S Aita

Utility of the Personality Assessment Inventory in detecting feigned Attention-Deficit/Hyperactivity Disorder (ADHD): The Feigned Adult ADHD index

ObjectivenThe high potential for secondary gain among college students presenting for Attention-Deficit/Hyperactivity Disorder (ADHD) evaluations highlights the need for psychometrically sound embedded validity indicators. The purpose of this study was to develop new validity indicators specific to feigned ADHD for the Personality Assessment Inventory (PAI) and compare them to preexisting imbedded PAI validity measures.nnnMethodnPAI scales that were theoretically related to feigned ADHD were evaluated. A binomial (ADHD simulators, n = 138, and genuine ADHD, n = 142) logistic regression was conducted with selected PAI scales and subscales. Classification rates were compared between the new and existing validity scales. A similar approach was used for item-level data in a second study in a subgroup of the original sample.nnnResultsnThe derived PAI scale-based logistic regression had a sensitivity of 54% and specificity of 92%. This algorithm accurately identified 97% of healthy controls as not feigning ADHD and correctly identified 98% of a no diagnosis group and 75% of a mood/anxiety disorders group. Classification accuracy of the new index was superior to the majority of existing PAI validity scales across groups. An item-level PAI algorithm had a sensitivity of 85% and specificity of 97% for identifying feigned ADHD.nnnConclusionsnNew validity measures were compared to existing PAI validity indicators and performed better than many of them in this study. The algorithms developed in this study of ADHD simulators and genuine ADHD cases have adequate sensitivity and good specificity and appear to function differently than other PAI symptom validity scales.

Executive, language, or both? An examination of the construct validity of verbal fluency measures

ABSTRACT The purpose of the present study was to evaluate whether phonemic and semantic verbal fluency were more related to aspects of language processing than executive functioning (EF). An exploratory factor analysis was performed on a college-aged sample of 320 healthy participants using principle axis factoring and promax rotation on nine measures of EF. The first three factors, labeled: working memory, fluid reasoning, and shifting/updating, were extracted and used as latent executive variables. Participants were also split into low, medium, and high phonemic and semantic verbal fluency ability groups. Phonemic and semantic fluency correlated similarly across all three extracted EF factors and word knowledge. Using one-way analysis of variance (ANOVAs), there was a main effect for both phonemic and semantic verbal fluency groups and all outcome variables (i.e., the EF factors and word knowledge). Tukey HSD post hoc analyses showed that those in the low verbal fluency ability groups had significantly lower scores across all outcome measures compared to the high verbal fluency ability groups. Across all analyses, semantic fluency had stronger relations with the EF factors, signifying a large executive component involved in the task. Both phonemic and semantic fluency were similarly related to multiple dimensions of EF and word knowledge and should be considered executive language tasks.

Behavioral Ratings of Executive Functioning Explain Instrumental Activities of Daily Living beyond Test Scores in Parkinson's Disease.

Objective: Executive dysfunction is common in Parkinson’s disease (PD), yet the relationship between executive functioning (EF) and instrumental activities of daily living (IADLs) is inconsistent. This inconsistency may be due to the limited relationship between EF test scores and behaviors. Rating scales provide a potential way to supplement test scores in predicting patient’s ability to complete IADLs by capturing a wide range of EF behaviors in their everyday environment. We hypothesized that informant-rated EF would provide incremental validity in predicting IADLs above and beyond EF test scores. Methods: Eighty-five patients were selected from a clinical neuropsychological database of PD patients evaluated for deep brain stimulation surgery at The Johns Hopkins Hospital between September 2006 and January 2015. Hierarchical regression was completed to determine the relationship between an EF behavioral rating scale (i.e., FrSBe), EF test scores, and IADLs. Results: The EF behavioral rating scale added incremental validity to neuropsychological test scores in predicting IADLs. Conclusions: Behavioral ratings of EF may provide additional information about how PD patients’ EF is influencing their everyday life.

Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals.

Empirical findings indicate that sexual and gender minorities report notably poorer outcomes on measures of mental health when compared with cisgender/heterosexual individuals. Although several studies have examined these issues, few have taken the time to examine differences between cisgender/heterosexual and specific lesbian, gay, bisexual, transgender, and queer identities. This is especially important as an increasing number of new gender and sexual identities emerge, yet limitations in statistical power often preclude such analyses. Thus, the following study addressed this gap by examining data from a large sample of college students from the national Health Minds Study (n = 43,632). Results indicated that college students with transgender and gender nonconforming identities reported significantly higher rates of depression and anxiety symptoms compared with students with cisgender identities, with large effect sizes. Disparities were also significant across sexual minority participants, with the smallest effect sizes being between heterosexual and gay/lesbian individuals, and the largest effect sizes between heterosexual and pansexual participants for depression, and heterosexual and demisexual participants for anxiety. We also found evidence of an interaction of gender and sexual identity impacting mental health such that those with minority statuses in both identity groups had significantly worse outcomes compared to those with only one minority identity. Our results indicate that individuals in the emerging sexual and gender minority categories (pansexual, demisexual, asexual, queer, questioning, and transgender/gender nonconforming) report significantly higher rates of depression and anxiety when compared with cisgender/heterosexual individuals, and even significantly more than those who identify as gay/lesbian. Implications for mental health providers and researchers are discussed.

The positive side of effort: A review of the impact of motivation and engagement on neuropsychological performance

ABSTRACT Almost the entirety of research on effort in clinical neuropsychology has focused on negative aspects of effort in neuropsychological assessment, with most work over the last 20 years emphasizing feigned cognitive impairment. In contrast, few studies have explored trait-level positive influences on motivation and engagement in regard to neuropsychological testing. This paper reviews potential constructs associated with positive aspects of effort in neuropsychological testing, including conation, grit, Need for Cognition, and personality factors from the Five Factor Model of personality (Big Five). Findings are discussed from a positive neuropsychological framework, with an emphasis on positive effort being conceptualized as perseverance and resiliency in cognitively demanding testing situations. Challenges for the field are discussed, and we offer suggestions for conceptualizing effort on a continuum and recommendations for future research directions.