FEIGNING NEUROPSYCHOLOGICAL IMPAIRMENT - A CRITICAL-REVIEW OF METHODOLOGICAL AND CLINICAL CONSIDERATIONS

Despite a burgeoning literature on malingering, clinicians have few as sessment tools for the accurate classification of those persons feigni ng cognitive and neuropsychological deficits. We examine problems inhe rent in the validation of these assessment measures. We identify and d iscuss six potential strategies for the detection of feigned neuropsyc hological deficits: (a) floor effect, (b) symptom validity testing (SV T), (c) performance curve, (d) magnitude of error, (e) atypical presen tation, and (f) psychological sequelae. In light of the available rese arch, we critically review specific methods which incorporate these st rategies. We found that Rey's 15-Item Memory Test, as a measure of flo or effect, had very low sensitivity rates. We also found considerable variability in SVT methods; a computerized version of SVT (Pritchard & Moses, 1991) that measured auditory, visual, and memory abilities had a satisfactory sensitivity of 67%. Overall, strategies that employed performance curves appeared to have the greatest promise in identifyin g potential malingerers. The remaining three detection strategies have not been adequately tested.