Identification Of Stimulant Misuse And Malingering Of Symptoms Of Attention Deficit Hyperactivity Disorder

It was estimated in 2013 that 54.3 million individuals reported overall lifetime prevalence of prescription drug abuse, and 16.7 million individuals reported misusing or abusing prescription drugs in the past year. This study focuses on the abuse of psychostimulants, popularly used for treatment of Attention Deficit Hyperactivity Disorder (ADHD). It is estimated that 10 to 30% of college students might be abusing stimulants, mostly for academic purposes. The incidence of stimulant related ER visits has nearly doubled in the last decade. It is also estimated that 10 to 50% of ADHD evaluations in a University setting might be exaggerated or malingered. This study, in three parts, explored the feasibility of identification of prescription stimulant abuse using large databases, developed a subtle behavioral self-reported scale, the Subtle ADHD Malingering Screener (SAMS), for use in the primary care setting to identify malingering among individuals reporting symptoms of ADHD, and compared the sensitivity of the SAMS to other existing scales. The first paper identified two latent classes in the stimulant user population based on risk factors for abuse identified from literature. The second paper developed a 10-item 2-factor screener instrument, the SAMS, with satisfactory reliability and factorial validity. The third paper calculated a cut-off score for the SAMS, and estimated a sensitivity of 90.3% and a specificity of 80.1% toward malingering of ADHD symptoms. This dissertation pursued innovative methods to help in the early identification of prescription stimulant abusers and malingerers, in order to reduce overdiagnosis of ADHD, and abuse of prescription stimulants.

Name thesis:degree_name

Ph.D. in Pharmaceutical Sciences

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Pharmacy Administration

Year dc:date.available

2017

Author dc:creator

• Ramachandran, Sujith

Contributors dc:contributor

• John P. Bentley
• John Young
• Meagen Rosenthal

• Latent Classes
• Malingering
• Prescription Stimulant Abuse
• Sams
• Subtle Scale
• Public Health

Repository record dc:identifier

https://egrove.olemiss.edu/etd/741

OAI identifier oai:identifier

oai:egrove.olemiss.edu:etd-1740