The Rey AVLT recognition memory task measures motivational impairment after mild head trauma

The effect of financial incentives on Rey AVLT recognition memory performance was assessed. Clinically referred mild head trauma (MHT) patients with financial incentives were compared to patients with neurologically documented brain dysfunction who did not have financial incentives. The MHT group was subdivided into a group with strong performance on a measure of motivation, the Portland Digit Recognition Test (PDRT), and a group with weak performance on the PDRT. The resulting three groups were equated on Rey AVLT acquisition, age, and education. The MHT subgroup with poor PDRT scores also was significantly impaired on recognition memory. In the total sample the prevalence of recognition scores of less than 6 correct was 27% in the MHT group and 5% in the brain dysfunction group. We conclude that severe Rey AVLT recognition memory impairment likely reflects motivation to exaggerate deficits, at least in MHT patients with no neurological evidence of brain injury.