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Malingering Scales for the Continuous Recognition Memory Test and the Continuous Visual Memory Test.

Glenn J Larrabee¹

¹Independent Practice, Sarasota, FL 34239, USA. GLarrabee@aol.com

The Clinical Neuropsychologist

|July 9, 2008

Summary

The Continuous Visual Memory Test (CVMT) and Continuous Recognition Memory Test (CRM) scales effectively identify malingered neurocognitive dysfunction (MND). These tests show higher accuracy in detecting definite MND compared to probable cases, distinguishing malingering from traumatic brain injury (TBI).

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Area of Science:

Neuropsychology
Forensic Psychology
Cognitive Assessment

Background:

Malingered neurocognitive dysfunction (MND) presents a challenge in clinical and forensic settings.
Distinguishing genuine cognitive impairment from malingering is crucial for accurate diagnosis and legal proceedings.
Visual memory tests, such as the CVMT and CRM, are utilized to assess cognitive function and detect potential deception.

Purpose of the Study:

To evaluate the efficacy of the Continuous Visual Memory Test (CVMT) and Continuous Recognition Memory Test (CRM) scales in identifying malingered neurocognitive dysfunction (MND).
To compare the performance of individuals with definite MND against patients with traumatic brain injury (TBI).
To assess the cross-validation of these scales in differentiating probable MND from psychiatric and neurologic conditions.

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Main Methods:

The study compared CVMT and CRM scores of litigants with definite MND (n=24) to patients with moderate to severe TBI (n=27).
Chi-square analysis identified discriminating items, and Receiver Operating Characteristic (ROC) curves were used to determine Area Under the Curve (AUC), sensitivity, and specificity.
Cross-validation involved comparing probable MND litigants (n=17) with psychiatric (n=14) and neurologic (n=13) patients.

Main Results:

The CVMT and CRM scales demonstrated high diagnostic accuracy in discriminating definite MND from TBI, with ROC AUCs of 0.918 and 0.962, respectively.
Derived cutting scores yielded good sensitivity and specificity for both scales in the initial sample.
In cross-validation, the scales showed moderate accuracy for probable MND, with higher specificity than sensitivity, suggesting better performance in ruling in rather than ruling out malingering.

Conclusions:

The CVMT and CRM malingering scales are valuable tools for detecting malingered neurocognitive dysfunction, particularly in cases of definite MND.
These scales appear more sensitive to definite MND than probable MND, indicating their strength in identifying clear instances of malingering.
The findings suggest that the CVMT and CRM scales are more effective at confirming malingered visual memory deficits (ruling in) than at excluding them (ruling out).