The Use of Significant Others to Enhance the Detection of Malingerers From Traumatically Brain-Injured Patients

Abstract

Cognitive and neurobehavioral symptoms are common following traumatic brain injuries (TBIs). Because malingerers are likely to complain of such symptoms and perform poorly on neuropsychological tests, clinicians may have considerable difficulty distinguishing malingerers from TBI patients. In this study, we compared the subjective complaints of malingerers to TBI patients and then compared both groups to the problems observed by their respective significant others. We tested the assumption whether significant others could add one more piece to the challenging puzzle of diagnosing malingering. Our results demonstrated that the malingerers complained of more problems than patients who had sustained moderate or severe TBI. However, the significant others of the malingerers observed fewer cognitive, emotional-behavioral, and total problems than did the significant others of patients with severe, moderate, and even mild TBI. These findings suggest that the detection of malingering can be enhanced by interviews with significant others.

Are the subjective complaints of traumatically brain injured patients reliable?

“…However, it appears that the evaluation of cognitive, behavioural and emotional problems is more challenging, and the data suggests that it is advantageous to interview significant others in addition to the patients. It would be a mistake to conclude, since the som atic symptoms are more reliable, that they are more`real' [22]. Even in normal populations, it is easier for individuals to complain of som atic problems than to self-disclose emotional or cognitive weaknesses [ 23± 25].…”

The Little Black Book of Neuropsychology

“…Collateral interviews can help an examiner review the consistency of the examinee's symptoms and history with other's observations of the examinee (Sbordonne et al 2000). Consistency or discrepancy are important factors in determining the reliability (and veracity) of self-reported symptoms.…”

Handbook of Complex Occupational Disability Claims

“…It is unfortunate that the invisible nature of MTBI just as often results in the individual being accused of malingering (Hilsabeck & Irby, 1999;Langeluddecke & Lucas, 2003;Sbordone, Seyranian & Ruff, 2000) as of "just" having premorbid psychological problems that are unrelated to traumatic injury. Undoubtedly, some people who have incurred MTBI are malingering in order to make financial or emotional secondary gains.…”