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Dissertation

Recent neuropsychological advances in the detection of malingering utilizing the paradigm of implicit memory

13 December 1999

Abstract

Neuropsychologists have an increasing role in the assessment and treatment of individuals suffering cognitive impairment following mild head injury. This task is complicated by the potential for individuals to feign or exaggerate their symptoms, posing a challenge to the medical and legal systems. _ The social and financial costs can be considerable. Neuropsychologists are encouraged to formally address the possibility of malingering in cases where there are incentives for dissimulation, such as financial gain, or when the subjective complaints outweigh the objective findings. The diagnosis of malingering is complex and multifaceted and instruments used to detect the disorder yield varying degrees of accuracy. A multimodal battery consisting of a variety of diagnostic instruments offers the most comprehensive approach to the assessment of malingering. Priming tests, which measure implicit memory, may be a useful addition to an assessment battery. This dissertation offers a literature review and critical analysis of available studies that employ priming tests in the assessment of malingering. A brief review of the literature regarding malingering, mild head injury, current assessment strategies for malingering, implicit memory and the viability of utilizing tests of implicit memory in the detection of malingering is included. A meta-analysis of the available studies was conducted and yielded a significant effect size to warrant further validation and cross-validation studies on this approach. It is concluded that priming tests have potential for use in an assessment battery for the diagnosis of malingering.


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