-ADHD-r revealed a cut score of <10 resulting in a specificity of 87.0% and sensitivity of 25.9% within the PVT-group. Similarly, the Veterans in the noncredible SVT group indicated more erroneous stereotypes of ADHD (M = 11.85; SD = 2.04) than those in the credible SVT group (M = 13.34; SD = 2.00). A ROC analysis indicated AUC of .70 (95% CI = .61 to .79). The Ds-ADHD-r cut score of <11 resulted in specificity of 91.8% and sensitivity of 35.8%. Conclusions: The Ds-ADHD-r scale sufficiently differentiated groups when credibility was defined by SVTs, but not by PVTs. Clinicians may find it helpful to convert a Ds-ADHD-r scale to determine credible and noncredible samples when using a MMPI-3. This is especially true as different cut-scores were identified based on how credibility was defined (i.e., PVT- vs. SVT-based definitions). As the Ds-ADHD-r scale is technically an SVT, clinicians may be best served emphasizing the psychometrics reported for the SVT-based than PVT-based groups, with a recommended <11 cut score. Future research should focus on replicating the findings using a credible sample that was limited to an independently verified diagnosis of ADHD.

Poster

02/17/2024
09:00 am - 10:15 am
Room: Shubert Complex (Posters 1-60)

Poster Session 10: Neurodevelopmental | Congenital Conditions

Final Abstract #22

Clinical Validation of an ADHD Dissimulation Scale (Ds-ADHD-r) on the MMPI-3

Katie Califano, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States
Timothy Arentsen, Semmes Murphey Clinic, Memphis, United States
Marcy Adler, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States
Jennifer Seeley McGee, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States
Brad Roper, Lt. Col. Luke Weathers, Jr. VA Medical Center, Memphis, United States

Category: ADHD/Attentional Functions

Keyword 1: symptom validity
Keyword 2: performance validity

Objective:

The MMPI assesses invalid response styles, especially potential symptom over-reporting and inconsistencies in reporting. Evaluations include additional validity indicators, such as performance validity tests (PVTs) and symptom validity tests (SVTs). However, there is a need to capture credible Attention-Deficit / Hyperactivity symptomatology. Robinson and Rogers (2018) developed a 10-item Dissimulation ADHD validity scale (Ds-ADHD) for the MMPI-2-RF to measure erroneous stereotypes of ADHD, which found to be effective in distinguishing credible and noncredible ADHD diagnoses. For this current study, the Ds-ADHD scale was converted to a 9-item, experimental Dissimulation ADHD validity scale (Ds-ADHD-r) for the MMPI-3. The utility was examined when a mixed sample of U.S. Military Veterans was divided into credible vs. noncredible groups according to either PVT- or SVT-based definitions.

Participants and Methods:

173 Veterans (M_age= 36.18, SD_age = 11.10, M_edu = 14.01, SD_edu = 2.11, 88% male, 81% White, 17% Black) completed a neuropsychological evaluation with a question about ADHD diagnosis. The evaluation included 2-9 PVTs, CAARS, and an internally consistent MMPI-2-RF. The proposed MMPI-3 Ds-ADHD-r scale was calculated to differentiate credible or noncredible performance on cognitive measures. “True” responses (i.e., erroneous stereotypes) were coded as 1 and “false” answers were coded as 2, creating a 9- to 18-point scale, with lower scores associated with a higher likelihood of feigned ADHD presentation. For PVT-based grouping, the credible group was determined if participants completed at least two PVTs and passed all PVTs (n=146). The noncredible group was determined by participants failing two or more PVTs (n=27). For SVT-based grouping, the credible group yielded a consistent CAARS-S:L profile (n=134), defined by a cut score of <21 in the Infrequency Index (CII). The noncredible SVT group (n=53) was classified as ≥ 21 on CII. Group assignment was clinically confirmed.

Results:

The Ds-ADHD-r scores resulted in a significant difference between credible and noncredible performance groups for both the PVT (t = -2.85, p = .007; Cohen’s d = -0.60) and the SVT (t = -4.51, p < .001; Cohen’s d = -.74) groups. Veterans in the noncredible PVT group endorsed more erroneous stereotypes of ADHD (M = 12.00, SD = 2.08) than those in the credible PVT group (M = 13.24, SD = 2.09). A ROC analysis specified an AUC of .66 (95% CI = .55 to .78). The Ds-ADHD-r revealed a cut score of <10 resulting in a specificity of 87.0% and sensitivity of 25.9% within the PVT-group. Similarly, the Veterans in the noncredible SVT group indicated more erroneous stereotypes of ADHD (M = 11.85; SD = 2.04) than those in the credible SVT group (M = 13.34; SD = 2.00). A ROC analysis indicated AUC of .70 (95% CI = .61 to .79). The Ds-ADHD-r cut score of <11 resulted in specificity of 91.8% and sensitivity of 35.8%.

Conclusions:

The Ds-ADHD-r scale sufficiently differentiated groups when credibility was defined by SVTs, but not by PVTs. Clinicians may find it helpful to convert a Ds-ADHD-r scale to determine credible and noncredible samples when using a MMPI-3. This is especially true as different cut-scores were identified based on how credibility was defined (i.e., PVT- vs. SVT-based definitions). As the Ds-ADHD-r scale is technically an SVT, clinicians may be best served emphasizing the psychometrics reported for the SVT-based than PVT-based groups, with a recommended <11 cut score. Future research should focus on replicating the findings using a credible sample that was limited to an independently verified diagnosis of ADHD.