How low is too low, revisited: sentence repetition and AVLT-recognition in the detection of malingering

Sentence Repetition (SR) and Rey Auditory Verbal Learning Test-Recognition Task (AVLT-R) scores of 5 groups of examinees (severe traumatic brain injury [TBI], mild TBI nonlitigants, normal controls, mild TBI litigants, and actors) were compared with the intent of determining cutoffs for the detection of malingering. Cutoff scores were set below the minimum of the severe TBI group, resulting in a specificity of 100% for both tests. At this level of specificity, the AVLT-R detected 10 of the 20 known actors (50% sensitivity), whereas SR correctly identified 14 of the 20 actors (70% sensitivity). Among litigants with mild injury, 12.24% were identified by the AVLT-R and 6.12% by SR as malingerers. These findings are similar to those found utilizing a variety of other common neuropsychological instruments. Employing commonly used neuropsychological tests as measures of motivation is both practical and clinically useful.