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Neuropsychological assessment of non-impaired individuals presenting with simulated symptoms of mild head trauma versus non-impaired individuals: A strategy for detection of malingering

25 July 1995


The detection of individuals who intentionally and falsely represent themselves as having neuropsychological deficits as a result of a reported head injury is an important medic-legal issue that many clinicians face on a regular basis. To identify possible strategies for detecting simulated malingering of cognitive deficits, three groups of 30 normal controls, 30 normal simulators, and 19 mild injured individuals were administered the California Verbal Learning Test (CVLT), The Rey Complex Figure (CFT) with recognition subtest, The Rosen Target Detection Test (RTDT), and the 21 Item test. Participants were offered a small financial incentive ($5.00) to participate, with the "best" simulator being offered a $50.00 bonus for performance. Simulators were provided with a case scenario and brief instructions on methods to simulate head injury performance. Discriminant functions analyses based on subtest scores and completion times were able to accurately classify 96.7%, 100% and 89.5% of the cases respectively. Normal simulators appeared to show a pattern on test scores that can be discriminated from the profiles produces by individuals with head injuries and normal controls. Specifically, simulators tended to overestimate the effects of head injuries and perform worse than those individuals with diagnosed head injury.


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