Thesis (Ph. D.)--West Virginia University, 2008. / Title from document title page. Document formatted into pages; contains v, 62 p. Includes abstract. Includes bibliographical references (p. 39-44).

Thesis (Ph. D.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains iv, 71 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 29-32).

This study evaluated the efficacy of various attention-related, neuropsychological, and symptom validity measures in the detection of feigned ADHD in an undergraduate sample. Performance was compared between a group of presumed normal students (HON), a group of diagnostically "clean" ADHD students asked to respond to the best of their ability (ADHD), and a group of motivated, coached feigners (FGN). Feigners were educated about symptoms and characteristics of ADHD, provided with a scenario to help them relate to the plight of a student who might seek diagnosis, admonition to feign believably, and a significant monetary incentive for "successful feigning" ($45). They were not forewarned about the specific types of tests they would take nor alerted to the presence of malingering detection instruments. Results illustrated that the ADHD symptom-report measures, though sensitive to ADHD, were quite susceptible to faking. The ARS and CAARS—S:L (using a stringent cut score of four or more scale elevations) were successfully faked by 80% and 67% of students, respectively. The Conners CPT, in contrast to those measures, had both limited sensitivity to ADHD and specificity for FGN in this sample. Very high specificity and moderate sensitivity were noted for symptom validity measures across the board, translating into high positive predictive values. Binary logistic regression results indicate that the TOMM Trial 1 coupled with the DMT, LMT, or NV-MSVT may be used to identify feigners with high predictive accuracy.

For response styles, malingering describes the deliberate production of feigned symptoms by persons seeking external gain such as financial compensation, exemption from duty, or leniency from the criminal justice system. In contradistinction, defensiveness occurs when patients attempt to downplay their symptoms of psychological impairment. Both of the aforementioned response styles can markedly affect the accuracy of diagnosis, especially on self-reports, such as multiscale inventories. As an important oversight, no studies have been conducted to examine the effect of culturally specific response styles on profile validity and the classification of malingering among Hispanic American clinical populations. The current study investigated whether the Spanish Personality Assessment Inventory (PAI) effectively distinguished between Spanish-speaking outpatient groups randomly assigned to honest, feigning, and defensive experimental conditions. In examining the results, PAI malingering indicators utilizing Rare Symptoms strategies (NIM and MAL) demonstrated moderate to large effect sizes. For defensiveness, Spanish PAI indicators also demonstrated moderate to very large effect sizes (M d = 1.27; range from 0.94 to 1.68). Regarding psychometric properties, Spanish PAI validity scales, provide adequate to good data on reliability and discriminant validity. Clinical utility of the Spanish PAI increases as different cut scores are employed.

Currently, only the TSI assesses complex traumatic reactions and patient response styles. However, its feigning scale, ATR, uses a flawed detection strategy and is potentially confounded by experiences of complex PTSD. As a consequence, clinicians using the TSI to evaluate severely traumatized patients have no useful method for discriminating genuine and feigned responding. Several detection strategies have demonstrated utility within evaluations of feigned trauma including the assessment of rare symptoms, symptom combinations, symptom selectivity, and symptom severity. The current study created scales on the TSI according to these strategies using a development sample of 107 severely traumatized patients. Validation of all TSI feigning scales was then performed with a second independent sample of 71 severely traumatized patients using a mixed simulation design. Results found support for each scale's convergent validity with SIRS primary scales (M rs = .52) and discriminant validity with measures of defensiveness on the SIRS (M rs = -.07) and TSI (M rs = -.19). Each scale also produced expectedly mild to moderate relationships with SADS-C clinical scales (M rs = .32) and the SCID-IV PTSD module (M rs = -.02). Support for their criterion validity was only moderate (M ds = .69) when comparing the scores of genuine patients to those simulating disability. Potential explanations for this trend were reviewed, including (a) the impact of comorbidity, (b) the restrictions associated with creating embedded feigning scales, and (c) the influence of simulator knowledge in analogue designs. Limitations of the study and future avenues of research were discussed.

The present study included three traumatic brain injury (TBI) groups (good effort mild TBI, poor effort mild TBI, and good effort moderate/severe TBI) and two neurologic control groups (dementia and unilateral left hemisphere stroke). Language impairment was examined using the following measures: Wechsler Adult Intelligence Scale-III Verbal Comprehension Index and the Vocabulary, Similarities, Information, and Comprehension subtests; the Boston Naming Test; the Phonemic and Semantic cue conditions of the Controlled Oral Word Association Test; the Auditory Comprehension subtest of the Cognistat; Wide Range Achievement Test-3 Reading subtest; and the Peabody Picture Vocabulary Test. When effort was controlled, there was a significant effect of injury severity on language impairment. Poor effort and diagnosable malingering were responsible for most of the neuropsychological test evidence of language impairment in mild TBI.

This study examined the ability of reaction time (RT) and Event-Related Potentials (ERP) to detect malingered neurocognitive deficit (MNCD)in two new tasks compared to the TOMM (N = 47). Honest (HON), malingering (MAL), and traumatic brain injury (TBI) groups were compared on accuracy, RT and ERP measures. Overall, the Test of Memory Malingering (TOMM) accuracy was the most effective at classifying groups (hit rate = 100%). Several non-TOMM accuracy variables and RT variables reached hit rates in the range of 71%-88%. The TOMM RT variable had an unlimited time for participants to respond and was the most successful RT variable compared to the Old/New and Repetition Priming tasks that had a short time limit for participants to respond (approximately 1.5 seconds). The classic old/new effect RT pattern was evident for both the HON and TBI groups with significantly faster RTs for old items compared to new items. A logistic regression was employed to see if a RT and/or ERP variable added any unique prediction power in detecting malingering. The frontal-posterior ERP difference score had unique prediction power to detect malingering when classifying MAL vs. TBI (hit rate = 86%). In the Old/New task, ERP responses of HON produced greater activity in the frontal region compared to the posterior region. The opposite trend was found in TBI (posterior activity andgt; frontal) and MAL showed no significant difference.

Neuropsychologists are increasingly asked to determine whether a patient may be malingering symptoms of a mild closed head injury. This issue is particularly salient within the context of civil litigation and the potential of significant financial awards. Patients' performances on neuropsychological tests have historically been assumed to accurately reflect their abilities and deficits. Optimal motivation and performance cannot be automatically assumed within the context of litigation. Moreover, comorbid anxiety and depression are frequently present in head injury patients and adversely affect the patient's performance.The frequent comorbidity of psychiatric and medical symptoms complicates interpretation of a patient's neuropsychological evaluation whether or not the patient is involved in litigation. This comorbidity may result in an inaccurate diagnosis, thus delaying treatment potentially causing greater harm to the patient.The present study was conducted to expand previous research that discriminated between simulated malingered and neurological patient responses to a neuropsychological self-report inventory. Additionally, the study investigated the, utility of the Neuropsychological Symptom Inventory in discriminating between simulated medical, psychiatric and malingered patient responses. Results indicated that the NSI was able to discriminate malingered responses from medical and psychiatric patient responses. However, applying a lie scale derived from previous research with the NSI did not allow discrimination between the malingered group and the psychiatric patients. Use of a factor solution derived from earlier research may offer not only greater prediction in detection of malingerers, but also evaluation of symptom profiles of medical and psychiatric patients. The NSI may provide an efficient screen for exaggerated symptoms as well as an indication of the level of general neuropsychological functioning of the patient when included in a neuropsychological evaluation. / Department of Educational Psychology

There is no abstract available for this dissertation. / Department of Counseling Psychology and Guidance Services

Thesis (Ph.D.)--University of Wollongong, 2003. / Typescript. Includes appendices. Embargo in place till November 2005. Bibliographical references: leaf 249-276.