Analyses suggest good criterion validity for the MAST in differentiating communication impairments among clinical and control samples.

Thirty-two studies of commonly researched neuropsychological malingering tests were meta-analytically reviewed to evaluate their effectiveness in discriminating between honest responders and dissimulators. Overall, studies using the Digit Memory Test (DMT), Portland Digit Recognition Test (PDRT), 15-Item Test, 21-Item Test, and the Dot Counting Test had average effect sizes indicating that dissimulators obtain scores that are approximately 1.1 standard deviations below those of honest responders. The DMT separated the means of groups of honest and dissimulating responders by approximately 2 standard deviations, whereas the 21-Item Test and the PDRT separated the groups by nearly 1.5 and 1.25 standard deviations, respectively. The 15-Item Test and the Dot Counting Test were less effective, separating group means by approximately 3/4 of a standard deviation. Although the DMT, PDRT, 15-, and 21-Item Tests all demonstrated very high specificity rates, at the level of individual classification, the DMT had the highest sensitivity and overall hit-rate parameters. The PDRT and 15-Item Test demonstrated moderate sensitivity, whereas the 21-Item Test demonstrated poor sensitivity. The less than perfect sensitivities of all the measures included in this review argue against their use in isolation as malingering screening devices.

These results suggest that intra-personal variables, such as self-concept and depression, impact the perceived QoL of the ABI survivor. Future research exploring the mediating effects of these variables on QoL may clarify this relationship and may aid in developing more effective interventions for these individuals.

The authors report on results from a new procedure for evaluating adequacy of effort given during neuropsychological testing. The letter memory test (LMT) is a computer-administered, 45-item, forced-choice recognition task that uses consonant letters as stimuli and manipulates face difficulty level along 2 dimensions: number of letters to be remembered and number of choices amongst which the target stimulus must be identified. In 3 studies that included either analogue or known groups designs, the LMT discriminated poorly motivated from well-motivated groups at a moderately high level of accuracy, which was comparable to that of the Digit Memory Test and superior to that of the 21-Item Test. The internal consistency reliability of the LMT was also high.Neuropsychological testing has developed primarily in medical settings where patient care is the main focus of attention. In

The non-verbal VASES appears to be minimally impacted by potentially invalidating patient factors (e.g. visual acuity, left visual neglect), although its use with patients with severe communication deficits is cautioned. The VASES may prove useful in identifying acute stroke survivors most at risk for emotional dysfunction, and may be useful as a research tool in this population.