title: The Development of an Embedded Figures Test for the Detection of Feigned Attention Deficit Hyperactivity Disorder in Adulthood.
abstract: OBJECTIVE
  It has been shown that an increasing number of adults deliberately feign attention deficit hyperactivity disorder (ADHD), which demonstrates the need for new tests designed to detect feigned ADHD.
  
  
  METHODS
  An Embedded Figures Test (EFT) was developed for the detection of feigned ADHD in adulthood. EFT performance of 51 adults with ADHD was compared to the performance of 52 matched healthy individuals, as well as to 268 undergraduate students who were randomly allocated in a simulation design to one of four experimental conditions, i.e. a control group, a naïve simulation group, a symptom-coached simulation group or a test-coached simulation group. Furthermore, an independent sample of 11 adults with ADHD as well as a sample of 17 clinicians experienced in the work with adults with ADHD were assessed for further validation of the EFT.
  
  
  RESULTS
  The EFT was relatively easy to perform for both patients with ADHD and healthy comparisons as shown by low error rates and non-significant group differences. However, simulation groups differed from patients with ADHD by significant and large effects. An EFT index for the prediction of feigned ADHD was derived based on logistic regression coefficients. Receiver Operating Characteristics (ROC) demonstrated good classification accuracy of feigned ADHD relative to ADHD (AUC = 94.8%), i.e. high sensitivity (88%) and specificity (90%).
  
  
  CONCLUSIONS
  This study supports the utility of the EFT for the detection of feigned adult ADHD.
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands.
authors.forename: Anselm B M
authors.initials: AB
authors.lastname: Fuermaier
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands.
authors.forename: Oliver
authors.initials: O
authors.lastname: Tucha
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Koerts
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands.
authors.forename: Meryem
authors.initials: M
authors.lastname: Grabski
authors.affiliation: Department of Experimental Psychology, University of Regensburg, 93040 Regensburg, Germany.
authors.forename: Klaus W
authors.initials: KW
authors.lastname: Lange
authors.affiliation: Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany.|Section for Experimental Psychopathology and Neurophysiology, Centre for Psychosocial Medicine, University of Heidelberg, 69115 Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Weisbrod
authors.affiliation: Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Aschenbrenner
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands.
authors.forename: Lara
authors.initials: L
authors.lastname: Tucha
mesh_terms: D000328:Adult; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D003071:Cognition; D006801:Humans; D007361:Intelligence Tests; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D012372:ROC Curve; D057566:Self Report; D055815:Young Adult