Maya A Marder, G Whitman Kent, Steven A Abalos, J Gabrielle Springer, Tyler J Kukla, Dillon W Sharp, Brian M Cerny, Matthew S Phillips, Troy A Webber, Jason R Soble
{"title":"基于神经心理测试表现的个体差异性的离散性和不一致性准确地识别了转介ADHD评估的成年人的表现无效。","authors":"Maya A Marder, G Whitman Kent, Steven A Abalos, J Gabrielle Springer, Tyler J Kukla, Dillon W Sharp, Brian M Cerny, Matthew S Phillips, Troy A Webber, Jason R Soble","doi":"10.1080/13854046.2025.2537903","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated intra-individual variability (IIV) metrics, dispersion (IIV-D) and inconsistency (IIV-I), for distinguishing the following groups: attention-deficit/hyperactivity disorder (ADHD), non-ADHD psychological diagnoses (PD), no diagnosis (ND), and invalid neuropsychological test performance.</p><p><strong>Method: </strong>A sample of 845 adults (ADHD = 518; PD = 170; ND = 39; invalid = 118) were administered a neuropsychological battery that yielded 12 indicator scores and five performance validity tests (PVTs). intra-individual standard deviation (ISD) and coefficient of variation (CoV) indexed IIV-D across the 12 test indicators, and Continuous Performance Test-3 Hit Reaction Time Standard Deviation (HRT SD), Variability (VAR), and HRT SD and VAR/mean Hit Reaction Time (HRT; e.g. HRT SD/HRT, VAR/HRT) scores indexed IIV-I.</p><p><strong>Results: </strong>ISD (<i>η</i><sup>2</sup> = 0.06), CoV (<i>η</i><sup>2</sup> = 0.15), HRT SD (<i>η</i><sup>2</sup> = 0.09), HRT SD/HRT (<i>η</i><sup>2</sup> = 0.04), VAR (<i>η</i><sup>2</sup> = 0.06), and VAR/HRT (<i>η</i><sup>2</sup> = 0.01), significantly differed across groups, with the Invalid group having higher IIV values than all other groups. Results for ISD, HRT SD, and VAR remained significant even after controlling for each individual's average performance. Higher IIV was often significantly associated with failure on individual PVTs. No IIV metric showed acceptable classification accuracy for ADHD vs. PD vs. ND, whereas all IIV metrics, except VAR/HRT, showed degrees of success in distinguishing groups from invalid performance (ISD: PD vs Invalid AUC = 0.71; CoV: ADHD/PD/ND vs. Invalid AUCs = 0.74/0.80/0.81; HRT SD: PD/ND vs. Invalid AUCs = 0.74/0.83; HRT SD/HRT: ND vs Invalid AUC = 0.76; VAR: PD/ND vs. Invalid AUCs = 0.70/0.81).</p><p><strong>Conclusions: </strong>Results validated IIV metrics as sensitive to cognitive dysfunction and confirmed their utility for clinically distinguishing invalid performance from genuine attentional and psychological impairments among adults undergoing ADHD evaluation.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-31"},"PeriodicalIF":2.7000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dispersion and inconsistency based intra‑individual variability in neuropsychological test performance accurately identify performance invalidity among adults referred for ADHD evaluation.\",\"authors\":\"Maya A Marder, G Whitman Kent, Steven A Abalos, J Gabrielle Springer, Tyler J Kukla, Dillon W Sharp, Brian M Cerny, Matthew S Phillips, Troy A Webber, Jason R Soble\",\"doi\":\"10.1080/13854046.2025.2537903\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study evaluated intra-individual variability (IIV) metrics, dispersion (IIV-D) and inconsistency (IIV-I), for distinguishing the following groups: attention-deficit/hyperactivity disorder (ADHD), non-ADHD psychological diagnoses (PD), no diagnosis (ND), and invalid neuropsychological test performance.</p><p><strong>Method: </strong>A sample of 845 adults (ADHD = 518; PD = 170; ND = 39; invalid = 118) were administered a neuropsychological battery that yielded 12 indicator scores and five performance validity tests (PVTs). intra-individual standard deviation (ISD) and coefficient of variation (CoV) indexed IIV-D across the 12 test indicators, and Continuous Performance Test-3 Hit Reaction Time Standard Deviation (HRT SD), Variability (VAR), and HRT SD and VAR/mean Hit Reaction Time (HRT; e.g. HRT SD/HRT, VAR/HRT) scores indexed IIV-I.</p><p><strong>Results: </strong>ISD (<i>η</i><sup>2</sup> = 0.06), CoV (<i>η</i><sup>2</sup> = 0.15), HRT SD (<i>η</i><sup>2</sup> = 0.09), HRT SD/HRT (<i>η</i><sup>2</sup> = 0.04), VAR (<i>η</i><sup>2</sup> = 0.06), and VAR/HRT (<i>η</i><sup>2</sup> = 0.01), significantly differed across groups, with the Invalid group having higher IIV values than all other groups. Results for ISD, HRT SD, and VAR remained significant even after controlling for each individual's average performance. Higher IIV was often significantly associated with failure on individual PVTs. No IIV metric showed acceptable classification accuracy for ADHD vs. PD vs. ND, whereas all IIV metrics, except VAR/HRT, showed degrees of success in distinguishing groups from invalid performance (ISD: PD vs Invalid AUC = 0.71; CoV: ADHD/PD/ND vs. Invalid AUCs = 0.74/0.80/0.81; HRT SD: PD/ND vs. Invalid AUCs = 0.74/0.83; HRT SD/HRT: ND vs Invalid AUC = 0.76; VAR: PD/ND vs. Invalid AUCs = 0.70/0.81).</p><p><strong>Conclusions: </strong>Results validated IIV metrics as sensitive to cognitive dysfunction and confirmed their utility for clinically distinguishing invalid performance from genuine attentional and psychological impairments among adults undergoing ADHD evaluation.</p>\",\"PeriodicalId\":55250,\"journal\":{\"name\":\"Clinical Neuropsychologist\",\"volume\":\" \",\"pages\":\"1-31\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Neuropsychologist\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1080/13854046.2025.2537903\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropsychologist","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/13854046.2025.2537903","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Dispersion and inconsistency based intra‑individual variability in neuropsychological test performance accurately identify performance invalidity among adults referred for ADHD evaluation.
Objective: This study evaluated intra-individual variability (IIV) metrics, dispersion (IIV-D) and inconsistency (IIV-I), for distinguishing the following groups: attention-deficit/hyperactivity disorder (ADHD), non-ADHD psychological diagnoses (PD), no diagnosis (ND), and invalid neuropsychological test performance.
Method: A sample of 845 adults (ADHD = 518; PD = 170; ND = 39; invalid = 118) were administered a neuropsychological battery that yielded 12 indicator scores and five performance validity tests (PVTs). intra-individual standard deviation (ISD) and coefficient of variation (CoV) indexed IIV-D across the 12 test indicators, and Continuous Performance Test-3 Hit Reaction Time Standard Deviation (HRT SD), Variability (VAR), and HRT SD and VAR/mean Hit Reaction Time (HRT; e.g. HRT SD/HRT, VAR/HRT) scores indexed IIV-I.
Results: ISD (η2 = 0.06), CoV (η2 = 0.15), HRT SD (η2 = 0.09), HRT SD/HRT (η2 = 0.04), VAR (η2 = 0.06), and VAR/HRT (η2 = 0.01), significantly differed across groups, with the Invalid group having higher IIV values than all other groups. Results for ISD, HRT SD, and VAR remained significant even after controlling for each individual's average performance. Higher IIV was often significantly associated with failure on individual PVTs. No IIV metric showed acceptable classification accuracy for ADHD vs. PD vs. ND, whereas all IIV metrics, except VAR/HRT, showed degrees of success in distinguishing groups from invalid performance (ISD: PD vs Invalid AUC = 0.71; CoV: ADHD/PD/ND vs. Invalid AUCs = 0.74/0.80/0.81; HRT SD: PD/ND vs. Invalid AUCs = 0.74/0.83; HRT SD/HRT: ND vs Invalid AUC = 0.76; VAR: PD/ND vs. Invalid AUCs = 0.70/0.81).
Conclusions: Results validated IIV metrics as sensitive to cognitive dysfunction and confirmed their utility for clinically distinguishing invalid performance from genuine attentional and psychological impairments among adults undergoing ADHD evaluation.
期刊介绍：
The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
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