Means of Combining or Summarizing Data

This chapter considers the ways that different facts and test results can be synthesized and summarized. The Slick criteria, which were designed to facilitate reliable encoding of the data that might be used to judge the validity of an examinee’s presentation during a neuropsychological evaluation, are discussed along with suggested modifications, criticisms, and alternatives. The chapter discusses several quantitative approaches that have been proposed to objectively weigh evidence of feigning, including below-chance performance and estimating the probability of multiple validity test failures. The challenges of creating similar criteria for feigned psychopathology and incompetence are presented, and the importance of considering poor effort (as opposed to an exclusive focus on malingering or feigning) is discussed.

Prevalence of poor effort and malingered neurocognitive dysfunction in litigating patients in Switzerland

To determine the prevalence of inauthentic cognitive test results, the data of 455 examinees who had finished at least two performance validity tests (PVTs) were analyzed retrospectively. The PVTs administered were the WMT, MSVT, NV-MSVT, ASTM, BSV, RMT, and RDS. Classification as “definite” or “probable” malingering was done according to the Slick criteria. Sociodemographic variables and diagnoses were described using binary logistic regression. Poor effort in at least two PVTs correlated significantly with education levels, immigration, and origin. Irrespective of education level, the highest risk of definite malingering was found in first-generation migrants. Cervical spine dysfunction, normal cerebral imaging, PTSD, somatoform, and/or depressive disorders also correlated with negative response bias. The probability that psychiatric patients fulfill criteria of probable malingering was higher than in patients with isolated organic mental disorders.