How well do standard clinical neuropsychological tests identify malingering? A preliminary analysis

Neuropsychological research has primarily focused on identification of malingerers through specialized tests designed for this purpose. Little attention has been given to the degree to which traditional clinical measures differentiate between malingerers and non-malingerers. This study examined the neuropsychological performance of 81 subjects who had a history of mild to moderate head injury, some of whom are believed to have been motivated to malinger their test performance. Subjects were classified as malingerers or non-malingerers based on their history as well as their performance on specific neuropsychological malingering tests. Performance on traditional neuropsychological clinical measures was examined for both groups. Results indicated that subjects' pattern of neuropsychological performance was not a reliable indicator of malingering performance, supporting the notion that specialized malingering tests are a critically necessary component to clinical classification of malingering. However, level of performance may provide an indication of malingering, as probable malingerers consistently performed worse on traditional and clinical neuropsychological measures. These findings are discussed in the context of the malingering literature.