Differential vulnerability between postconcussion self-report and objective malingering tests in identifying...

The present study examined the ability of analog malingerers to feign postconcussion symptoms and neuropsychological performance patterns seen in mild head-injured patients. Experimental subjects were randomly assigned to either a control condition, asked to feign deficits consistent with mild head injury without task specific instruction, or feign deficits while given task-specific instruction. A separate group of mild head-injured patients served as a clinical comparison group. Analog malingering groups accurately simulated levels of postconcussive symptoms seen in the mild head-injured patients. However, poorer performance was displayed by the analog malingerers on the objective malingering tests. Coaching did not facilitate realistic patterns of performance for analog malingerers. The results of this study indicate that analog malingerers accurately replicated self-reported postconcussive symptoms, but were less able to simulate objective clinical malingering test performance. These results suggest that self-report measures of postconcussive symptoms and clinical tests are differentially vulnerable to simulation attempts.