Thirty-nine head-injured outpatients were compared with 39 age-matched subjects who were instructed to malinger head trauma symptoms on the Wechsler Memory Scale-Revised (WMS-R) and Wechsler Adult Intelligence Scale-Revised. Head-injured patients were selected who were not involved in litigation or pursuing a Worker's Compensation claim. Groups did not differ significantly on IQs or memory indexes. Discriminant function analyses based on the WMS-R subtests and indexes were able to accurately classify 91% and 83% of the cases, respectively. Decision rules were cross-validated on published data from several independent studies and statistically by means of the jackknife procedure. Head-injured patients appear to show a pattern of WMS-R scores that can be discriminated from the profile produced by individuals who attempt to malinger head trauma symptoms.

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Examination of the relationship between self-reported psychological symptoms (e.g., depression and anxiety) and cognitive tests assumes individuals are highly motivated to both openly disclose psychological symptoms and to extend best-effort on cognitive tests. Situations that change this ideal motivational state on either self-report questionnaires or cognitive tests attenuate the validity of this assumption. To illustrate this problem, this study examined the emotional-cognitive correlation in a clinical series of 136 cardiac patients undergoing psychosocial and cognitive evaluation as part of a standard protocol for entry into a cardiac transplant program. The evaluative nature of the psychosocial assessment motivates some candidates to respond in a defensive manner, thereby decreasing the validity of self-report psychological measures. This same situation likely promotes high performance motivation on cognitive tests. It was hypothesized that a defensive response set on the Minnesota Multiphasic Personality Inventory (MMPI), as measured by the F-K (Frequency-Correction) Gough Dissimulation Index, would attenuate the strength of the emotional-cognitive relationship. Cognitive factor scores were generated and correlated with the MMPI state clinical scales (i.e., scales 2, 7, and 8) for both nondefensive and defensive ( F-K ≥ −15) groups. Results show increased emotional distress was reliably associated with decreased cognitive functioning ( rs = −.22 to −.27) among the nondefensive group, but was unrelated in the defensive group. The importance of considering the influence of performance contingencies within research and clinical settings is discussed.

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