Detection of Malingering during Head Injury Litigation

Description

Expanding both the conceptual and clinical knowledge base on the subject, the Third Edition of Detection of Malingering during Head Injury Litigation offers the latest detection tools and techniques for veteran and novice alike. Increased public awareness of traumatic brain injuries has fueled a number of significant developments: on the one hand, more funding and more research related to these injuries and their resulting deficits; on the other, the possibility of higher stakes in personal injury suits—and more reasons for individuals to feign injury. As in its earlier editions, this practical revision demonstrates how to combine clinical expertise, carefully-gathered data, and the use of actuarial models as well as common sense in making sound evaluations and reducing ambiguous results. The book navigates the reader through the many caveats that come with the job, beginning with the scenario that an individual may be malingering despite having an actual brain injury. Among the updated features: Specific chapters on malingering on the Word Memory Test (WMT), Test of Malingered Memory (TOMM) MMPI-2, MMPI-RF and MMPI-3; Detailed information regarding performance on performance validity tests in the domain of executive functioning and memory, Guidelines for explaining performance and symptom validity testing to the trier of fact; Chapters on mild TBI in children in head injury litigation, cultural concerns and ethical issues in the context of head injury litigation. Preface Contents Assessment of Malingering and Falsification: Continuing to Push the Boundaries of Knowledge in Research and Clinical Practice 1 Limitations of Experience in Learning to Detect Malingering: Benefits of Augmenting Clinical Judgment with Formal Methods 2 Potential Benefits of Experience and Case Study 3 What Is the Nature of the Phenomenon We Are Trying to Measure? 3.1 Fundamental Components 3.2 Malingering Is a Hypothetical Construct 3.3 Distinguishing Between the Nature of Entities and Effective Measurement Strategies Key Questions About the Nature of Malingering 4 Clinical Needs and Research Agenda 4.1 Framing the Problem 4.2 Sources of Inaccuracy 4.3 Factors That Contribute to Case Difficulty and Ambiguity 4.4 Examiner Factors: Data Gathering and Selection of Procedures 4.5 Examiner Factors: Interpretive Approaches Confirmatory Bias and Premature Closure Illusory Correlation and Failure to Analyze Covariation Overconfidence Inappropriate Disjunctive or Conjunctive Strategies Data Combination Failure to Consider or Properly Apply Base Rates Misappraisal of Injury Severity 4.6 Examinee Factors The Skill of the Falsifier Preparation/“Coaching”/Incentives Overlap and Other Factors Compromising Effort Fluctuations or Changes in Conditions Complexity Less Well-Studied Conditions Absence of Hard Evidence Cultural Diversity Subtlety of Presentation/Relevant Differentials 5 Research Factors and Pressing Needs 5.1 Mixed Presentations: Injured and Malingering Variations in Conjoint Presentations Conjoint Presentations: Limits in Knowledge and Potential Consequences Implications of Conjoint Presentations for Clinical and Research Obstacles Created by Inter- and Intra-Individual Variation and the Need for Baseline Measurement Mixed Presentations: Some Additional Thoughts 5.2 The Extreme Group Problem Explanation of the EGP Possible Strategies for Addressing the EGP 5.3 Lack of Representative Samples 5.4 Base Rates: Some Research Priorities 5.5 Transparency 5.6 Data Combination and Incremental Validity 6 Caveats and Final Comments 6.1 Proposed Criteria for Malingering Detection 6.2 Labeling 6.3 Values Placed on Avoiding False-Positive Versus False-Negative Errors 6.4 Effort Is Not All or None 6.5 Extreme Results of Malingering Tests Are Often Not What They Seem 6.6 Response Set Measures on Questionnaires/Appraisal Of Informants 6.7 Potential Benefits of Adaptive Testing 6.8 Creative Use of Simulation Designs 6.9 Some Additional Thoughts on Research References Ethical Issues in Assessing Malingering in Head Injury Litigation 1 Introduction 2 Defining Malingering and Related Terms 3 Five Common Misconceptions of Validity Assessment 3.1 Litigants Who Intentionally Deceive Are “Bad” 3.2 The Base Rate for Litigant Deception Is Definitively Known 3.3 Litigant Deception Is of Trivial Significance 3.4 Litigant Deception Occurs in a Straightforward, Predictable Manner 3.5 Cutoff Scores on Validity Tests Are Extremely Accurate and Work Equally Well with all Litigant Populations 4 Twelve Important Ethical and Professional Issues in Forensic Neuropsychology 4.1 Professional Competence 4.2 Third-Party Requests for Service 4.3 Multiple Relationships and Conflicts of Interest 4.4 Informed Consent and Notification of Purpose 4.5 Bases for Assessments and Scientific and Professional Judgment 4.6 Use of Assessments and Interpreting Assessment Results 4.7 Test Security and Release of Test Data 4.8 Contingency Fees 4.9 Impartiality and Bias 4.10 Third-Party Observers 4.11 Accuracy and Truthfulness in Public Statements 4.12 Addressing Ethical Misconduct 5 Conclusions References Cultural Aspects in Assessing Malingering Detection 1 Overview of the Chapter 2 Assessing Cognition in a Cross-Cultural Context 3 Cross-Cultural Effects on Malingering Detection 3.1 Efficacy of Stand-Alone Validity Indicators 3.2 Efficacy of Embedded Validity Indicators 4 Recommendations 4.1 Recommendations for the Individual Clinician Prior to the Assessment (Acquiring Cultural Competence, Examinee/Examiner Characteristics, and Use of Interpreters) During the Assessment (Testing Environment and Test Selection) Post Assessment (Interpretation and Report Writing) 4.2 General Recommendations Adequate Adaptation of Tests Need for Further Research and Test Development 5 Summary 6 Appendix (Case Report: Reaching Informed Decisions Regarding Malingering in a Cross-Cultural Context) References Neuroimaging and Invalid Neuropsychological Test Performance 1 Lesion Analysis: How Neuropathology May Influence SVT and PVT Interpretation 2 Neuroimaging Findings, SVT/PVT Results, and Forensic Application 3 Functional Neuroimaging and Experimental Paradigms of Malingering 4 Conclusions References Use of the Word Memory Test (WMT), Medical Symptom Validity Test (MSVT) and Nonverbal Medical Symptom Validity Test (NV-MSVT) in Assessment Following Head Injury 1 Word Memory Test 1.1 WMT Structure 1.2 Development of the WMT 1.3 Overwhelming Effects of Poor Task Engagement 1.4 WMT in Criminal Settings 1.5 Important GMIP Considerations 2 Medical Symptom Validity Test 3 Non-Verbal Medical Symptom Validity Test 4 MSVT and NV-MSVT TBI Studies 5 The Concern about WMT False-Positives References Nonverbal Performance Validity Testing: Test of Memory Malingering (TOMM) 1 Introduction 1.1 TOMM Use with Children 1.2 TOMM Use with Different Groups Hearing Impaired Spanish Speaking 1.3 Differential Cut Score Results in Adults and Children and Adults Versus Children 1.4 TOMM Accuracy: Specificity/Sensitivity 2 Trial 1 Versus Both Trails 3 The TOMM First Ten Items Versus Full First Trial 3.1 TOMM Agreement with Other PVTs References Malingering of Executive Functioning in Head Injury Litigation 1 Methodological Issues 2 Performance-Based Executive Functioning Measures 2.1 Wisconsin Card Sorting Test 2.2 Category Test 2.3 Fluency Tasks 2.4 Stroop Tasks 2.5 Trail Making Test 2.6 Summary 3 Physiological Measures 4 Self-Reported Executive Functioning 5 Summary and Conclusions References Assessment of Malingering Among Head Injury Litigants with the MMPI-2, MMPI-2-RF, and MMPI-3 1 Threats to Protocol Validity 2 MMPI-2 and MMPI-2-RF Validity Scales 2.1 MMPI-2 Validity Scales 2.2 MMPI-2-RF Validity Scales 2.3 Research on the MMPI-2-RF Overreporting Scales 2.4 MMPI-2-RF Interpretation Recommendations 3 Looking Ahead: The MMPI-3 3.1 Development and Description of the MMPI-3 3.2 MMPI-3 Substantive Scales 3.3 MMPI-3 Validity Scales 4 Chapter Summary References Performance Validity Assessment in Pediatric Evaluations 1 Development of Deception in Children 2 Is There Evidence That Children Engage in Deception in Clinical Settings? 3 How Good Are Adults at Deception Detection? 4 Brief Overview of PVTs in Youth 5 Free-Standing PVTs 5.1 Tests Specifically Developed for Pediatric Samples 5.2 Adult PVTs Researched for Use with Pediatric Samples 6 Embedded PVTs 6.1 Tests Developed Specifically for Pediatric Samples 6.2 Embedded PVTs Originally Derived for Adult Samples 7 Important Groups to Consider 7.1 Attention Deficit Hyperactivity Disorder (ADHD) 7.2 Learning Disabilities (LD) 7.3 Sports-Related Concussions 7.4 mTBI (Without Litigation) 8 Potential Reasons for Failure 8.1 Legal Factors 8.2 Family Factors 8.3 Academic Difficulties 8.4 Social Factors 8.5 Sports Factors 8.6 Psychological Factors 9 PVT and mTBI Litigation 10 Concluding Thought References Explaining Performance and Symptom Validity Testing to the Trier of Fact 1 Scenario 1 1.1 Cross-Examination By Plaintiff’s Attorney of the Defense Neuropsychologist 1.2 Redirect by Defense Attorney 2 Scenario 2 2.1 Cross-Examination by Plaintiff’s Attorney of the Defense Neuropsychologist 2.2 Redirect by Defense Attorney 3 Scenario 3 3.1 Cross-Examination by Plaintiff’s Attorney of the Defense Neuropsychologist 3.2 Redirect by Defense Attorney 4 Scenario 4 5 Scenario 5 5.1 Cross-Examination by Plaintiff’s Attorney of the Defense Neuropsychologist 6 Concluding Comment References Index