Search

The current study investigated neuropsychologists' beliefs and practices with respect to assessing effort and malingering by surveying a sample of NAN professional members and fellows (n=712). The results from 188 (26.4%) returned surveys indicated that 57% of respondents frequently included measures of effort when conducting a neuropsychological evaluation. While a majority of respondents (52%) rarely or never provide a warning that effort indicators will be administered, 27% of respondents often or always provide such a warning. The five most frequently used measures of effort or response bias were the Test of Memory Malingering (TOMM), MMPI-2 F-K ratio, MMPI-2 FBS, Rey 15-item test, and the California Verbal Learning Test. However, the TOMM, Validity Indicator Profile, Word Memory Test, Victoria Symptom Validity Test, and the Computerized Assessment of Response Bias were rated as most accurate for detecting suboptimal effort. These results and other findings are presented and discussed.

The WAIS-III Digit Span and Vocabulary subtests were investigated as indicators of feigned cognitive impairment. Participants included 64 undergraduates randomly assigned to control, symptom-coached, or test-coached groups. Six previously researched validity indicators were examined. We hypothesized that symptom-coached participants would perform worse relative to test-coached simulators. Analyses determined both simulator groups performed lower than controls on all indicators except Vocabulary. Symptom-coached participants, however, did not differ from test-coached participants on any indicator. Classification accuracies for these six indicators ranged from 42 to 78%. While the WAIS-III validity indicators hold some promise, they should not be employed as independent measures.

This investigation explored the usefulness of serial position patterns during word recall on the Rey Auditory Verbal Learning Test (RAVLT; Rey, 1964) as an indicator of poor effort. Significantly better recall for early (primacy) and recent (recency) material defines the serial position effect (SPE; Rundus, 1971). The SPE on the RAVLT was examined in four groups: normal controls (NC), symptom-coached simulators (SC), test-coached simulators (TC), and a group of moderate to severe subacute traumatic brain injury (TBI) patients. Normal control participants and TBI patients demonstrated the expected SPE. Only the SC simulators clearly suppressed the primacy effect. The SPE appears neither sensitive nor specific enough to be used independently of more sensitive symptom validity tests in the detection of suboptimal effort. It may be especially problematic when used with clients presenting with sophisticated styles of exaggeration and in settings with lower base rates of compromised effort.

The ability of the Test of Memory Malingering (TOMM; Tombaugh, 1996) to detect feigned-memory impairment was explored. The TOMM was administered to three groups: (a) a control group instructed to perform optimally, (b) a symptom-coached group instructed to feign memory problems after being educated about traumatic brain injury symptomatology, and (c) a test-coached group instructed to feign memory problems after being educated about test-taking strategies to avoid detection. The recommended cutoff scores (Tombaugh, 1996) on Trial 2 and the Retention Trial produced overall classification accuracy rates of 96%, with high levels of sensitivity and specificity. Although the symptom-coached group performed more poorly on the TOMM relative to the test-coached group, the test was equally sensitive in detecting suboptimal effort across the different coaching paradigms.

Objective: Research consistently shows how easily students can feign symptoms of ADHD on self-report checklists to determine eligibility for curricular and standardized testing accommodations. However, it is unclear how easily students can feign psychological symptoms to accesses academic accommodations, making the assessment of symptom validity important in both populations.Method: Using a between-subjects design, 75 college students were randomly assigned to one of three groups: (1) coached feigning of ADHD, (2) coached feigning of depression and anxiety (DA), and (3) honest responding (HR). Participants completed the Depression, Anxiety, and Stress Scale (DASS-21) and the Structured Inventory of Malingered Symptomatology (SIMS).Results: The SIMS showed 100% specificity, but low sensitivity (36-52%) for detecting feigned symptoms with different cutoffs. Differences on SIMS subtests were apparent by group with elevated scores for the DA group on the Affective Disorders subscale and elevation for the ADHD group on the Low Intelligence and Amnestic subscales. Participants identified as feigning by the SIMS typically reported more severe symptoms than participants not identified on the DASS-21.Conclusions: The SIMS equally classified the feigned ADHD and DA participants for both cutoff scores utilized. Potential reasons for low sensitivity rates are discussed and future research recommendations are made. [ABSTRACT FROM AUTHOR]