How to test for effort, response bias, and malingering? - Chapter 20
Most neuropsychological examinations are performed with the ultimate goal to improve the patient's quality of live. Hence, patients have everything to gain from giving their best effort. However, wittingly or unwittingly, some patients may give distorted of erroneous responses that are not in correspondence with their actual neuropsychological status. It is important to identify such non neurological contributions. This chapter focuses of methods to determine whether aspects of the neuropsychological performance have been distorted by poor effort or response bias for whatever reason, or by outright malingering. Traditionally, four sources are used for this manner: (1) evidence of consistency in the history of examination; (2) the likelihood that the set of symptoms and the neuropsychological test profile make medical sense; (3) an understanding of the patient's present situation, personal and social history, and emotional predispositions; (4) emotional reactions to their symptoms and complaints. Although a large-scale meta-analysis (1996) concluded that neuropsychologist's judgement in general is reliable and moderately valid, the effectiveness of traditional strategies has been sharply questioned. Nowadays, it is becoming increasingly common for neuropsychologists to include in their assessment batteries some tests that are developed to assess effort, symptom validity, and malingering. A yet unresolved issue is whether patients should be warned that the test battery will include measures of effort and response bias. Finally, an important note on using such tests: findings of measures designed to assess performance validity and response bias should not be interpreted outside the context of clinical history and other measures of cognitive function.
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- How has neuropsychological assessment developed in clinical practice over the past century? - Chapter 1
- What are the basic concepts of neuropsychological assessment? - Chapter 2
- What is known about the behavioral geography of the brain? - Chapter 3
- What is the rationale behind deficit measurement? - Chapter 4
- What are important rules in neuropsychological examination? - Chapter 5
- How to interpret a neuropsychological examination? - Chapter 6
- How is neuropathology used for neuropsychological assessment? - Chapter 7
- Which neurobiological variables influence behavioral changes that follow from brain injury? - Chapter 8
- How to assess orientation and attention? - Chapter 9
- How to assess perception? - Chapter 10
- How to assess memory? - Chapter 11
- Which test batteries for memory assessment are available? - Chapter 12
- How to asses verbal and language skills? - Chapter 13
- What are important features when assessing construction and motor performance? - Chapter 14
- How to assess concept formation and reasoning? - Chapter 15
- Which four components comprise executive functioning? - Chapter 16
- For what purposes are neuropsychological test batteries designed? - Chapter 17
- What are the most commonly used observational methods, rating scales, and inventories used for neuropsychological assessment? - Chapter 18
- How does the assessment of personal adjustment and emotional functioning contribute to neuropsychological assessment? - Chapter 19
- How to test for effort, response bias, and malingering? - Chapter 20
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