Assessing Functional Impairment in ADHD: Concerns for Validity of Self-Report

We examined the influence of invalid self-report and invalid performance on report of functional impairment in a sample of 49 adults referred for evaluation for ADHD and/or learning disorder concerns. Overall, 26 –59% of participants referred for evaluation endorsed at least moderate levels of impairment in the domains of understanding and communicating, household, and school/work. Individuals with evidence of invalid self-report of ADHD symptoms endorsed significantly higher levels of disability/impairmen t on the WHODAS, particularly in the domains of understanding and communicating, household, school/work, and participation in society. Further, individuals who failed a measure of performance validity reported significantly higher levels of impairment/disability, particularly in the domains of under standing and communicating, school/work, and participation in society. Results emphasize the need to assess for validity of self-report and performance in ADHD assessment. Since self-report of impairment may be suspect, clinicians should include data such as school records, past performance on high- stakes standardized testing, evidence of prior accommodations, and collateral reports before making diagnoses and/or recommendations regarding treatment or academic/workplace accommodations.
Source: Psychological Injury and Law - Category: Medical Law Source Type: research