Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Pharmaceutical Sciences


Pharmacy Administration

First Advisor

John P. Bentley

Second Advisor

John Young

Third Advisor

Meagen Rosenthal

Relational Format



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.


Emphasis: Pharmacy Administration

Included in

Public Health Commons



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