Neuropsychological Assessment of Suspected Malingering: Research Results, Evaluation Techniques, and Further Directions of Research and Application

1998 ◽  
Vol 14 (3) ◽  
pp. 211-225 ◽  
Author(s):  
Dietmar Heubrock ◽  
Franz Petermann
Keyword(s):  
Neuropsychological Assessment ◽  
Current Status ◽  
Research Strategies ◽  
Clinical Neuropsychology ◽  
Factitious Disorders ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
Clinical Methods ◽  
Assessment Techniques ◽  
Evaluation Techniques

Possibilities for neuropsychological assessment of suspected malingering are addressed. First, various forms of deception (malingering, factitious disorders, hysteria) and their implications for clinical neuropsychology are discussed. Then, threshold models for the detection of malingering as well as specially designed assessment techniques (e. g., individual tests, deficit testing, tests specifically for malingerers, and symptom validity testing) are described. Finally, the current status of clinical methods and research strategies is summarized, and recent and further developments of assessment and research are reported.

Symptom Validity Testing, Effort, and Neuropsychological Assessment

2012 ◽  
Vol 18 (4) ◽  
pp. 632-640 ◽  
Author(s):  
Erin D. Bigler
Keyword(s):  
Neuropsychological Assessment ◽  
Symptom Validity ◽  
Major Theme ◽  
Cut Scores ◽  
Research Issues ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
Research Designs ◽  
Critical Issues ◽  
Design And Methods

AbstractSymptom validity testing (SVT) has become a major theme of contemporary neuropsychological research. However, many issues about the meaning and interpretation of SVT findings will require the best in research design and methods to more precisely characterize what SVT tasks measure and how SVT test findings are to be used in neuropsychological assessment. Major clinical and research issues are overviewed including the use of the “effort” term to connote validity of SVT performance, the use of cut-scores, the absence of lesion-localization studies in SVT research, neuropsychiatric status and SVT performance and the rigor of SVT research designs. Case studies that demonstrate critical issues involving SVT interpretation are presented. (JINS, 2012,18, 1–11)

Performance and Symptom Validity

2019 ◽  
pp. 201-227
Author(s):  
Karen Postal
Keyword(s):  
Assessment Tools ◽  
Symptom Validity ◽  
Accurate Information ◽  
Performance Validity ◽  
Critical Component ◽  
Clinical Neuropsychology ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
And Performance ◽  
Symptom Patterns

Position papers from the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology define assessment of symptom and performance validity, using well-validated assessment tools, as a critical component of a competent neuropsychological assessment. The ability to provide information to the court about whether defendants/plaintiffs are providing accurate information about their symptoms and abilities is a unique and valuable contribution that our field brings to the forensic table. This chapter addresses strategies to assist jurors and other triers of fact in their understanding of concepts of effort and exaggeration, through evaluation of noncredible symptom patterns and performance validity and symptom validity testing.

Symptom Validity Testing

2018 ◽  
Vol 23 (6) ◽  
pp. 14-15
Author(s):  
Lee H. Ensalada
Keyword(s):  
Memory Deficits ◽  
Symptom Validity ◽  
Sensory Cues ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
Tunnel Vision ◽  
Blurry Vision ◽  
The Common ◽  
Fatigue Evaluation ◽  
Choice Testing

Abstract Symptom validity testing (SVT), also known as forced-choice testing, is a means of assessing the validity of sensory and memory deficits, including tactile anesthesias, paresthesias, blindness, color blindness, tunnel vision, blurry vision, and deafness. The common feature among these symptoms is a claimed inability to perceive or remember a sensory signal. SVT comprises two elements: a specific ability is assessed by presenting a large number of items in a multiple-choice format, and then the examinee's performance is compared to the statistical likelihood of success based on chance alone. These tests usually present two alternatives; thus the probability of simply guessing the correct response (equivalent to having no ability at all) is 50%. Thus, scores significantly below chance performance indicate that the sensory cues must have been perceived, but the examinee chose not to report the correct answer—alternative explanations are not apparent. SVT also has the capacity to demonstrate that the examinee performed below the probabilities of chance. Scoring below a norm can be explained by fatigue, evaluation anxiety, inattention, or limited intelligence. Scoring below the probabilities of chance alone most likely indicates deliberate deceptions and is evidence of malingering because it provides strong evidence that the examinee received the sensory cues and denied the perception. Even so, malingering must be evaluated from the total clinical context.

Impairment Questions and Answers

1999 ◽  
Vol 4 (4) ◽  
pp. 4-4
Keyword(s):  
Symptom Validity ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
Negative Results ◽  
Tunnel Vision ◽  
Questions And Answers ◽  
Blurry Vision ◽  
Fatigue Evaluation ◽  
Choice Testing ◽  
Rule Out

Abstract Symptom validity testing, also known as forced-choice testing, is a way to assess the validity of sensory and memory deficits, including tactile anesthesias, paresthesias, blindness, color blindness, tunnel vision, blurry vision, and deafness—the common feature of which is a claimed inability to perceive or remember a sensory signal. Symptom validity testing comprises two elements: A specific ability is assessed by presenting a large number of items in a multiple-choice format, and then the examinee's performance is compared with the statistical likelihood of success based on chance alone. Scoring below a norm can be explained in many different ways (eg, fatigue, evaluation anxiety, limited intelligence, and so on), but scoring below the probabilities of chance alone most likely indicates deliberate deception. The positive predictive value of the symptom validity technique likely is quite high because there is no alternative explanation to deliberate distortion when performance is below the probability of chance. The sensitivity of this technique is not likely to be good because, as with a thermometer, positive findings indicate that a problem is present, but negative results do not rule out a problem. Although a compelling conclusion is that the examinee who scores below probabilities is deliberately motivated to perform poorly, malingering must be concluded from the total clinical context.

Behavioral Factors Impact Impairment and Disability Evaluation

2011 ◽  
Vol 16 (5) ◽  
pp. 5-7
Author(s):  
Lee Ensalada
Keyword(s):  
Social History ◽  
Standardized Test ◽  
Somatoform Disorders ◽  
Disability Evaluation ◽  
Body Part ◽  
Emotional Reactions ◽  
Illness Behavior ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
Disease Pattern

Abstract Illness behavior refers to the ways in which symptoms are perceived, understood, acted upon, and communicated and include facial grimacing, holding or supporting the affected body part, limping, using a cane, and stooping while walking. Illness behavior can be unconscious or conscious: In the former, the person is unaware of the mental processes and content that are significant in determining behavior; conscious illness behavior may be voluntary and conscious (the two are not necessarily associated). The first broad category of inappropriate illness behavior is defensiveness, which is characterized by denial or minimization of symptoms. The second category includes somatoform disorders, factitious disorders, and malingering and is characterized by exaggerating, fabricating, or denying symptoms; minimizing capabilities or positive traits; or misattributing actual deficits to a false cause. Evaluators can detect the presence of inappropriate illness behaviors based on evidence of consistency in the history or examination; the likelihood that the reported symptoms make medical sense and fit a reasonable disease pattern; understanding of the patient's current situation, personal and social history, and emotional predispositions; emotional reactions to symptoms; evaluation of nonphysiological findings; results obtained using standardized test instruments; and tests of dissimulation, such as symptom validity testing. Unsupported and insupportable conclusions regarding inappropriate illness behavior represent substandard practice in view of the importance of these conclusions for the assessment of impairment or disability.

scholarly journals Evaluation of Internship Assessment in Medical Colleges of Bangladesh

2017 ◽  
Vol 8 (1) ◽  
pp. 14-17
Author(s):  
Farhana Noman ◽  
AKM Asaduzzaman ◽  
Humayun Kabir Talukder ◽  
ASM Shamsul Arefin ◽  
Shamima Rahman
Keyword(s):  
Feedback System ◽  
Descriptive Study ◽  
Current Status ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Assessment Feedback ◽  
Assessment Techniques ◽  
Major Discipline ◽  
Medical Colleges

This study aimed to evaluate the current status of the internship assessment in medical colleges of Bangladesh. Internship acts as the pathway from being a medical student to becoming a registered doctor. Hence, a rigorous and robust internship leads to producing better doctor and in turn better healthcare. Thus, proper assessment is necessary to ensure the quality of the future medical practitioners. Unfortunately, no study has been done in Bangladesh related to this context. A cross-sectional descriptive study with pre-tested self-administered questionnaires covering study place and population and factors relevant to intern assessment (assessment after each major discipline completion, assessment techniques, and feedback) was performed. The study was carried out in 8 medical colleges (4 public and 4 non-government; 4 inside Dhaka and 4 outside). 300 completed questionnaires (250 interns, 50 supervisors) were analyzed. All the collected data were analyzed and presented with SPSS v 19.0 software. Results revealed that there was no assessment present after completion of major placement rotation (about 54% interns and 24% teachers). Furthermore, only logbook was signed as the prevailing assessment technique (more than 66% interns and 72% doctors). Moreover, assessment feedback system was not fully functional (48.7% respondent views). Hence, the overall scenario is shabby and poses questions on our future doctors' skill set.Bangladesh Journal of Medical Education Vol.8(1) 2017: 14-17

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