The prevalence of cognitive malingering in persons reporting exposure to occupational and environmental substances.
OBJECTIVE
Directly estimate the prevalence of cognitive malingering in persons claiming exposure to occupational and environmental substances.


METHODS
Retrospective review of 128 neuropsychological cases with financial incentive. Estimates were based on two methods: (1) clinical identification using the Slick, Sherman and Iverson criteria for malingered neurocognitive dysfunction (MND), and (2) statistical modeling based on patient performance on several individual psychometric indicators of malingering.


RESULTS
The prevalence based on the clinical method was 40%. The statistically based estimates ranged from 30% to more than 45% depending on model parameters. Different incentive parameters may influence prevalence.


CONCLUSIONS
Cognitive malingering in toxic exposure is common and must be adequately addressed in the clinical neuropsychological assessment of toxic exposure and in research on its neurocognitive effects or findings will likely over-estimate the degree of cognitive impairment and related disability.
Greve
Kevin W
KW
Department of Psychology, University of New Orleans, New Orleans-Lakefront, New Orleans, LA 70148, USA. kgreve@uno.edu
Bianchini
Kevin J
KJ
Black
F William
FW
Heinly
Matthew T
MT
Love
Jeffrey M
JM
Swift
Douglas A
DA
Ciota
Megan
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders; D003710:Demography; D004781:Environmental Exposure / Q000009:adverse effects*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity