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Malingering following Minor head trauma.

Laurence M Binder1,2

  • 1a Veterans Affairs Medical Center , Portland , OR.

The Clinical Neuropsychologist
|October 13, 2017
PubMed
Summary
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Malingering, or faking illness for gain, is a concern in minor head injury cases. Specific testing methods can help identify patients who may be exaggerating symptoms for external benefits.

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Area of Science:

  • Neuropsychology
  • Forensic Psychology
  • Trauma Studies

Background:

  • Malingering should be suspected when financial gain is possible or subjective symptoms exceed objective findings.
  • Patients with minor head injuries frequently present with these indicators.
  • Distinguishing genuine symptoms from malingering is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To explore the diagnostic utility of specific tests in identifying malingering after minor head injury.
  • To present case studies illustrating the challenges and methods in detecting malingering.
  • To introduce an improved forced-choice testing method for memory complaints.

Main Methods:

  • Case study analysis of five patients with suspected malingering post-minor head injury.
  • Utilized observations of untruthfulness and discrepancies between subjective and objective findings.
  • Employed Face-Hand (Double Simultaneous Stimulation) testing and forced-choice memory testing.

Main Results:

  • Specific diagnostic data were obtained from observations of untruthfulness and test abnormalities.
  • Abnormalities more severe than expected based on injury severity were noted.
  • Forced-choice testing revealing performance significantly worse than chance indicated deliberate fabrication of answers.

Conclusions:

  • Malingering is a relevant consideration in minor head injury evaluations.
  • A combination of clinical observation and specialized testing, particularly forced-choice methods, aids in detecting malingering.
  • An improved forced-choice technique offers a more reliable approach to assessing memory complaints in suspected malingering cases.