title: Can individuals with schizophrenia be instructed to deliberately feign memory deficits?
abstract: BACKGROUND
  Neuropsychological tests are increasingly applied in research studies and clinical practice in psychiatry. In this context, the detection of poor effort is crucial to adequately interpret data. We measured schizophrenia patients' performance on a memory test designed to detect excessive malingering (the "21-Item Test"), before examining whether a second group of schizophrenia patients would excessively malinger on this test when given an incentive to feign memory impairment.
  
  
  METHODS
  Two independent studies including respectively 49 schizophrenia patients and 100 controls (study 1) and 25 schizophrenia patients and 25 controls (study 2) were conducted. In study 1, participants were asked to complete the 21-Item Test to the best of their ability. In study 2, participants were given a hypothetical scenario in which having a memory impairment would be financially advantageous for them, before completing the 21-Item Test.
  
  
  RESULTS
  In study 1, no participant scored at levels indicative of excessive malingering. In study 2, 84% of controls but only 36% of patients scored at excessive levels of malingering, and these patients had higher executive functioning than patients who did not excessively malinger, although it should be noted that a significantly greater proportion of patients excessively malingered in study 2 compared to study 1.
  
  
  CONCLUSIONS
  These results indicate that schizophrenia patients do not normally feign excessive memory impairment during psychological testing. Furthermore, they are less able and/or less inclined to excessively malinger than controls in situations where a memory impairment would be advantageous, perhaps indicating a better ability to malinger without detection. Potential clinical implications are discussed.
authors.affiliation: a Laboratory Epsylon , University Montpellier 3 , EA 4425, Boulevard Henri IV, Montpellier , France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Raffard
authors.forename: Delphine
authors.initials: D
authors.lastname: Capdevielle
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Boulenger
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Gely-Nargeot
authors.forename: Sophie
authors.initials: S
authors.lastname: Bayard
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D008192:Deception; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000523:psychology*; D008568:Memory / Q000502:physiology; D008569:Memory Disorders / Q000523:psychology*; D009042:Motivation; D009483:Neuropsychological Tests; D012565:Schizophrenic Psychology
keywords: deception; executive functioning; malingering; memory; schizophrenia