This article describes how a 2-alternative, forced-choice response technique was applied to a nonverbal test of cognition in order to generate measures of noncompliance and serve as a means to detect malingering. Three studies were conducted. Study 1 used a 2-alternative, forced-choice test format comprising 100 nonverbal test items of a hierarchy of difficulty presented in a random order. In a simulation study, a combination of decision rules regarding (a) performance curves slope; (b) a measure of response consistency ("consistency ratio"); and (c) the product of the slope and consistency ratio resulted in high discriminability among the test results of normal and cognitively impaired controls and simulating malingerers. A replication, Study 2, yielded similar findings. Study 3 demonstrated the robustness of these decision rules. Most subjects (73%) who simulated malingering after receiving accurate information on how to avoid detection were still classified as malingerers.Psychologists currently have no established objective methods of detecting malingering on the most commonly used instruments of cognitive, intellectual, or neuropsychological ability. The expanded use of such tests in both criminal and civil forensic evaluations increases the likelihood of impaired performances for secondary gain and necessitates the development of indicators of response validity (Bash & Alpert, 1980;Hiscock & Hiscock, 1989). This article describes how a test of cognitive ability was altered so that it could yield quantitative measures of noncompliance.Studies of clinical detection of malingering on cognitive tests are not encouraging. Patients are able to produce realistic findings of impairment on neuropsychological tests (Mensch & Woods, 1986), whereas clinicians are generally unable to detect malingered performance at better than chance levels (Faust,
Human studies of the link between serum cholesterol and aggression have yielded equivocal results. Depending on the type of aggression studied (e.g., criminal violence or Type A hostility), investigators have found either a negative or a positive association between cholesterol and aggressive behavior. We conducted a retrospective analysis of aggressive incidents in a sample of hospitalized male forensic patients. The whole sample had lower cholesterol levels than the general population. Patients with low cholesterol levels (< 200 mg/dl) engaged in more frequent aggressive behavior but showed no difference in severity of aggression. They also showed no difference in verbal vs physical aggression. The relationship between cholesterol and frequency of aggression was curvilinear, with the most frequent acts of aggression committed by patients with moderately low cholesterol levels. Current research findings regarding the cholesterol-aggression association suggest the need for further clarification of the behavioral parameters under investigation.
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