Determination of Effort Level, Exaggeration, and Malingering in Neurocognitive Assessment

Abstract

Depending on the neurocognitive test performances(s) evidencing suboptimal effort or complaints that may be questionable, it is recommended that at least 2 of the above-listed measures be employed for proper assessment of effort level.

Frequency and Detection of Malingering in Homicide Defendants Undergoing Criminal Responsibility Evaluations Using the Schedule for Nonadaptive and Adaptive Personality

“…Having more instruments in the field lessens the potential threat from coaching (by defense lawyers, legally savvy inmates, etc. ), self-study of mental illness symptoms, and other negative external influences (e.g., Internet instruction on test-taking strategies) on the reliability of psychometric assessment outcomes (Hall & Hall, 2012b;Larrabee, 2008;Lynch, 2004). In summary, we believe further investigative efforts examining the feasibility of the SNAP for assessing malingering in forensic populations are warranted.…”

“…Thus, psychometric testing merely allows for inferences, and not conclusions, to be drawn about the traits and abilities of a specific individual (Cassel, 1969;Tyson, 1979). Only after a comprehensive assessment of all relevant data has been completed and other possible explanations have been confidently ruled out (e.g., genuine pathology, unconscious motivation, medical disorders, clinician countertransference), should a diagnosis of malingering be made (Dean, Victor, Boone, Philpott, & Hess, 2008;Drob, Meehan, & Waxman, 2009;Hall & Hall, 2012a;Lee, Loring, & Martin, 1992;Lynch, 2004).…”

“…In correctional populations, for instance, inmates often have abundant free time to interact, and those with the knowledge or experience may take the opportunity to coach others about how to successfully deceive on psychometric testing. Having multiple measures and strategies for the detection of malingering helps to cast a wider net to uncover it, increases the likelihood of correctly identifying it when it occurs, and reduces the likelihood that those with the intention to deceive during assessment will be successful (Larrabee, 2008;Lynch, 2004). For example, Larrabee's (2008) study, which manipulated multiple conditions, determined the probability of detecting malingering based on one symptom validity test was 35.7% to 97.8%, with two was 73.5% to 99.6%, and with three was 93.3% to 99.9%.…”

Call for an Integrative and Multi-Disciplinary Approach to Traumatic Brain Injury (TBI)

“…Several effort level measures have been cross-validation in TBI that include Computerized Assessment of Response Bias (Allen, Conder, Green, & Cox, 1997), Rey Dot Counting Test (translated by Corwin & Bylsma, 1993), Test of Memory Malingering (Tombaugh, 1996), Rey 15-Item Test (Rey, 1964), Victoria Symptom Validity Test (Slick, Hopp, Strauss, & Spellacy, 1996), and Word Memory Test (Green, Allen, & Astner, 1996) and it is recommended that at least two of these measures be used in assessing effort level (Lynch, 2004). …”

“…Effort, a clear mediator of neuropsychological performance, is difficult to control and accounts for more of the variance in performance that trauma severity (Green, Rohling, Lees-Haley, & Allen, 2001). Discrepant performance within and between assessment measures need to be evaluated for possible signs of reduced effort and at least two tests of malingering need to be included in an evaluation (Lynch, 2004). Third, racial and cultural biases need to be considered in evaluating the results of neuropsychological testing.…”