Are screening tests accurate?

I've had ADHD symptoms ever since I was a kid, but it mainly manifested as depression. At 15 I was diagnosed with ADHD, but refused to accept it and didn't seek help for the next 10 years.

Long story short, I'm back in study and failing hard because I can't get my work done. My psychiatrist sent me off for an assessment with a neuropsychologist. Basically, I was given three small tests to test my memory and attention. After half an hour and completing the tests, I was told not to bother with advanced ADHD screening because I could focus my attention for a whole thirty seconds.

Are the small, preliminary tests accurate at all? Or should I push for more tests? Whatever is going on isn't just depression and I can't deal with it any longer.

Honestly, I don't know. I would want to have the most thorough evaluation as possible, if not to diagnose, then to rule out alternatives.

When I saw a neuropsychologist for my screening, it was a full 5-6 hours of testing. I personally don't believe in those quick screeners because there are so many components to ADHD. For instance, ADHD can impact working memory and visual-spatial reasoning. There are specific tests that can identify deficits in those areas. Basically what I am trying to say is there are tests that can screen for deficits in different areas which combined, might point towards an ADHD diagnosis. The results of a few tests are hardly conclusive.

What type of test did he use that determined you could focus your "attention for a whole thirty seconds?"

Not sure what they're called, but basically I was given a short list of words and four pictures. I had to match the words to the pictures. The second test was just copying basic printed patterns using red and white blocks.

I would have thought they would have been more aimed at detecting memory or learning problems, not focus?

It sounds like the test was very incomplete. I aced the block test and I have ADHD. There needs to be more parts for the test to be valid.

An ADHD screening to go through to the bigger test, is often a self report test. That is how I qualified to a bigger test. My self report test was quite extensive and asked things on very many levels.

They cannot just take 3 random tests in the WAIS package and judge from that, that is ridiculous. Actually, only WAIS cannot in itself tell you if you have ADD/ADHD, it has to be completed with an interview and usually a computerized test as well.

I had a 4-6 hour eval (they tested everything!) by a psychologist and in the end they concluded that I have schizoaffective disorder. My Psychiatrist in the end didn't agree and diagnosed me with ADD and Bipolar (I already had the bipolar diagnosis before the eval). So in my opinion, and I'm no doctor, I don't think those test work... at least not for me anyways.

samj40:

I went through a very long, detailed, and time-consuming survey administered by a competent Psychiatrist to diagnose ADD. The survey gave more than enough evidence that I have ADD. It was years before I could fully accept that I had the disorder, but my daily experience, and psychotherapy, gave me the additional proof that I needed.

If I were you, I'd take the additional time and effort to wade through any surveys available to you to be convinced. After that, I'd get an experienced therapist, and go through all the drug combinations necessary to get relief, while seeing your therapist for as long as you need to.

I found ADD a very difficult condition to treat effectively, but going through it is better than doing nothing. Once you are an adult, I don't think it gets any better on its own.

Good luck with this. I know your pain. We are not alone. Take Care.

JohnMike

"Screening" tests by definition aren't accurate. They're just to get a rough idea.

But putting aside the difference between a screening test and a full diagnostic exam, neuropsychological tests in general have limited usefulness for diagnosing ADHD. They're useful in "neurologically complicated" cases where you have a brain injury, might have a learning disability, etc. (If that were the case, I'd expect the psychologist to have screened for other possible problems, not just ADHD.) The valid way to diagnose ADHD is with a detailed patient interview with rating scales, symptom checklists, etc.

The fact that your psychiatrist sent you to get neuropsychological tests is a bit concerning. Psychiatrists should be able to diagnose ADHD themselves.

A lot of mental health professionals are wary of college students with ADHD symptoms because they're worried you are faking it for drugs. (Among unimpaired people, the meds can make persisting in tedious tasks less miserable, and some people believe they just plain make you smarter even though research has not backed up that idea. Other people want to use the meds to eat less/healthier, or for sports performance, or take large amounts to get high, or sell it illegally to one of those other people.) I guess they are hoping for something more objective than an interview, but it seems like it'd be just as easy, if not easier, to fake ADHD symptoms during the neuropsych tests. Hopefully you can find a professional who's more interested in helping people in need than keeping drugs away from people who want it but don't need it.