![]() Furthermore, there are also tests for detecting simulated deficits in different cognitive areas, such as in overlearned information and processing speed. Most performance validity tests (PVTs) used in compensation-seeking settings are designed to detect feigned short-term memory disorders ( Boone et al., 2000 Sharland and Gfeller, 2007 Young et al., 2016). As reported by the American Academy of Clinical Neuropsychology Consensus Conference Statement on the neuropsychological assessment of effort, response bias and malingering ( Heilbronner et al., 2009), these tests are typically well performed with a minimum effort by patients suffering from neurologic and psychiatric diseases, unless there is a deliberate intention to perform them poorly. One strategy used in neuropsychological testing for detecting malingering is based on the use of simple tests. In order to overcome this limitation, it is possible to rely on outcomes provided by the clinical research ( Coin et al., 2009 Orrù et al., 2009). However, mild cognitive impairments are not usually accompanied by daily living impairments and malingerers may be difficult to detect using simple strategies consisting in comparing cognitive test results (very low) and daily activities (preserved). Unimpaired daily living activities paired with severe impairment at cognitive tests tapping on the same functions is an indication of malingering. While more recent techniques rely on complex computer-based tools (e.g., Sartori et al., 2016a), paper-and-pencil tests (such as the b Test investigated here) still have great practical advantages.įaked severe cognitive impairment can be clinically detected by comparing cognitive test results with the patient everyday abilities. For the mentioned reason, it is crucial to rely on psychometric tools in order to distinguish, on an objective basis, whether neuropsychological test scores accurately reflect cognitive dysfunctions or whether individuals attempted to simulate or over-exaggerate their difficulties ( Sartori et al., 2016b, 2017). The more extensive the cognitive dysfunction is displayed, the more monetary compensation is expected and individuals have significant motive to simulate or over-exaggerate symptoms.Ĭritically, most of the cognitive symptoms are easily faked even by naïve non-coached examinees in order to achieve economic compensation. Evidence exists suggesting that external incentive to malinger typically involves financial compensation for injuries resulting in physical impairments and/or cognitive deficits. Clinical and research efforts have led to increasingly sophisticated and effective methods and instruments designed to detect malingering which are typically observed in most medico-legal settings. In the context of cognitive dysfunctions, neuropsychologists and clinical psychologists have increasingly relied on the results of neuropsychological evaluations to inform their opinions regarding the nature, extent, and credibility of claimed cognitive impairments. ![]() A number of investigations (e.g., Sartori et al., 2016b Walczyk et al., 2018) indicate that malingering typically occurs in three broad domains: psychopathology, cognitive impairment, and medical illness. Recently, an increasing number of studies have been published in order to address the phenomenon of malingering and the detection of malingered cognitive symptoms. Machine learning models achieve an overall accuracy higher than 90% in distinguishing patients from malingerers on the basis of b Test results alone.Ĭonclusions: Our findings suggest that b Test error scores accurately distinguish patients with Mild Neurocognitive Disorder from malingerers and may complement other validated procedures such as the Medical Symptom Validity Test. By contrast, malingerers exhibited the opposite pattern with more commission errors than omission errors. Patients performed significantly worse than controls on all scores, but both groups showed the same pattern of more omission than commission errors. Results: Malingerers performed significantly worse on all error scores as compared to patients and controls, and performed poorly than controls, but comparably to patients, on the time score. Method: Three groups of participants, patients with Mild Neurocognitive Disorder ( n = 21), healthy elders (controls, n = 21), and healthy elders instructed to simulate mild cognitive disorder (malingerers, n = 21) were administered two background neuropsychological tests (MMSE, FAB) as well as the b Test. Objective: Here we report an investigation on the accuracy of the b Test, a measure to identify malingering of cognitive symptoms, in detecting malingerers of mild cognitive impairment.
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