Elsevier

Clinical Psychology Review

Feigning neuropsychological impairment: A disquisitional review of methodological and clinical considerations

Abstruse

Despite a burgeoning literature on malingering, clinicians accept few assessment tools for the accurate classification of those persons feigning cognitive and neuropsychological deficits. Nosotros examine problems inherent in the validation of these assessment measures. Nosotros identify and talk over 6 potential strategies for the detection of feigned neuropsychological deficits: (a) floor effect, (b) symptom validity testing (SVT), (c) performance curve, (d) magnitude of mistake, (e) atypical presentation, and (f) psychological sequelae. In light of the available inquiry, nosotros critically review specific methods which incorporate these strategies. We found that Rey'due south 15-Item Memory Test, every bit a measure of floor upshot, had very low sensitivity rates. We also found considerable variability in SVT methods; a computerized version of SVT (Pritchard & Moses, 1991) that measured auditory, visual, and retentiveness abilities had a satisfactory sensitivity of 67%. Overall, strategies that employed functioning curves appeared to have the greatest hope in identifying potential malingerers. The remaining 3 detection strategies have not been adequately tested.

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      In the case of FASD, malingering measures should include those that appraise exam attempt to address the possibility of fabricated cognitive impairments as well as instruments that accost exaggerated or fabricated psychopathology. Not only should the measures selected address the presumed harm(s) at issue (e.g., a simple test of memory recognition if memory damage is at outcome), detection measures should correspond different choice strategies, such as detection by excessive impairment and detection by unexpected patterns (Rogers, Harrell, & Liff, 1993). Examples of the former are failure on very easy items or scores below chance on forced-choice measures.

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