A – 24 Beyond Continuous Performance Tasks: Eye Vergence as a Malingering-Resistant Measure of Attention-Deficit/Hyperactivity Disorder

Abstract Objective College students may feign ADHD symptoms to obtain stimulant prescriptions or academic accommodations. Research suggests 20–50% of college students seeking ADHD evaluations may exaggerate symptoms. Traditional performance validity tests (PVTs) demonstrate strong specificity but often lack sensitivity. This study examined the utility of a novel PVT detection tool, BGaze, an eye vergence task validated for ADHD diagnosis, to detect malingering among college students. Method Participants were 112 college students assigned to one of three groups: (1) typically developing controls without ADHD, (2) students with a childhood ADHD diagnosis, and (3) students without ADHD instructed to feign symptoms. All participants completed a self-report ADHD measure, continuous performance task (CPT), a PVT, and the BGaze task. Results A leave-one-subject-out classification using BGaze data achieved 97% accuracy in distinguishing ADHD from control participants. ROC curve analysis identified classification thresholds: scores 0.35 identified malingerers. When applied to the malingering group, BGaze effectively distinguished malingerers from both ADHD and control participants, demonstrating strong sensitivity and specificity. Conclusion These findings provide preliminary evidence that BGaze may differentiate individuals with ADHD, without ADHD, and those feigning symptoms. While other CPTs also assess attention and executive functioning, eye vergence tasks like BGaze may be uniquely suited to detecting malingering, as the eye movement patterns involved in cognitive effort are difficult to consciously control. As such, these tasks have implications for reducing stimulant misuse and optimizing clinical resources in college settings.