Faking ADHD for Special Treatment

You might ask, “Why would anyone want to fake attention deficit hyperactivity disorder (ADHD)?”

Many years ago, when ADHD was first proposed as a diagnosis, you would’ve been right — few people would’ve bothered faking the diagnosis because it brought you little reward to do so.

But as ADHD diagnoses bloomed over the past two decades, so did special accommodations in the school systems for children and teenagers diagnosed with the disorder. And one of the primary treatments for attention deficit disorder is stimulant medication, something that can be used for less-than-legitimate reasons.

Could teens today really be faking ADHD to get into college?

Welcome to the world of unintended secondary gains and rewards.

Secondary gains are when you get something unintended or secondary to the primary objective. For instance, let’s say you need to get good grades in school in order to get to the next grade or keep your GPA up. But when you bring home a report card with mostly As on it, your parents are so excited they treat you to a special dinner out or a gift certificate. You didn’t get good grades just to get the dinner or gift certificate — those are secondary to the real reason.

Psychologists have long understood the power of secondary gains as rewarding to people, sometimes in very unintended ways. So when some well-meaning people give those disabled by a mental illness such as ADHD special treatment (such as unlimited time to take a test or the SATs), others see the benefits and take advantage of the situation.

Heidi Mitchell has the story over at The Daily Beast about an anonymous student named “Steven” who decided to fake ADHD in order to get into a college in upstate New York (not Harvard, as the article’s headline mistakenly claims).

Steven decided to dupe his doctor when he returned from his elite boarding school exhausted by the intense competition there. He needed an edge to help him, he felt. So through written evaluations from teachers and his parents, and by deliberately failing tests, he succeeded in getting himself diagnosed with attention-deficit/hyperactivity disorder (ADHD), and was given both his in-school tests and his SATs untimed. Eventually Steven, which is not his real name, was accepted to a top college in upstate New York, although he no longer takes medication, nor does he consider himself ADHD. The ADHD diagnosis, and the benefits that came with it, he acknowledges, helped him beat the competition. […]

Faking the test that diagnoses ADHD is easy, shows a recent study by Prof. David Berry at the University of Kentucky. His group of fakers was assessed on the ADHA Rating Scale (ARS) developed by Barkley and Murphy and on the Conners Adult ADHD Rating Scale. The test givers could not distinguish between the fakers, who had spent five minutes on Google learning what signs to display in order to trick assessors, and the real ADHD group.

Nobody knows the exact numbers of students who are doing this, but it appears to be enough of a problem that researchers are finally trying to better detect malingering, the technical term for faking.

I’d argue that rating and screening scales for ADHD, like those for most mental disorders, aren’t there to make a definitive diagnosis — that’s the mental health professional’s job. They are there to act as a rough screening measure to give a person or a professional an idea of the likelihood of ADHD.

The problem is that most symptom criteria for nearly all mental disorders are subjective behavioral symptoms arrived at, most usually, be self-report by the patient. It’s really hard to tell a person is lying when they say all the right things that a person with actual ADHD might say.

Luckily, researchers are on it. A study published in The Clinical Neuropsychologist in December 2011 by Lindsey Jasinski and colleagues suggests that the administration of a battery of neuropsychological tests can pick up on ADHD malingering:

Similar to Sollman et al. (2010) and other recent research on feigned ADHD, several symptom validity tests, including the Test of Memory Malingering (TOMM), Letter Memory Test (LMT), Digit Memory Test (DMT), Nonverbal Medical Symptom Validity Test (NV-MSVT), and the b Test were reasonably successful at discriminating feigned and genuine ADHD.

I’d also suggest that if someone wants special academic accommodations for their mental illness, it’s required they see a specialist in that area who is most qualified to render an accurate and objective diagnosis. A neuropsychologist, for instance, is the most qualified professional to render an accurate ADHD diagnosis, since they are the only professionals trained and qualified to administer neuropsychological testing.

Unfortunately, such consultations don’t come cheaply. But it’s one solution to this potentially burgeoning problem.

Read the full article: Faking ADHD Gets You Into Harvard