Detecting neuropsychological malingering: effects of coaching and information

Concerns that patients presenting for neuropsychological assessment may not be putting forth maximum effort during testing has prompted the development of measures designed to detect malingering and incomplete effort. Two of these measures are the Computerized Assessment of Response Bias-97 (CARB-97) and Word Memory Test (WMT). Despite widespread use of these instruments, no study has been published determining the vulnerability of neuropsychological malingering measures to explicit coaching or brain injury information. The present study, using analog participants, found that the CARB-97 and WMT differentiate "normal" from "malingered" instructional sets, and show little difference between nai;ve and coached malingering efforts. There was also little difference between providing brain injury information and a no-information condition, but when effects were present, the information group generally scored worse. Further, it was found that response times (RTs), in addition to items correct, may also be effective in detecting those who are not giving their full effort.