An overview of malingering and deception in neuropsychiatric cases.

Forensic practitioners must shoulder special responsibilities when evaluating over-stated pathology (e.g., malingering) as well as simulated adjustment. Such determinations may modify or even override other clinical findings. As a result, practitioners must be alert to their own misassumptions that may unintentionally bias their conclusions about response styles. Detection strategies for malingering-based on unlikely or markedly amplified presentations-are highlighted in this article. Given page constraints, assessment methods for feigning are succinctly presented with their applications to administrative, civil, and criminal referrals.

SLAM on the stand: how the sports-related concussion literature can inform the expert witness.

Mild head injury is a controversial topic because patients may have subtle deficits and widely varied outcomes. Accordingly, neuropsychologists are frequently asked to provide expert testimony about the nature of mild head injury. This article discusses how the sports-related concussion literature, including the concept of baseline assessment, can inform expert witnesses who are asked to provide such testimony. We first provide a review of several of the controversies surrounding mild head injury, both within and outside of the forensic context. This is followed by a review of the sports as a laboratory assessment model literature, which demonstrates consistent and meaningful evidence of cognitive sequelae following mild head injury. We conclude with a description of how the sports as a laboratory assessment model literature may be utilized in a forensic neuropsychology context to address some of the identified controversies. We end with a call for more research that will further inform the forensic neuropsychologist about mild head injury and those factors that may result in poor recovery.

Validity Assessment in Traumatic Brain Injury Impairment and Disability Evaluations.

This article provides an overview of validity assessment in persons with traumatic brain injury including evaluation caveats. Specific discussion is provided on post-concussive disorders, malingering, examination techniques to assess for validity, response bias, effort and non-organic/functional presentations. Examinee and examiner biases issues will also be explored. Discussion is also provided regarding judicial trends in limiting examiner scope of testing and/or testimony, and risk of liability when providing expert witness opinions on validity of examinee presentations. The hope is to encourage physiatrists to become more aware and skilled in validity assessment given its importance in differential diagnosis of impairment following traumatic brain injury.

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

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.