Detection of Inadequate Effort on Neuropsychological Testing: A Meta-Analytic Update and Extension

Abstract

The present meta-analysis provides the first meta-analysis of research on stand-alone neurocognitive feigning tests since publication of the preceding paper by Vickery, Berry, Inman, Harris & Orey (2001). Studies of dedicated neurocognitive feigning test performances in adults appearing in published or unpublished (theses and dissertations) sources through October 2010 were reviewed and subjected to stringent inclusion criteria to maximize the validity of results. Neurocognitive feigning tests were included only if at least three contrasts of criterion-supported honest patient groups and feigners were available. Tests that met criteria for review included the Victoria Symptom Validity Test, used as an anchor to compare Vickery and colleagues' results; Test of Memory Malingering, Word Memory Test, Letter Memory Test, and Medical Symptom Validity Test. Effect sizes and test parameters at published cut scores were compiled and compared. Results reflected large effect sizes for all measures (mean d = 1.55, 95% confidence interval [CI] = 1.48-1.63). Mean specificity was 0.90 (95% CI = 0.85-0.94). Mean sensitivity was 0.69 (95% CI = 0.63-0.75). Several moderators of effect size were identified, with certain manipulations resulting in a weakening of effect size. Unexpectedly, warning simulators to feign believably increased effect sizes.

The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans

“…36 A recent meta-analysis showed LMT efficacy in differentiating feigned and honest responders to be comparable to the Word Memory Test (WMT), the Digit Memory Test (DMT), and the Test of Memory Malingering (TOMM). 37 Using the optimal cut-rate of 93%, the LMT has moderate sensitivity (70.2%) and high specificity (93%) to detect feigning. 37 The participants also were administered the Miller Forensic Assessment of Symptoms Test (M-FAST), a 25-item structured interview designed to screen for invalid psychiatric symptoms.…”

“…37 Using the optimal cut-rate of 93%, the LMT has moderate sensitivity (70.2%) and high specificity (93%) to detect feigning. 37 The participants also were administered the Miller Forensic Assessment of Symptoms Test (M-FAST), a 25-item structured interview designed to screen for invalid psychiatric symptoms. 38 All participants also completed the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF).…”

1741 – Social cognition in a case of amnesia with neurodevelopmental mechanisms

“…As ML was quite deficient in memory recall of new material in general, these test outcomes cannot be interpreted as providing evidence for feigning or malingering (Sollman and Berry, 2011).…”

Neuroimaging as a biomarker in symptom validity and performance validity testing

“…3 is whether the Bfailed^SVT/PVT performance has any bearing on the neuropsychological test results and should they be interpreted? Incontrovertible findings at a group level consistently show significantly reduced neuropsychological test results in the group that Bfails^the SVT/PVT measure(s) compared to the Bpass^group even controlling for other demographic and disease/injury variables (Sollman and Berry 2011;Sweet et al 2013). While group data may be informative, the real issue for the clinician is what decisions to make with the individual case.…”