The Impact of Adverse Childhood Experiences on Symptom and Performance Validity Tests Among a Multiracial Sample Presenting for ADHD Evaluation.

This article investigates the relationship between adverse childhood experiences (ACEs) and validity test performance in adults undergoing neuropsychological evaluation for attention-deficit hyperactivity disorder (ADHD). In a diverse sample of 170 adults, those with high ACE exposure (≥4 ACEs) showed significantly higher rates of symptom validity test (SVT) elevations indicating possible over-reporting of ADHD, somatic, and psychopathological symptoms, particularly on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). However, no significant differences were found between high and low ACE groups in performance validity test (PVT) failures, suggesting ACEs do not affect objective cognitive test effort. The findings highlight the importance of considering ACE exposure when interpreting SVT results in ADHD evaluations to avoid misclassification and emphasize the need for further research to clarify whether elevated symptom reporting reflects genuine distress or exaggeration.