Detecting malingering in traumatic brain injury: Combining response time with performance validity test accuracy

Area of Science:

• Neuropsychology
• Forensic Psychology

Background:

• Performance validity tests (PVTs) are crucial in neurocognitive assessments.
• Distinguishing genuine Traumatic Brain Injury (TBI) from feigned impairment is a significant clinical challenge.

Purpose of the Study:

• To investigate the added value of item-level response time (RT) variables from a PVT in differentiating adults with verified TBI from those coached to feign impairment.
• To assess if RT data improves the diagnostic accuracy of traditional PVTs.

Main Methods:

• Utilized a computerized Test of Memory Malingering (TOMM-C) with 45 TBI participants, 45 simulated malingerers (SIM), and 61 healthy controls (HC).
• Analyzed mean RTs (Trials 1, 2, correct/incorrect trials) and RT variability indices alongside TOMM-C accuracy scores.

Main Results:

• Response time indices significantly differed across groups, with SIM generally exhibiting longer and more variable RTs than HC and TBI groups.
• Average RT for Trial 1 and 2 were strong predictors, particularly distinguishing SIM from HC.
• While RT indices were less effective in differentiating SIM from TBI, they provided incremental predictive value when combined with TOMM-C accuracy.

Conclusions:

• Combining response time variables with traditional PVT accuracy enhances the ability to detect feigned neurocognitive impairment in TBI evaluations.
• Findings support the utility of integrating RT data into PVTs for improved diagnostic precision.
• Further research is recommended to explore these methods with other clinical populations.