Assessment of Feigned Cognitive Impairment: A Neuropsychological Perspective [Hardcover]

Kyle Brauer Boone (Editor)

Book Description

Publication Date: June 6, 2007 | ISBN-10: 1593854641 | ISBN-13: 978-1593854645 | Edition: 1

Comprehensive and user friendly, this book synthesizes the growing literature on symptom feigning in cognitive testing and translates it into evidence-based recommendations for clinical and forensic practice. A wide range of cognitive effort assessment techniques and strategies are critically reviewed, including both dedicated measures and the use of embedded indicators in standard clinical tests. The book describes approaches to distinguishing between credible and noncredible performance in specific clinical populations: persons presenting with head injury, chronic pain and fatigue, attention-deficit/hyperactivity disorder and learning disability, mental retardation, seizures, and exposure to environmental toxins. Special topics include the potentially confounding effects of psychiatric disorder and ethnocultural factors on effort testing, and cognitive assessment in the criminal forensic setting.

Editorial Reviews

Review

"This is an excellent book that provides state-of-the-art perspectives on assessing and determining noncredible neuropsychological performance. The book suggests advances beyond the pejorative and sometimes simplistic term 'malingering,' looking instead at both conscious and nonconscious motives for poor performance. Contributors review an astonishing array of techniques and strategies for detecting noncredible performance on symptom validity tests and clinical measures. Proposing novel nomenclature and conceptual thinking, this volume will help move the field forward in this important area of research and practice."--Wilfred G. van Gorp, PhD, Department of Psychiatry, Columbia University College of Physicians and Surgeons

 

"This comprehensive work features contributions by many of the best-known people in the field. Covering assessment of diverse groups--including persons with psychogenic seizures, criminal forensic examinees, and cultural and linguistic minority group members--this will be a useful text for graduate-level courses and a resource for practicing clinicians."--Laurence M. Binder, PhD, Departments of Psychiatry and Neurology, Oregon Health and Science University

 

"Boone and her colleagues effectively review a large selection of clinical circumstances that require neuropsychological assessment of feigned cognitive impairment, and thoroughly examine a broad range of tests used for that purpose. The book is filled with thoughtful exploration of current issues attending assessment of feigning. This comprehensive text will become an essential reference for neuropsychologists and other forensic clinicians, and will serve well as a textbook for graduate-level courses in neuropsychological assessment."--Richard I. Frederick, PhD, United States Medical Center for Federal Prisoners, Springfield, Missouri

 

"Boone is well known for her innovative research on assessment of response bias, making her an ideal editor for this comprehensive volume. The section on effort testing in various clinical populations is important, for it focuses not only on feigned impairment in different clinical disorders, but also on correct identification of legitimately impaired patients who are manifesting valid test performance. This book will be a valuable asset to the practicing clinician, and it is also appropriate for use as a text in advanced graduate and postdoctoral clinical training."--Glenn J. Larrabee, PhD, private practice, Sarasota, Florida

About the Author

Kyle Brauer Boone, PhD, ABPP, is Professor-in-Residence in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine, University of California, Los Angeles, and Director of Neuropsychological Services and Training in the Department of Psychiatry at Harbor-UCLA Medical Center in Torrance, California. She has published over 100 peer-reviewed articles in professional journals in the area of neuropsychological assessment and is a coauthor of Handbook of Normative Data for Neuropsychological Assessment. Dr. Boone has also published two tests used to assess for effort on neuropsychological exams: the b Test and the Dot Counting Test.

Product Details

• Hardcover: 481 pages
• Publisher: The Guilford Press; 1 edition (June 6, 2007)
• Language: English
• ISBN-10: 1593854641
• ISBN-13: 978-1593854645
• Product Dimensions: 9.4 x 6.5 x 1.1 inches
• Shipping Weight: 1.6 pounds (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (2 customer reviews)
• Amazon Best Sellers Rank: #825,714 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

1 of 1 people found the following review helpful:

5.0 out of 5 stars I use this with every evaluation., December 25, 2008

By 

Derek Grimmell (Clinton, IA USA) - See all my reviews
(REAL NAME)   

This review is from: Assessment of Feigned Cognitive Impairment: A Neuropsychological Perspective (Hardcover)

In addition to the comments in Dost's review, note that there is extensive coverage of indices of feigned cognitive impairment in a variety of standard neuropsychological tests. Thes include the Wechsler scales, some of which will need to be updated with the WAIS-IV / WMS-IV; the Rey Auditory Verbal Learning Test; the Rey-Osterrieth Complex Figure Test and recognition trial; both the California Verbal Learning Test and the CVLT-II; Warrington Recognition Memory; Wisconsin Card Sort; Category Test; verbal and visual fluency; Stroop color-word test; Trail Making; the three motor skills tests in the Halstead-Reitan; finger agnosia and fingertip number writing; and more.

I use the data from this volume to include cross-checks of poor effort, in addition to the Word Memory Test. I find the combination of a specific effort test with the dozens of indicators in this volume make it virtually impossible for a person to feign, without excessively scoring people as faking.

3 of 4 people found the following review helpful:

5.0 out of 5 stars Malingering or Non-Credible Performance?, September 7, 2008

By 

Rehan Dost (Canada) - See all my reviews
(REAL NAME)   

This review is from: Assessment of Feigned Cognitive Impairment: A Neuropsychological Perspective (Hardcover)

The text covers the Slick et al criteria for Malingering and suggests that this be renamed "noncredible performance" since the former implies conscious effort which at this time is not quantifiable. However, they do admit, fortunately, that there is a significant qualitative difference between the malingerer and the patient with somatoform disorder discernable to medical professionals in the absence of testing protocols.

Within the confines of Neuropsychology I would not disagree.


The book covers:

1) Tests specifically targeting "non credible performance" forced choice measures and non forced choice measures with a nice collection of studies replete with sensitivity and specificity of each test. In addition there are entire sections of test comparisons and most importantly correlations which emphasize that one test, like the TOMM, is meaningless. Contrary to popular opinion the TOMM is NOT sensitive ( recall this measures the probabilistic truth of the implication: if patient is malingerer then the test is positive OR what is the same logical statement: If the test is negative then the patient is not a malinger. Hence the Mneumonic SNout - sensitive test rules out disease ). As is turns out the TOMM is not as specific as we would like it to be ( recall this measures the probabilistic truth of the implication: if patient is not malingering then the test is negative OR what is the same logical statement: If the test is positive then the patient is a malinger. Hence the Mneumonic SPin - specific test rules in disease ). In other words there is a non-zero false positive rate, albeit very very small. The authors contend that multiple minimally correlated ( at least 3 ) measures be administered increasing the specificity and sensitivity considerably. Not suprisingly, in poor effort NON simulator studies ( compensation seeking clients ) 30% of the individuals passed TOMM AND failed WMT ( Word Memory Test ). The failure was at a level worse than early confirmed Alzheimer patients and mentally retarded children lending strong support to the argument that passing the TOMM really means nothing. Yet perplexingly this is often the only formal validity test administered ( if there is one ) .
Non forced choice measures are discussed and offer the advantage of poor detection by the would be malingerer and hence less opportunity to pass validity testing yet simultaneous knowingly fail formal measures of cognitive functioning.

2) Other integrated measures which serve the dual purpose of formally measuring an ability and at the same time offering information about validity. Unfortunately most such measures are inferior to dedicated "non credible" performance testing. Eg- IQ, memory, executive function and sensorimotor tests.

3) Nice historical overview of MMPI 1 then 2 and then the addition of validity checks ( F family of imbedded scales looking at symptom exaggeration ) since it was recognized that the scales could be easily manipulated by respondents. The issue with F scales is that a negative result does not rule out malingering ( SNout- sensitivity issue ) and they have a bias towards psychotic symptoms not adequately capturing somatic symptoms. The authors then review the data of the Fake Bad Scale ( FBS ) pointing out it's use, limitations and interpretation and suggest that the MMP 2 with F scales be administered along with the FBS which increases sensitivity and specificity.

4) Several excellent chapters on cognitive effort testing in special populations ( mTBI, Multiple Chemical Sensitivity, Pain and Fatigue, Feigned Mental Retardation, Epilepsy etc

Overall a fantastic succinct overview of validity measures, uses, and error rates.

FYI the authors agree that Neuropsych testing in the absence of MULTIPLE measures of validity is suspect.