Detecting Feigned Attention-Deficit/Hyperactivity Disorder (ADHD): Current Methods and Future Directions

Feigned attention-deficit/hyperactivity disorder (ADHD) in adults is a significant issue in clinical settings, particularly regarding academic accommodations and access to controlled substances by university students. This article discusses the definitions, base rates, external incentives, psychometric detection strategies, and ethical implications of feigned ADHD. ADHD is characterized by a pattern of developmentally inappropriate inattentive, overactivity, and/or impulsivity, often persisting into adulthood. Estimates of the prevalence of non-credible ADHD in university settings range from 25 to 50%. Feigned ADHD may be detected with symptom and performance validity measures. The existing empirical research has failed to produce a clear psychometric solution to this important differential diagnosis. Identifying feigned ADHD is a difficult task, possibly because of the highly transparent, face-valid diagnostic criteria, and an atypical malingering strategy that evades established detection methods. Performance validity tests remain the best available method for identifying non-credible presentation during psychological evaluations of ADHD. Future practice recommendations should consider educational policy, diagnostic criteria, and psychometric research, including the development of self-report measures that reliably differentiate between genuine and feigned ADHD. © 2017, Springer Science+Business Media New York.