PSYC31H3 Chapter Notes - Chapter 20: Response Bias, Neuropsychological Test, Malingering

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Published on 19 Apr 2013
School
UTSC
Department
Psychology
Course
PSYC31H3
Chapter 20 Testing for Effort, Response Bias, and Malingering
-accurate interpretation and conclusions about neuropsychological test data are necessarily premised
on the assumption that the data are valid
-essential for drawing conclusions, rending diagnoses, and making treatment recommendations
-compromised validity is more likely when an evaluation involves the possibility of secondary gain
-emotional reactions to new limitations occasioned by injury or disease, or due to the primary effects of
neurologic condition itself can bring about additional symptoms or exacerbate existing ones
-traditionally determination of whether the neuropsychological findings are valid usually rested on:
-evidence of consistency in the history or examination
-the likelihood that the set of symptoms and neuropsychological test profile makes medical
sense
-an understanding of the patient’s present situation, personal/social history, and emotional
predispositions
-emotional reactions to their symptoms and complaints, such as patients who smile while
relating a medical history rife with physical ailments and doctor visits
-the increased involvement of neuropsychologists in forensic evaluations of all kinds has sharpened the
focus on symptom validity and malingering issues
-on the other hand the problem of effort, response bias, and malingering is further complicated by
patients with real neuropsychological deficits, that “fake good” to maintain dignity and appear
competent
-generally it is harder to “fake good” than to “fake bad” on cognitive performance-based measures
-near impossible to function above ones true ability without substantial practice
-motivation to perform poorly may simply be due to the desire to receive attention as a patient or to
play the sick role
-the DSM suggests that malingering should be strongly suspected whenever diagnosis involves a
medicolegal issue
-to avoid prediction error, giving only one test of effort or bias should be avoided
-also varying the time frame when test of effort and malingering can be extremely useful
-some patients with neurologically based deficits may intentionally perform poorly on
neuropsychological testing to exaggerate their symptoms
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Document Summary

Chapter 20 testing for effort, response bias, and malingering. Accurate interpretation and conclusions about neuropsychological test data are necessarily premised on the assumption that the data are valid. Essential for drawing conclusions, rending diagnoses, and making treatment recommendations. Compromised validity is more likely when an evaluation involves the possibility of secondary gain. Emotional reactions to new limitations occasioned by injury or disease, or due to the primary effects of neurologic condition itself can bring about additional symptoms or exacerbate existing ones. Traditionally determination of whether the neuropsychological findings are valid usually rested on: Evidence of consistency in the history or examination. The likelihood that the set of symptoms and neuropsychological test profile makes medical sense. An understanding of the patient"s present situation, personal/social history, and emotional predispositions. Emotional reactions to their symptoms and complaints, such as patients who smile while relating a medical history rife with physical ailments and doctor visits.

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