Detection of inadequate effort on neuropsychological testing: A meta-analytic review of selected procedures

Thirty-two studies of commonly researched neuropsychological malingering te sts were meta-analytically reviewed to evaluate their effectiveness in disc riminating between honest responders and dissimulators. Overall, studies us ing the Digit Memory Test (DMT), Portland Digit Recognition Test (PDRT), 15 -Item Test, 21-Item Test, and the Dot Counting Test had average effect size s indicating that dissimulators obtain scores that are approximately 1.1 st andard deviations below those of honest responders. The DMT separated the m eans of groups of honest and dissimulating responders by approximately 2 st andard deviations, whereas the 21-Item Test and the PDRT separated the grou ps by nearly 1.5 and 1.25 standard deviations, respectively. The 15-Item Te st and the Dot Counting Test were less effective, separating group means by approximately 3/4 of a standard deviation. Although the DMT, PDRT, 15-, an d 21-Item Tests all demonstrated very high specificity rates, at the level of individual classification, the DMT had the highest sensitivity and overa ll hit-rate parameters. The PDRT and 15-Item Test demonstrated moderate sen sitivity, whereas the 21-Item Test demonstrated poor sensitivity. The less than perfect sensitivities of all the measures included in this review argu e against their use in isolation as malingering screening devices. (C) 2000 National Academy of Neuropsychology. Published by Elsevier Science Ltd.