The Relationship Between Subjective Cognitive Complaints, Invalid Symptom Reporting, and Neurocognitive Test Performance Validity Among Adults Being Evaluated for ADHD.
Matthew S Phillips, Nataliya Turchmanovych-Hienkel, Mira I Leese, Brian Ramanauskas, Hannah B VanLandingham, Christopher Gonzalez, Gabriel P Ovsiew, Anthony D Robinson, Brian M Cerny, Devin M Ulrich, Jason R Soble
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Abstract
Objective: Subjective cognitive complaints are common among patients presenting for evaluation of attention-deficit/hyperactivity disorder (ADHD). Despite these complaints, research overwhelmingly suggests that reported cognitive deficits do not align with objective neurocognitive performance. This study explored the relationship between subjective cognitive complaints, objective neuropsychological functioning, and performance and symptom validity testing in adult patients referred for evaluation due to concern about ADHD.
Methods: The sample consisted of 523 adult referrals who underwent comprehensive evaluation for concern about ADHD and to characterize cognitive strengths and weaknesses. Four hundred patients were diagnosed with ADHD, and 123 did not meet the diagnostic criteria for ADHD. Patients were dichotomized to form nonelevated (n=134) and elevated (n=389) cognitive complaint groups, which were compared on objective neurocognitive performance, report of ADHD-specific symptoms, and performance validity tests.
Results: Significant differences were identified between the elevated and nonelevated cognitive complaints groups in performance validity tests and ADHD symptom reporting; however, clinical differences were not identified on objective neurocognitive measures.
Conclusions: Consistent with the results of previously published research, subjective cognitive complaints did not align with objective neurocognitive deficits in a sample of adult ADHD referrals. Elevated cognitive complaints were associated with higher rates of performance validity failure and invalid ADHD-specific symptom reporting. These findings highlight the importance of assessing cognitive complaints using symptom report inventories and cognitive tests that include objective validity indices.
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Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field.
Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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