Objective Tests of Symptom Exaggeration in Independent Medical Examinations

Richman, Jack E.; Green, Paul; Gervais, Roger O.; Flaro, Lloyd; Merten, Thomas; Brockhaus, Robbi; Ranks, David

doi:10.1097/01.jom.0000183482.41957.c3

Cited by 60 publications

(42 citation statements)

References 10 publications

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“…However, this time they were asked to 'malinger', or purposely perform poorly on the test during the recall segment under fMRI conditions (Lee et al, 2002(Lee et al, , 2005. The specific instructions given to the subjects were those recommended as suggested by Richman et al (2006), in which subjects are told to imagine that they have been involved in a car accident in which they have sustained a serious head injury. Subjects were told to imagine that they had claimed to have serious memory impairment due to the accident, and that they would receive a large financial settlement if the test confirmed their claim.…”

Section: Administration Of the Fmri Word Memory Testmentioning

confidence: 99%

Functional Neuroimaging of Symptom Validity Testing in Traumatic Brain Injury

Allen

Goodrich-Hunsaker

et al. 2010

Psychol. Inj. and Law

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The Word Memory Test (WMT) is a commonly used symptom validity test (SVT) that assesses recognition verbal memory. The task has been adapted for use within a functional magnetic resonance imaging (fMRI) paradigm so the neural correlates of WMT activation patterns can be studied. In the current investigation, performance on the delayed recognition subtest of the WMT was examined in two patients who sustained severe TBI and compared to ten healthy controls. The patients underwent comprehensive neuropsychological evaluations and structural MRI. All participants completed two versions of the WMT: full-effort and simulated poor effort conditions. Despite extensive structural brain damage, the fMRI activation patterns during full-effort WMT performance were somewhat similar in the two TBI patients and likewise, somewhat similar to controls. The fMRI activation pattern in both patients demonstrated intact activation of the basic neural structures necessary to perform the WMT. Dissimilar patterns of activation were obtained during the simulated poor effort condition of WMT performance suggesting that fMRI techniques may be sensitive in demonstrating non-credible cognitive performance. The results of our study represent the first fMRI investigation of normal and simulated poor effort SVT performance in individuals with documented brain damage. The implications of fMRI techniques in SVT research and their clinical application are discussed.

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Section: Administration Of the Fmri Word Memory Testmentioning

confidence: 99%

Functional Neuroimaging of Symptom Validity Testing in Traumatic Brain Injury

Allen

Goodrich-Hunsaker

et al. 2010

Psychol. Inj. and Law

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show abstract

“…Data from participants who obtained a BDI score of C20 (i.e., moderate depression) or more were excluded from the study. The Medical Symptom Validity Test (MSVT), an empirically-supported, quantitative measure of effort, was administered to screen for poor effort (Richman et al 2006;Merten et al 2005). Five participants were excluded from this study due to endorsing symptoms of current psychosis.…”

Section: Participantsmentioning

confidence: 99%

Executive Function Mechanisms of Theory of Mind

Ahmed

Miller

2010

J Autism Dev Disord

169

123

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This study examined the relationship between Executive Function (EF) and Theory of Mind (ToM) using the Delis-Kaplan Executive Function System (D-KEFS) and three tests of ToM (Reading the Mind in the Eyes test (RMET), Strange Stories test, and Faux Pas test). Separate regression analyses were conducted, and EF predictors varied by ToM test. No EF domains accounted for significant variance in RMET scores; only estimated IQ scores were significant predictors of RMET performance. Verbal fluency and deductive reasoning were significant predictors of performance on the Strange Stories test, while verbal fluency, problem solving, and gender accounted for a significant variance in the Faux Pas test. Results suggest that the ToM tests each utilized differing cognitive mechanisms.

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“…The authors cite a study indicating that the exaggeration of cognitive symptoms is "widespread" in evaluations pertaining to disability. In this particular study, 42% of claimants "were not truthful" on a test of memory (Richman et al 2006). Problems also exist with physicians who may inappropriately attribute causation to the event at claim, perhaps "based on a misguided sense of social justice.…”

Section: Causality In Medicinementioning

confidence: 96%

Causality and Causation in Law, Medicine, Psychiatry, and Psychology: Progression or Regression?

Young

2008

Psychol. Inj. and Law

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In this article, I review recent developments in the areas of law, medicine, psychiatry, and psychology concerning causality and causation. I analyze the validity of the 2008 edition of the American Medical Association (AMA)'s guides to the evaluation of permanent impairment and its accompanying volume on causation. I conclude with recommendations for a synthetic approach to causality in the legal field and a more consistent model of impairment in the mental health one. The AMA's book on medical causation needs careful revision.

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Objective Tests of Symptom Exaggeration in Independent Medical Examinations

Abstract: This study suggests that exaggeration of cognitive symptoms is widespread in disability-related evaluations. It would be unwise to accept self-reported memory complaints at face value. Criteria-normed symptom validity testing should be done to rule out symptom exaggeration.

Cited by 60 publications

References 10 publications

Functional Neuroimaging of Symptom Validity Testing in Traumatic Brain Injury

Functional Neuroimaging of Symptom Validity Testing in Traumatic Brain Injury

Executive Function Mechanisms of Theory of Mind

Causality and Causation in Law, Medicine, Psychiatry, and Psychology: Progression or Regression?

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