Multiple measures of malingering on a forced-choice test of cognitive ability.

Abstract

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,

The Rey AVLT Serial Position Effect: A Useful Indicator of Symptom Exaggeration?

“…Those in the SC group were asked to believably feign cognitive impairment during the assessment in an attempt to obtain imaginal financial compensation, and were given instructions describing typical symptomatology associated with mild TBI (e.g., memory problems). Those in the TC simulation group were instructed to feign cognitive impairment during the assessment in an attempt to obtain imaginal financial compensation, and were given instructions describing effective test-taking strategies that would help them avoid detection (see test-coaching used by Frederick & Foster, 1991). The specific instructions for the three groups are available from the first author.…”

Motivation and Neuropsychological Test Performance Following Mild Head Injury

“…Various versions of the PDRT (Binder, 1993;Binder & Willis, 1991;Greiffenstein et al, 1994;Rose, Hall, & Szalda-Petree, 1995) and the Hiscock procedure (Guilmette, Hart, & Giuliano, 1993;Hiscock & Hiscock, 1989;Martin, Bolter, Todd, Gouvier, & Niccolls, 1993;Prigatano & Amin, 1993;Slick, Hopp, Strauss, Hunter, & Pinch, 1994) have been repeatedly validated with encouraging results. Studies employing a variety of forced-choice procedures have also found that the majority of malingerers do not obtain scores significantly below chance (Binder & Willis, 1991;Frederick & Foster, 1991;Guilmette et al, 1993;Martin et al, 1993;Slick et al, 1994) and have provided cutoff scores for assessment of motivation.…”

Detecting feigned neuropsychological impairment with the Seashore Rhythm Test

“…Additionally, we did not provide our sophisticated simulating subjects with specific test-taking strategies to avoid detection. Provision of such information, as has been done by some investigators (Frederick & Foster, 1991;Martin, Bolter, Todd, & Gouvier, 1992), may have produced different results.…”