Cross-validation of indicators of malingering: a comparison of nine neuropsychological tests, four tests of malingering, and behavioral observations

Abstract

Few studies to date have cross-validated indicators of malingering that have been suggested on various neuropsychological tests. This study presents data cross-validating several indicators of malingering on neuropsychological tests, as well as on tests of malingering and via behavioral observations. It incorporates methodological recommendations by Rogers [Researching dissimulation. In: R. Rogers (Ed.), Clinical assessment of malingering and deception (pp. 309-327). New York: Guilford Press.] resulting in an ecologically valid design utilizing college students with a history of mild head injury as analog malingerers. Results indicated that the Letter Memory Test (LMT) and the Digit Memory Test (DMT) attained the highest hit rates for the detection of malingering, while the sensitivity of many other measures declined on cross-validation.

Sensitivity and Specificity of Reliable Digit Span in Malingered Pain-Related Disability

“…Even moderate to severe TBI scores of 6 or lower were associated with a specificity of .99. These results are consistent with the findings of Etherton et al (2005) based on their laboratory-induced pain study and with multiple reports of the performance of patients with TBI (e.g., Inman & Berry, 2002;Larrabee, 2003;Mathias et al, 2002;Meyers & Volbrecht, 1998;Strauss et al, 2002). It is worth mentioning that in all studies except Etherton et al (2005), digit span was administered as part of the WAIS so it is possible that these results may not generalize to the administration of digit span in isolation.…”

“…RDS is calculated by summing the longest forward and backward digit strings for which both trials were completed without error. Although there is some variability in the literature, RDS scores of 7 or less have generally been associated with specificity of greater than 90% in braininjured and healthy populations (e.g., Inman & Berry, 2002;Larrabee, 2003;Mathias et al, 2002;Meyers & Volbrecht, 1998;Strauss et al, 2002). At this cutoff, sensitivity higher than 50% to both simulated and clinically diagnosed malingering has been reported (Larrabee, 2003;Mathias et al, 2002;Strauss et al, 2002).…”

Psychological Symptoms and Rates of Performance Validity Improve Following Trauma-Focused Treatment in Veterans with PTSD and History of Mild-to-Moderate TBI

“…These measures have been widely used to detect poor performance validity in Veterans with TBI history (Flaherty, Spencer, Drag, Pangilinan, & Bieliauskas, 2015;Jak et al, 2015;Lippa, 2018, Whitney, Davis, Shepard, Bertram, & Adams, 2009Young et al, 2016) and have shown adequate sensitivity, specificity (false positive rates <10%), and positive predictive power (Denning, 2012(Denning, , 2014Fazio, Denning, & Denney, 2017;Haber & Fichtenberg, 2006;Kulas, Axelrod, & Rinaldi, 2014;Schwartz et al, 2016;Spencer et al, 2013;Tombaugh, 1997;Young, Sawyer, Roper, & Baughman, 2012). Furthermore, it has been recommended that failure of even one PVT should warrant consideration of performance invalidity, particularly for tests with adequate positive predictive power used in populations with relatively high base rates including individuals with remote history of mTBI (Denning, 2019;Inman & Berry, 2002;Iverson & Franzen, 1996;Lippa, 2018;Proto et al, 2014;Vickery et al, 2004).…”

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

“…This exploratory, retrospective study originated from the empirical observation that, during the assessment of homicide defendants, the SNAP validity scale results often complimented the findings from other evaluation methods and information sources regarding the presence or absence of malingering. Furthermore, research investigating clinical instruments for potential application in the assessment of malingering assessment too, as in this study, ultimately can lead to the development of more time-and cost-efficient forensic evaluation approaches (i.e., if single tests can be shown to serve both purposes; Inman & Berry, 2002).…”

“…Moreover, the importance of new tests being developed for malingering has been stressed over time due to concerns that the instruments may become less effective the more a population becomes familiar with them. That is, the more knowledge about the content and mechanics of a test that leaks out over time, the easier it becomes for enlightened test takers to deceive psychometricians (Hall & Hall, 2012b;Inman & Berry, 2002;Youngjohn, 1995). This concern has some parallels with the Flynn effect, which refers to the increase over time in IQ scores for a particular test (Neisser, 1997).…”