The 48-Pictures Test: A two-alternative forced-choice recognition test for the detection of malingering

Abstract

We tested the validity of the 48-Pictures Test, a 2-alternative forced-choice recognition test, in detecting exaggerated memory impairments. This test maximizes subjective difficulty, through a large number of stimuli and shows minimal objective difficulty. We compared 17 suspected malingerers to 39 patients with memory impairments (6 amnesic, 15 frontal lobe dysfunctions, 18 other etiologies), and 17 normal adults instructed to simulate malingering on three memory tests: the 48-Pictures Test, the Rey Auditory Verbal Learning Test (RAVLT), and the Rey Complex Figure Test (RCFT). On the 48-Pictures Test, the clinical groups showed good recognition performance (amnesics: 85%; frontal dysfunction: 94%; other memory impairments: 97%), whereas the two simulator groups showed a poor performance (suspected malingerers: 62% correct; volunteer simulators 68% correct). The two other tests did not show a high degree of discrimination between the clinical groups and the simulator groups, except in 2 measures: the 2 simulator groups tended to show a performance decrement from the last recall trial to immediate recognition of the RAVLT and also performed better than the clinical groups on the immediate recall of the RCFT. A discriminant analysis with the latter 2 measures and the 48-Pictures Test correctly classified 96% of the participants. These results suggest that the 48-Pictures Test is a useful tool for the detection of possible simulated memory impairment and that when combined to the RAVLT recall–recognition difference score and to the immediate recall score on the RCFT can provide strong evidence of exaggerated memory impairment. (JINS, 1997, 3, 545–552.)

Two Routes to Losing One’s Past Life: A Brain Trauma, an Emotional Trauma

“…Significant improvement in performance was seen when retention was assessed with recognition. No evidence of malingering was observed ; the patient obtained a score of 98.75% correct in a forced-choice picture recognition test known to be sensitive to malingering [5].…”

Chance guessing in a forced-choice recognition task and the detection of malingering.

“…It certainly seems that the higher the level of actual memory malingerers possess (so that chance guessing is a minimal part of their performance), the more likely they are to be caught out by exaggerating their deficit, because they do not seem to take into consideration that on a two-alternative FC test they should be getting somewhat more than half the items correct whatever their impairment. This is, of course, the rationale of tests proposed to detect malingering by below-chance scores, and why they all use only a two-choice format (Chouinard & Rouleau, 1997;Pancratz, 1979Pancratz, , 1988.…”

Causality of Psychological Injury

“…Several symptom validity measures based upon the forced choice methodology that have more recently been developed focus on memory, attention, or related cognitive processes. The more commonly used procedures include the Digit Memory Test (DMT; Hiscock & Hiscock, 1989), the Portland Digit Recognition Test (PDRT; Binder, 1990Binder, , 1993, the 21-Item Test (Iverson, Franzen, & McCracken, 1991;Iverson, Franzen, & McCracken, 1994), the Test of Memory Malingering (TOMM; Rees, Tombaugh, Gansler, & Moczynski, 1998;, the Word Memory Test (WMT; Green, Allen, & Astner, 1996;, the Medical Symptom Validity Test (MSVT; Green, 2004), the Letter Memory Test (LMT; Inman et al, 1998), the Victoria Symptom Validity Test (VSVT; Slick, Hopp, Strauss, & Thompson, 1997;Slick et al, 2003), the Computerized Assessment of Response Bias (CARB; Allen, Conder, Green, & Cox, 1997;Conder, Allen, & Cox, 1992), the 48 Pictures Test (Chouinard & Rouleau, 1997), and the Amsterdam Short Term Memory Test (ASTM; Schagen, Schmand, de Sterke, & Lindeboom, 1997;.…”