A New Subscale for the Personality Assessment Inventory (PAI) to Screen Adults for Attention-Deficit/Hyperactivity Disorder (ADHD) Page: 57
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Performance Task (C-CPT-II) was included in the assessment than when self-report measures
were used alone (Sollman, Ranseen & Berry, 2010). The literature clearly supports the use of
continuous performance tests (CPTs) for ADHD diagnosis because they are less susceptible to
bias or faked symptomatology. Yet, some question the validity and reliability of CPTs for
ADHD diagnosis (Abikoff, Courtney, Pelham & Koplewicz, 1993; Christensen, Margolin &
Sullaway, 1992; See, Howe, Warm & Dember, 1995).
The aim of CPTs is to assess for executive functioning, inhibitory abilities, and attention
skills. There is evidence, however, to suggest that this is not the case (Demurie, Roeyers,
Wiersema & Songua-Barke, 2016). In 2004, Nichols and Waschbusch completed a literature
review of studies that utilized cognitive tasks to diagnose ADHD (Nichols & Waschbusch,
2004). In their review, the authors analyzed the convergent validity, discriminant validity, and
predictive validity of popular CPTs. They asserted that, despite the high levels of acceptance and
use, CPT task validity is extremely mixed for eventual diagnosis of ADHD. Across the literature
reviewed, the authors concluded that CPTs could only successfully and consistently discriminate
between ADHD and typical control groups. CPTs could not successfully discriminate between
ADHD groups and comparison groups with other mental health diagnoses such as depression
and anxiety (Nichols & Waschbusch, 2004). Moreover, discriminant validity between ADHD
and non-ADHD groups was even worse when ADHD groups were allowed to have taken their
stimulant medication before testing (Nichols & Waschbusch, 2004). Poor validity could also be
due to most CPT's being boring, not challenging enough to require much cognitive processing,
and too long (Lufi & Pan, 2015).
Finally, a retrospective account of symptomatology is necessary when assessing the adult
population for ADHD. Retrospective accounts of behavior are necessary for ADHD diagnosis57
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Calmenson, Nina E. A New Subscale for the Personality Assessment Inventory (PAI) to Screen Adults for Attention-Deficit/Hyperactivity Disorder (ADHD), dissertation, August 2021; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc1833444/m1/65/: accessed July 17, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .