The Booklet Category Test and malingering in traumatic brain injury: classification accuracy in known groups

A known-groups design was used to determine the classification accuracy of 12 Booklet Category Test variables in the detection of malingered neurocognitive dysfunction (MND) in traumatic brain injury (TBI). Participants were 206 TBI and 60 general clinical patients seen for neuropsychological evaluation. Slick, Sherman, and Iverson's (1999) criteria were used to classify the TBI patients into non-malingering, suspect, and MND groups. Classification accuracy of the BCT depended on the specific variable and injury severity examined, with some scores detecting more than 40% of malingerers with false positive error rates of 10% or less. However, the BCT variables are often influenced by cognitive ability as well as malingering, so caution is indicated in applying the BCT to the diagnosis of malingering. Application of these data in clinical practice is discussed.