Assessing for Noncredible Presentations in ADHD Across the Lifespan

1.5 CE Credits

 

Julie A. Suhr, Ph.D.
Professor of Psychology and Director of Clinical Training
Ohio University






In this workshop, concerns about noncredible presentations of Attention Deficit Hyperactivity Disorder (ADHD) will be discussed. The workshop will include review of the existing research literature on noncredible presentations of ADHD in both children and adults. The base rates of noncredible presentation will be discussed. Evidence that assessment for noncredible presentation is currently lacking in most psychoeducational evaluations will also be presented. The workshop will include discussion of both noncredible self-report (including prior and current symptoms and impairment) and noncredible behavior on cognitive tests. Empirical evidence for the use of both Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs) in ADHD assessment across the lifespan will be reviewed, and some “best practices” based on this literature will be presented. There will also be attention given to development of new SVTs and PVTS for use in ADHD assessment, with discussion of research methodology relevant to both child and adult assessments.

After the session, participants will be able to:
1. Describe the need for assessment for noncredible presentations in both child and adult ADHD.
2. Explain the empirical support for SVT and PVT use in child and adult ADHD assessment.
3. Describe methods for development of new SVTs and PVTS for use on ADHD assessment across the lifespan.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate
 
Julie A. Suhr, Ph.D., is Professor of Psychology and Director of Clinical Training at Ohio University. She received her Ph.D. in clinical psychology from the University of Iowa in 1994. She completed a year-long internship in clinical neuropsychology at Brown University in 1994, and 3 years of postdoctoral training in clinical neuropsychology in the Department of Neurology, University of Iowa College of Medicine in 1994-1997. She has published over 80 peer-reviewed articles, a sole authored book on psychological assessment in 2015, and a co-edited book on clinical assessment and diagnosis in 2019, as well as over a dozen book chapters. She is a Fellow of the Society for Clinical Neuropsychology (APA Division 40) and the National Academy of Neuropsychology.  

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Historical Development and Evolution of the Neuropsychological Test Battery

1.0 CE Credit

Presented by:
William B. Barr, PhD, ABPP
Associate Professor
Director, Neuropsychology Division
Department of Neurology
NYU Grossman School of Medicine

Examining the historical origins of our methodology provides us with a theoretical framework to critically examine our current work while providing us with a basis to move ahead in the future. This workshop will begin with an examination of the origins of neuropsychology and some of the field’s earliest practitioners. It will continue with an analysis of the evolution of neuropsychological assessment methodology from its 19th century roots through its use in modern-day clinical and research settings. Historical origins of “quantitative” (e.g., Halstead-Reitan Battery) and “qualitative” (e.g., Boston Process Approach) methods in neuropsychology can be traced back to European universities and the great “age of schools” in North America. Other important influences on development of the tests we use come from the intelligence testing movement, U.S. immigration, and demands initiated by the great wars (WWI and WWII). We will review scientific and social trends that have contributed to the development of modern-day testing methods. We will also discuss how our testing methodology has adapted to changes in health-care reimbursement, new areas of practice, application to diverse populations, and a continued movement towards the use of digital methodology.

Learning Objectives
After the session, participants will be able to:
1. Describe the historical origins of neuropsychology.
2. Critique the strengths and weaknesses of quantitative versus qualitative approaches to neuropsychological assessment.
3. Trace the development and evolution of the neuropsychological test battery.
4. Discuss the need to apply changes to the neuropsychological test battery in response to ongoing changes in economics and society.

Target Audience: Neuropsychologists and trainees
Instructional Level: Introductory

Dr. Barr is the Director of the Neuropsychology Division in the Department of Neurology at NYU-Langone Health. He is an Associate Professor of Neurology at the NYU Grossman School of Medicine. He is board-certified in Clinical Neuropsychology through the American Board of Professional Psychology and has over 30 years of experience in clinical practice, training, and research in that field. Dr. Barr has been on the editorial boards of multiple professional journals and has served as an officer and board member of a number of professional societies, including a term as President of the Society for Clinical Neuropsychology (Division 40) of the American Psychological Association (APA). He has an active clinical practice in neuropsychological assessment, involving both clinical and forensic cases, with ongoing research programs on cognitive and behavioral aspects of epilepsy in addition to other programs in mild traumatic brain injury and forensic neuropsychology. He has served as a professional consultant to professional sports leagues, including the NFL and NHL. He has a long history of research studies on concussion in athletes and is an active participant in current studies on chronic traumatic encephalopathy (CTE).

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Review and Update on Adult Performance Validity Testing

1.5 CE Credits

Presented by:
Patrick Armistead-Jehle, Ph.D.
Chief, Concussion Clinic
Munson Army Health Center

This course will provide a review and update on performance validity testing (PVT) in adult neuropsychological evaluations.  Recent literature discussing the utility of validity testing in neuropsychological assessment, as well as reviews of stand-alone and embedded measures, will be discussed.  Special topics to be covered will include:  (1) feedback to patients and referring providers; and (2) use of PVTs in special populations. Emphasis will also be given to future directions in PVT research.

After the webinar, participants will be able to:

  1. Describe the influence of performance validity testing on interpretation of cognitive test results.
  2. Explain and utilize feedback strategies with patients and referring providers. 
  3. Discuss application of PVTs in patients with low IQ, dementia, and English as a second language.

Target Audience: Neuropsychologists, as well as psychologists involved in cognitive assessments.

Instructional Level: Intermediate

Patrick Armistead-Jehle, Ph.D. ABPP-CN is the chief of the concussion clinic at Munson Army Health Center at Fort Leavenworth, KS.  He completed undergraduate training at the University of Wisconsin-Green Bay and subsequently obtained a PhD in clinical psychology from Virginia Commonwealth University.  He is board certified by the American Board of Clinical Neuropsychology.  Dr. Armistead-Jehle has published several dozen articles in peer reviewed psychological and neuropsychological journals, with the majority if these publications addressing the topics of validity testing and traumatic brain injury.  In addition to part time research and administrative duties, he maintains day to day patient care responsibilities.

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The Use of Positive and Negative Validity Findings in Clinical Versus Forensic Cases

1.5 CE Credits

 

Michael Chafetz, Ph.D., ABPP 
Algiers Neurobehavioral Resource, LLC







The central question of this workshop is whether negative validity test findings should be used in the aggregate along with positive test findings for the determination of a case of illness-deception (ID), as it was asserted by Frederick (2015) and Black, Necrason, and Omasta (2016). A comparison of the use of validity tests versus other kinds of medical and psychological tests is made, with findings suggesting that ID is fundamentally different from other constructs/diseases in evidence-based medicine, psychology, and neuropsychology because deception about illness involves a deliberate process that may involve coaching, research, and/or focusing the deception on one aspect of functioning (e.g., slowness). A case study is presented to consider how decisions about other medical and neuropsychological problems are enhanced by considering positive and negative findings, how likely findings are to be manipulated by the patient, and how well the assertion that both positive and negative validity test findings must be used together in the aggregate stands up to comparative scrutiny. The fundamental assumption that a negative test finding concerning ID represents good effort is flawed, as it simply represents a lack of evidence of ID which cannot, in turn, be construed as evidence of lack of deception. Commentary is provided on best practice in neuropsychology regarding use of validity tests.

After the session, participants will be able to:
1. Explain how positive and negative test results are used together to determine the probability of a given condition of interest in medicine and psychology.
2. Compare the changes in posterior probabilities from positive versus negative test findings for a condition of interest.
3. Describe how the case example supports using only positive test findings in a determination of illness-deception.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate
 
Dr. Michael Chafetz is a Board Certified clinical neuropsychologist in independent practice in New Orleans.  His research interests have focused on the validity of Social Security disability examinations, where he has sought to understand how validity testing operates in low functioning claimants.  This research led to an initiative to help the Social Security system produce more accurate assessments.  In these endeavors, he consulted with a United States Senator and the Office of the Inspector General to bring attention to this research in the Social Security system.  More recently, he consulted with the Swedish Social Security system to help bring about needed changes in assessment. His current research interests include the connection between factitious disorder and malingering and in the probability calculations you will see in this talk.

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