Examining the Utility of the BAARS-IV Scales As Embedded Symptom Validity Indicators for Adult Attention-Deficit/hyperactivity Disorder Evaluations.

Objective: This study investigated whether extreme cut-scores on the Barkley Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-Fourth Edition (BAARS-IV) self-report scales could serve as symptom overreporting indicators in adult ADHD evaluations. Method: The sample consisted of 162 adults who underwent a neuropsychological evaluation for ADHD. Patients were classified into valid (n = 115) and invalid (n = 47) groups based on multiple criterion symptom validity tests. Results: Overreporting cut-scores identified for each of the BAARS-IV scales demonstrated acceptable classification accuracy or better. The Current Total scale yielded the highest classification accuracy (area under the curve of .83). An optimal raw cut-score of >= 56 for this scale yielded 47% sensitivity when upholding >= 90% specificity. A cut-score of >= 31 for the Current Inattention scale (90% specificity; 47% sensitivity) and >= 29 for the Current Sluggish Cognitive Tempo scale (88% specificity; 46% sensitivity) were also relatively strong indicators of overreporting. The Current Total and Current Sluggish Cognitive Tempo scales captured nonredundant aspects of symptom validity, and using them together increased sensitivity to 57% while maintaining >= 90% specificity. Conclusions: Findings provide preliminary support for the criterion and construct validity of extreme cut-scores on the BAARS-IV Current Sluggish Cognitive Tempo, Current Inattention, and Current Total scales as indicators of ADHD symptom overreporting. However, employing the cut-scores from the Current Sluggish Cognitive Tempo (>= 29) and Current Total (>= 56) together may be the most promising way to detect overreporting. Scores above both of these cut-points should, at a minimum, prompt further investigation into the validity of a patient's reported symptoms.