Embedded WAIS-IV Detection Strategies and Feigned Cognitive Impairment: An Investigation of Malingered ADHD

Abstract

Malingered attention-deficit hyperactivity disorder (ADHD) may be strongly motivated on college campuses by recreational use of ADHD medications and to obtain unwarranted academic accommodations. Rather than rely on face-valid (easily faked) ADHD checklists, the study focused on the more complex Wechsler Adult Intelligence Scale–Fourth edition (WAIS-IV; Wechsler, 2008). However, the current literature has not yet investigated well-defined detection strategies for feigned WAIS-IV presentations. Using aprioristic standards, four different detection strategies from the feigning literature were adapted to certain WAIS-IV subscales. For example, significantly below-chance performance was applied to visual puzzles. Using a between-subjects simulation design, 74 undergraduate simulators were compared with archival data on 73 outpatients diagnosed with ADHD at a university psychology clinic. Very large effect sizes (Cohen’s ds from 1.66 to 1.90) differentiated between genuine and feigned ADHD. Two strategies (significantly below-chance performance and floor effect) showed strong promise if cross-validated for other feigning presentations. The study concluded with clinical considerations and future avenues for research.