Application of the new MMPI-2 Malingered Depression scale to individuals undergoing neuropsychological evaluation: relative lack of relationship to secondary gain and failure on validity indices.

The Malingered Depression (Md) scale for the MMPI-2 (Steffan, Clopton, & Morgan, 2003) was recently developed to detect attempts at malingering depressive symptomatology. The Steffan et al. cutoffs for the Md scale were derived through comparisons of undergraduate malingering simulators with depressed undergraduates. In order to explore the potential utility for neuropsychological practice, we examined the Md scale among 160 individuals with and without a context of secondary gain referred for neuropsychological evaluation. Md results were compared to other MMPI-2 validity indices and performance on effort testing. While Md was found to correlate highly with other validity indices from the MMPI-2, it was also correlated significantly with measures of depression, both in individuals with and without a secondary gain context. Md scores were not significantly different between secondary gain and no secondary gain groups, whereas FBS and L were significantly different. The effect of passing or failing validity indicators on rates of Md scores exceeding the Steffan et al. cutoffs was limited. Only among the few individuals exceeding a high threshold on the F scale or combinations of F, FBS, and effort indicators was it common to also surpass the Md cutoff. Overall, Md showed relatively little relationship to either secondary gain status or cognitive malingering in our sample. Given that such factors do not necessarily produce high scores on Md, the utility of the scale to clinical neuropsychologists appears low.

Neuropsychological changes following electrical injury.

The clinical presentation of electrical injury commonly involves physical, cognitive, and emotional complaints. Neuropsychological studies, including case reports, have indicated that electrical injury (EI) survivors may experience a broad range of impaired neuropsychological functions, although this has not been clarified through controlled investigation. In this study, we describe the neuropsychological test findings in a series of 29 EI patients carefully screened and matched to a group of 29 demographically similar healthy electricians. Participants were matched by their estimated premorbid intellectual ability. Multivariate analysis of variance was used to assess group differences in the following neuropsychological domains: attention and mental speed, working memory, verbal memory, visual memory, and motor skills. EI patients performed significantly worse on composite measures of attention/mental speed and motor skills, which could not be explained by demographic differences, injury parameters, litigation status, or mood disturbance. Results suggest that cognitive changes do occur in patients suffering from electrical injury.

National survey of clinical neuropsychology postdoctoral fellows.

The present study was designed to survey postdoctoral fellows in clinical neuropsychology about their perceptions of a variety of training standards and recommendations. Survey packets were mailed to the 78 training directors listed in Cripe's (1998) most recent listing of postdoctoral training programs at the time of survey. A response rate of 44% was achieved. Results were notable in that most fellows had been trained in clinical psychology, and mostly in Ph.D. programs. Approximately half had been trained and/or supervised by diplomates in clinical neuropsychology from the American Board of Professional Psychology. Continuing education was judged by respondents to be an insufficient substitute for formal training. Most respondents completed internships and postdoctoral residencies in a hospital setting, with greater than 50% of their time devoted to clinical neuropsychology.

Documenting the prominence of forensic neuropsychology at national meetings and in relevant professional journals from 1990 to 2000.

Numerous authors have opined that forensic activities have become more prominent within clinical neuropsychology. To investigate the merits of these claims, the entire contents of Archives of Clinical Neuropsychology (ACN), Journal of Clinical and Experimental Neuropsychology (JCEN), and The Clinical Neuropsychologist (TCN) from 1990 through 2000 were reviewed and cataloged. These three journals were selected because they are the highest-ranking clinical subscription journals according to surveys of neuropsychology practitioners. Prior to rating journal content, various categories of interest were delineated and practice ratings were obtained until the two raters reached 92% agreement. Each of the raters read the journal contents and recorded content ratings for half of the journal issues under review. Results of the 8323 ratings demonstrated increases across time in the absolute numbers of articles related to forensic neuropsychology, although variable and different for each journal. Published articles that were partially or substantially forensic in nature in the three journals combined increased from 4% in 1990 to 14% in 2000. An annual peak in absolute number (n=32;16%) of forensic journal articles occurred in 1997. The most common topic of 139 articles published in ACN, JCEN, and TCN from 1990 to 2000 was malingering, which appeared in 86% of the general forensic articles. Forensic presentations at annual NAN meetings ranged from 3.9 to 11.3% (M=8%) of the convention programs, whereas within Division 40's programs at the American Psychological Association meeting, the average percentage ranged from 2.3 to 11.7% (M=6%). Results pertaining to each journal and to specific forensic topics are presented and implications of these and other results are discussed.