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Revista Brasileira de Psiquiatria (Sao... May 2023To identify under what circumstances a university student should be allowed academic accommodation for ADHD. To frame an evidence-based policy for use in Brazil based on...
OBJECTIVE
To identify under what circumstances a university student should be allowed academic accommodation for ADHD. To frame an evidence-based policy for use in Brazil based on a worldwide experience.
METHODS
We reviewed the literature to acquire information on what documents are commonly required by disability services before accommodation for ADHD is made (including malingering detection). We scrutinized the eligibility criteria of the best universities worldwide. Renowned experts in the field and national stakeholders were consulted.
RESULTS
We found no international standard for the assessment of students with ADHD who request academic accommodation. Even renowned institutions worldwide differ from one another in their approaches to academic accommodation on the grounds of ADHD. We propose a national unified set of criteria for Brazilian universities, which could generalize internationally.
DISCUSSION
Rigorous assessment is paramount for aiding students with disabilities while preventing ineligible students gaining an unfair advantage. Higher education institutions nationwide and beyond may benefit from adopting a unified set of criteria for eligibility to ADHD accommodation programs.
PubMed: 37127329
DOI: 10.47626/1516-4446-2022-2999 -
PCN Reports : Psychiatry and Clinical... Jun 2023In general clinical psychiatric practice, open questions are favored over closed ones because they are considered more therapeutically effective and less likely to make...
BACKGROUND
In general clinical psychiatric practice, open questions are favored over closed ones because they are considered more therapeutically effective and less likely to make the patients pander to us. However, in forensic psychiatric examinations, suspects may attempt malingering.
CASE PRESENTATION
Using a simple examination based on a forced-choice technique, the author proved that the level of intelligence of a theft suspect pretending to have an intellectual developmental disorder was not so low. The author prepared two sets consisting of a few coins each and asked the suspect to choose which set had a higher total value. The suspect was questioned repeatedly over multiple trials. He always selected the wrong set over the course of more than 10 trials.
CONCLUSION
If the suspect really did not know the correct answer, the probability of getting the answer right or wrong in a binary choice question is 50% for both. The probability of answering the question wrong by chance 10 times in a row is (1/2), in other words, about 0.1%. It was evident that the suspect intentionally kept answering incorrectly. When suspects who pretend to have an intellectual developmental disorder answer only "I do not know" to all questions without actively playing out the symptoms, it is difficult to demonstrate that the symptoms are psychiatrically conflicting and prove that they are malingering. Even in such cases, this type of test based on a forced-choice technique can be used to prove that suspects are behaving falsely.
PubMed: 38868139
DOI: 10.1002/pcn5.87 -
Ugeskrift For Laeger Mar 2023This is a case report of a woman with a long history of schizophrenia. She suddenly "confessed" that she had been feigning symptoms all along. Taken at face value, this...
This is a case report of a woman with a long history of schizophrenia. She suddenly "confessed" that she had been feigning symptoms all along. Taken at face value, this statement caused a delay in antipsychotic treatment followed by a serious deterioration of the patient's mental state. It became clear over time that several components of the patient's experience of lying were delusional in nature. The diagnosis of schizophrenia was once again validated and antipsychotic treatment resumed. Doctors are advised to be very careful when basing clinical decisions upon suspicion of malingering.
Topics: Female; Humans; Antipsychotic Agents; Malingering; Schizophrenia; Psychiatry
PubMed: 36999298
DOI: No ID Found -
International Journal of Environmental... Feb 2023The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer...
The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery to 57 adults with ADHD, 60 neurotypical controls, and 151 instructed simulators, we examined each test's utility in detecting noncredible performance. Cut-off scores were derived for all available outcome variables. Although all ensured at least 90% specificity in the ADHD Group, sensitivity differed significantly between tests, ranging from 0% to 64.9%. Tests of selective attention, vigilance, and inhibition were most useful in detecting the instructed simulation of adult ADHD, whereas figural fluency and task switching lacked sensitivity. Five or more test variables demonstrating results in the second to fourth percentile were rare among cases of genuine adult ADHD but identified approximately 58% of instructed simulators.
Topics: Adult; Humans; Attention Deficit Disorder with Hyperactivity; Malingering; Neuropsychological Tests; Wakefulness; Mentoring; Reproducibility of Results
PubMed: 36901080
DOI: 10.3390/ijerph20054070 -
Topics in Cognitive Science Feb 2023Amnesia is a frequent claim in major crimes, and it is estimated that the complete or partial absence of memory following a crime ranges from 25% to 50% of total cases....
Amnesia is a frequent claim in major crimes, and it is estimated that the complete or partial absence of memory following a crime ranges from 25% to 50% of total cases. Although some cases may constitute a genuine form of amnesia, due to organic-neurological defects or psychological causes, and possibly combined with a dissociative or repressive coping style after an extreme experience, malingering is still fairly common in offenders. Therefore, one of the main goals in medico-legal proceedings is to find methods to determine the credibility of crime-related amnesia. At present, a number of lie and memory detection techniques can assist the forensic assessment of the reliability of declarative proof, and have been devised and improved over the past century: for example, modern polygraphs, event-related potentials, thermal imaging, functional magnetic resonance imaging, kinematic, and facial analysis. Other ad hoc psychological tests, such as the so-called Symptom Validity Test (SVT) and Performance Validity Test (PVT), as well as the autobiographical Implicit Association Test (aIAT), can also be used. To date, however, there is little evidence or case reports that document their real usefulness in forensic practice. Here, we report two cases of crime-related amnesia, whereby both defendants, who were found guilty of homicide, appeared to exhibit dissociative amnesia but where the application of SVTs, PVTs, and aIAT detected a malingered amnesia.
PubMed: 36855315
DOI: 10.1111/tops.12643 -
Cureus Jan 2023We report a case of a 41-year-old male diagnosed with pulmonary coccidioidomycosis and pulmonary embolism (PE) based on a point-of-care ultrasound (POCUS) finding who...
We report a case of a 41-year-old male diagnosed with pulmonary coccidioidomycosis and pulmonary embolism (PE) based on a point-of-care ultrasound (POCUS) finding who was suspected to be malingering for right-sided chest pain considering his psychiatric history. POCUS was performed and showed right ventricular strain with a D-shaped left ventricle and B-lines with subpleural consolidations, and PE was confirmed with computed tomography pulmonary angiography. No other risk factors for PE were found except for coccidioidomycosis. The patient was treated with apixaban and fluconazole and discharged in stable condition. We discuss the usefulness of POCUS in diagnosing PE and the very rare association between coccidioidomycosis and PE.
PubMed: 36843761
DOI: 10.7759/cureus.34288 -
Cureus Jan 2023Background Currently, there are no tests that have been proven to be capable of rating an individual's grip force measurement as sincere or insincere. However, different...
Background Currently, there are no tests that have been proven to be capable of rating an individual's grip force measurement as sincere or insincere. However, different parameters have been found to vary in grip force testing for maximal versus submaximal effort. A novel data analysis and processing approach might be key to improving these measurements. This study explores the use of a machine learning (ML) algorithm as a means to more accurately determine the sincerity or insincerity of grip force testing. The ML algorithm compares the hand's load distribution pattern with the information generated using conventional statistical methods. Methodology This study uses manugraphy data collected as part of a previous investigation that analyzed load distribution patterns of the right and left hands of 54 healthy subjects. The subjects underwent grip force testing using maximal or submaximal effort, and the percentage contributions of each of the seven defined anatomical areas of the hand were calculated with respect to the total load applied. The predictions based on the load distribution and its use for rating individual grip force measurements as sincere or insincere were compared with the results of conventional statistical methods (thresholds for a bi-manual area-to-area comparison) and an ML algorithm. Results Based on an area-to-area comparison, our method achieved a sensitivity of 54% and a specificity of 78% to detect insincere effort. A predictive ML model developed using these data was capable of recognizing submaximal effort based on the hand's load distribution pattern, determining a sensitivity of 94% and a specificity of 99%. Conclusions Compared to conventional methods, the use of an ML algorithm considerably improved the validity of manugraphy results in discerning the sincerity or insincerity of grip effort.
PubMed: 36819383
DOI: 10.7759/cureus.33837 -
Ultrasound in Obstetrics & Gynecology :... Feb 2023
Topics: Humans; Female; Pregnancy; Fetus; Prenatal Care
PubMed: 36722431
DOI: 10.1002/uog.26129