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Arch Clin Neuropsychol. 2004 Jan;19(1):49-60.

Detection of neurocognitive feigning: development of a multi-strategy assessment.

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Department of Neurology, University of Virginia Health Sciences Center, 500 Ray C. Hunt Drive, P.O. Box 801018, Charlottesville, VA 22908-1018, USA.


Neuropsychological assessments can be completely invalidated by persons successfully feigning neurocognitive impairment. The current investigation examines via a research measure, the Test of Cognitive Abilities (TOCA), the usefulness of multiple detection strategies for the classification of neurocognitive feigning. Using a simulation design with a manipulation check and both positive and negative incentives, two groups of simulators (Cautioned and NonCautioned) were compared with brain-injured patients and nonimpaired controls. Among detection strategies, Magnitude of Error (hit rate=.94) was highly effective, while Floor Effect (hit rate=.80) and Reaction Time (hit rate=.85) were moderately effective. When presented with complex strategies, the cautioning of simulators did not improve their performances.

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