Detection of Malingered Neurocognitive Dysfunction Among Patients with Acquired Brain
Injuries

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Abstract

The Word Memory Test (WMT) is one of the most sensitive forced-choice tests available designed to evaluate negative response bias (NRB). Presently there is no valid verbal test designed to evaluate NRB for Hebrew-speaking patients. The aims of the present study were to validate the response bias measures of the WMT among Hebrew-speaking patients with acquired brain injuries and to reveal the malingering base rate among Israeli patients involved in compensation-seeking. Participants were 112 patients. The Test of Memory Malingering (TOMM) was used for convergent validity and injury related variables were used for concurrent validity. A translated version of the WMT had high split-half reliability. Regarding convergent validity, WMT effort measures had high positive correlations with the TOMM. Moreover, based on TOMM cutoff scores for classification, the WMT had reasonable classification rates. Regarding concurrent validity, multivariate logistic regression revealed that failure in the WMT was significantly predicted by normal brainscans and involvement in compensation-seeking behavior. The baserate of probable malingering was 34%. These findings emphasize the universality of the WMT in detecting NRB and establishing a malingered neurocognitive dysfunction baserate among Israeli patients involved in compensation-seeking.

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Most cited references 47

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Diagnostic criteria for malingered neurocognitive dysfunction: proposed standards for clinical practice and research.

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Over the past 10 years, widespread and concerted research efforts have led to increasingly sophisticated and efficient methods and instruments for detecting exaggeration or fabrication of cognitive dysfunction. Despite these psychometric advances, the process of diagnosing malingering remains difficult and largely idiosyncratic. This article presents a proposed set of diagnostic criteria that define psychometric, behavioral, and collateral data indicative of possible, probable, and definite malingering of cognitive dysfunction, for use in clinical practice and for defining populations for clinical research. Relevant literature is reviewed, and limitations and benefits of the proposed criteria are discussed.

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Effort has a greater effect on test scores than severe brain injury in compensation claimants.

Andreana Haley, Mark P. Green, M L Rohling … (2001)

Nine-hundred and four consecutive patients, including 80 neurological patients and 470 with head injuries, were given neuropsychological tests. All 43 test scores were converted to normative Z-scores and averaged, giving an Overall Test Battery Mean (OTBM). A variable measuring effort correlated 0.73 with the OTBM. The OTBM mean score was 1.20 SD lower in those who failed the Word Memory Test (WMT) than in those who passed the WMT. Sub-optimal effort suppressed the OTBM 4.5 times more than did moderate-severe brain injury. When only those making a good effort were included, patients with severe brain injuries and neurological diseases scored significantly lower than groups presumed to have no neurological impairment, but these group differences were not seen when all cases were analysed together. These data illustrate the importance of measuring and controlling for sub-optimal effort in individual neuropsychological evaluations, as well as in empirical research with similar groups of patients.

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Gitit Kavé (2005)

Norms for Hebrew semantic and phonemic fluency were collected in a sample of 369 participants, ranging in age from 18 to 85. Two hundred and sixty nine persons completed both tests and the rest completed only the semantic test. Phonemic fluency was assessed with the use of three letters (bet, gimel, and shin) and semantic fluency with the use of three categories (animals, fruits and vegetables, and vehicles). Scores of individual letters and categories, sum scores, as well as the difference between the semantic and phonemic sum scores are presented for four age groups (18-30, 31-50, 51-70, and 71-85). Results show that age had the greatest effect on fluency performance, level of education was positively correlated to sum scores but contributed little to its prediction beyond the contribution of age, and gender had no significant effect.

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Author and article information

Journal

Journal ID (publisher-id): jpa

Title: European Journal of Psychological Assessment

Publisher: Hogrefe Publishing

ISSN (Print): 1015-5759

ISSN (Electronic): 2151-2426

Publication date (Print): October 2012

Publication date (Electronic): 2013

Volume: 29

Issue: 4

Pages: 253-262

Affiliations

[ ¹ ] The National Institute for the Rehabilitation of the Brain Injured Person, Tel Aviv, Israel

[ ² ] Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel

Author notes

Dan Hoofien, Department of Psychology, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel, +972 3 565-0820, +972 3 562-4779, mshoofi@ 123456mscc.huji.ac.il

Article

Apa ID: jpa_29_4_253

DOI: 10.1027/1015-5759/a000154

SO-VID: 2d5e6309-1eee-4d94-bc5d-20b641d37e94

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Detection of Malingered Neurocognitive Dysfunction Among Patients with Acquired Brain Injuries : A Word Memory Test Study

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