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The efficacy of a neuropsychological symptom inventory in the differential diagnosis of medical, psychiatric, and malingering patients / NSI efficacy

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

Identiferoai:union.ndltd.org:BSU/oai:cardinalscholar.bsu.edu:handle/176373
Date January 1999
CreatorsGelder, Barbara C.
ContributorsDean, Raymond S.
Source SetsBall State University
Detected LanguageEnglish
Formatv, 95 leaves ; 28 cm.
SourceVirtual Press

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