ADHD

30 August 2010

Many fake ADHD just to get drugs

New research suggests there is a cluster of kids and adults who successfully fake the condition either to get drugs or gain special privileges in school.

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While attention-deficit hyperactivity disorder (ADHD) is a real and pervasive condition, new research suggests there is a cluster of kids and adults who successfully fake the condition either to get drugs or gain special privileges in school. 

"People who want to fake ADHD could be able to do a good job of faking on a number of standard clinical instruments that are used to diagnose ADHD," said David Berry, senior author of the report appearing in 1sychological Assessment.

Obviously, health-care professionals need to be concerned, he said, adding that "our evidence suggests [fakers] are pretty good at it if they want to be." 

"This goes on around the country," confirmed Dr Ana Campo, an associate professor of clinical psychiatry at the University of Miami Miller School of Medicine. "There's an overuse of stimulants around the country [among students] to get any competitive edge. There's blatant misuse. We need to be really careful when we're prescribing medications." 

Berry used the same test methodology that he had designed two decades ago to determine whether patients were claiming head trauma to collect money after accidents. 

"We were interested in whether people who were normal college students could fake ADHD," said Berry, a professor of psychology at the University of Kentucky, Lexington, who conducted the research with UK psychologist John Ranseen and graduate student Myriam Sollman.

The study

Seventy-three University of Kentucky students were split into two groups, one of which was instructed to respond honestly to questions on standard assessments of ADHD. The others were given five minutes to review easily accessible information from the Internet on the condition and told to do their best to fake it. Their incentive: $45 (about R360)  if they succeeded (in reality, all participants were given $45 at the end of the study). 

A third "control" group consisted of students legitimately diagnosed with ADHD who took the same test. 

"Almost nobody [in the fakers' group] failed the test," said Berry. 

"Drugs is the obvious [motivation], but there are others," he continued. "Most universities provide people who have a diagnosis of ADHD with a variety of things that vary from one institution to another - extra time on tests, copies of teachers' notes that they're lecturing from. They may get special accommodations in terms of where they're staying at the university, a single room versus a double room." 

They can also get prescriptions for stimulants that can help them focus, the researchers said.

Risky side-effects  

It's unclear how widespread the practice is, although Campo said her review of the literature had turned up prevalence rates of 8 to 35%. 

The problem, she said, "is that there's always the risk of side effects when taking these medications: increasing blood pressure, tachycardia [abnormal heartbeat], anxiety symptoms. If you use them illegally and are vulnerable, you could become dependent."

Berry advocates using additional anti-fraud screening - also called "malingering" tests - to sort out the ADHD frauds from the legitimate cases. (In medical terms, "malingering" means fabricating or exaggerating symptoms of physical or mental disorders for a variety of "secondary gains" motives, such as drugs, money, or even sympathy and attention.) 

"These should accompany the standard ADHD test," he said. "I think you can't use one without the other. You can't diagnose ADHD with the malingering test but you can't diagnose malingering with the ADHD test." (August 2010) 


(Copyright © 2010 HealthDay. All rights reserved.)

 

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Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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