Neuropsychological assessment and malingering: a critical review of past and present strategies.
In recent years, neuropsychologists and clinical psychologists have shown a greatly increased interest in methods of discriminating malingerers from legitimate psychiatric and neurological patients. In part, this increased interest has resulted from increased demand from the legal system (i.e., pertaining to disposition of personal injury, worker's compensation, medical malpractice, and criminal cases) for expert psychological testimony which can distinguish malingering from genuine neuropsychological deficits. Additional interest, and some controversy, has been generated by recent research studies that have reported no success in diagnosing malingering, although others have reported more positive evidence. The present literature review describes the historical and current methods of detecting malingerers, along with the empirical evidence supporting, or condemning, their use. The majority of empirical studies suggest that although malingering of brain dysfunction is not easy to detect, it is possible to detect, if looked for deliberately. Review and critique of the available strategies indicates that a multidimensional, multimethod approach is needed. Continued research effort is needed on this important clinical issue.
Healthsouth Rehabilitation Hospital, USA.
K J
KJ
Nies
J J
JJ
Sweet