DRUG TREATMENT OF ADHD

Drug Treatment of ADHD



ADHD Multi-Genre Research

Introduction

Since awareness has grown that learning disorders can disrupt postsecondary education, young-adult student's increasingly present requesting evaluation and treatment for suspected learning problems. Significant motivations and incentives currently exist for young adults seeking a diagnosis of a learning disorder, including attention deficit/hyperactivity disorder (ADHD), within higher education facilities Laws including the Individuals With Disabilities Act, the Rehabilitation Act of 1983, and the Americans With Disabilities Act provide the legal basis guaranteeing students with disabilities, including mental disabilities, provision for academic accommodation and resources (McGuire, 1998).

Procedure

All procedures and an informed-consent document were approved by the local institutional review board. Students in the ADHD group, who came in following a 12-hr medication washout period, were asked to take a battery of counterbalanced tests and questionnaires to the best of their ability. Students with no history of ADHD were randomly assigned to the HON or FGN conditions by selecting from two envelopes with enclosed role-specific information.

Results

ADHD Measures

While high sensitivity for the detection of ADHD was found by at least two CAARS indices (Scale 5: DSM-IV Inattentive Symptoms, 93%; Scale 7: DSM-IV Total ADHD Symptoms, 86%) and the ARS Childhood (90%) and Current Symptoms (86%) scales, all of these indices were successfully faked. The FGN- and ADHD-group means, though significantly greater than the HON-group means in all cases (p < .000), were statistically equivalent to one another across the board (median CAARS scale g = .25, median ARS g = .31). These results suggest that a sizable proportion of university students avoided the blanket-endorsement strategy for Current Symptoms. Of note, the CAARS Inconsistency index did not differentiate the ADHD and FGN groups (p = .951, g = .00), suggesting that it is not effective in detecting feigned symptom reports.

Discussion

Sufficient data now exist to show that adult ADHD clinical evaluations include significant numbers of individuals motivated to provide inaccurate test performance(Osmon,2006)Thus, ADHD evaluations are not immune to the interpretive problems associated with false presentation due to symptom over reporting and inadequate effort on cognitive tests. The desire for medication and extra help within the college environment provides external incentives potentially motivating inaccurate presentation by some college students presenting for evaluation (Frazier,2008).It was found that both the Victoria Symptom Validity Test and the Validity Indicator Profile show good ability to discriminate both simulated ADHD and reading disorder groups while having a low rate of inaccurate identification of controls as simulators.

Finally, combining the SVT indices resulted in only modest declines in overall sensitivity but robust specificity beginning at a criterion of predicting feigning when two or more of the indices were failed. Given the common use of multiple SVT measures in clinical evaluations, further work on the optimal methods for combining these results is warranted. In particular, it will be important to cross-validate the specificity rates found here in additional genuine ADHD patients.

The identification of students who feign impairment on ADHD evaluations within the university setting will likely remain a vexing ...