The detection of malingering in neuropsychological assessment

Although malingering, or the manipulation of data by the patient, is a problem commonly faced by neuropsychologists, there has been little systematic investigation of this problem. This paper reviews the literature on the detection of malingering in assessment instruments commonly used by clinical neuropsychologists. Criticism of previous research is discussed, and suggestions are made both for future research and for clinical practice.     

Rationally developed fake-good and fake-bad scales for the Jesness Inventory

Develops two validity scales for the Jesness Inventory using a rational approach: a fake-good scale, Lie (L); and a fake-bad scale, Overt Symptomatology (OS). Effectiveness was assessed using 293 male delinquents classified as fake-good, fake-bad, or honest based on a matched-pair MMPI-A. L was moderately effective in detecting the fake-good set, and OS tentatively effective in detecting the fake-bad set. Both correlated well with their MMPI-A counterparts. Sensitivity, specificity, positive predictive power, negative predictive power, and overall effectiveness data were reported. The L scale and OS scale were related to race but differences were less than 1 raw score point. L was unrelated to age. OS was related to age, with younger children showing more willingness to admit to symptomatology. Age-based modified T-score norms were developed for the newly constructed scales using 1142 male and 360 female delinquents. ages 13–18.     

Psychometric qualities of the White Bear Suppression Inventory in a Dutch sample of children and adolescents

The White Bear Suppression Inventory [WBSI; Wegner and Zanakos (1994)] was developed to assess the tendency to suppress unwanted thoughts. Most psychometric studies of the WBSI have included healthy students and adults with obsessive-compulsive disorder. There has been increasing interest in thought suppression in children and adolescents, especially after a traumatic event, but little is known about the psychometric properties of the WBSI for children. The aim of this research was to examine the psychometric qualities of the WBSI in a Dutch sample of children and adolescents. Two studies were conducted. First, the WBSI’s factor structure, internal consistency and test-retest stability were examined in a sample of 203 primary school children (9-13 years). Second, the factor structure and content validity were assessed in 89 children and adolescents (8-18 years) who attended the emergency room after a road traffic accident. Results demonstrated that the WBSI items contribute to a single factor measuring the suppression of unwanted thoughts and that the reliability is satisfactory. Associations between the WBSI and PTSD-symptoms demonstrated sufficient content validity. The findings suggest that the WBSI can appropriately be used in child and adolescent samples.     

Validity of the German Test Anxiety Inventory (TAI‐G) in an Australian sample

Test anxiety (TA) is a prevalent issue among students that can result in deleterious consequences, such as underachievement. However, a contemporary measure that has been validated for use with Australian students seems to be lacking. This study, therefore, investigated the suitability of the German Test Anxiety Inventory (TAI‐G) for use with Australian university students. While the original TAI‐G contains 30 items and was designed to measure four factors (worry, emotionality, interference, and lack of confidence), differing factorial models have been supported in the literature using either the original or a shortened 17‐item version of the measure. These differing TAI‐G models were tested and compared in the current study via confirmatory factor analysis using 224 Australian university students. As expected, results supported the superior fit of the 17‐item four‐factor model. Additionally, the convergent validity of the measure was supported since measures of self‐esteem, self‐efficacy, and general anxiety were all found to correlate significantly with the TAI‐G in the hypothesised directions. Finally, the finding that all of the TAI‐G subscales had acceptably high reliabilities led to the conclusion that the 17‐item TAI‐G is a valid and reliable measure of TA in an Australian university population.     

Assessing depressive symptoms with the Borg centiMax Scale® in a Swedish sample of patients and students

The Borg centiMax Scale, is a psychophysically composed general intensity ratio scale, which could enable more precise inter- and intraindividual comparisons of the intensity of depressive symptoms. In the present study, the properties of the centiMax scale were examined in 38 patients with clinical depression and 109 students. Additionally, preliminary centiMax cut-off scores for mild, moderate and severe depression were estimated. The psychometric properties of the centiMax were found to be satisfactory regarding internal consistency, convergent, discriminative and predictive validity. Moreover, the centiMax was demonstrated to provide meaningful comparisons of symptom intensity, which makes it possible to evaluate the relative importance of individual symptoms in a profile and make more precise comparisons within and between individuals. With regard to intraindividual comparisons, patients rated , for example, the intensity of feeling “guilt” twice as strong as feelings of “being punished,” and the intensity of “loss of pleasure” almost three times as strong as “being punished.” With regard to interindividual comparisons, patients rated e.g., the intensity of “being punished” as 12 times stronger than controls, and the intensity of “worthlessness” about nine times stronger. In conclusion, the centiMax was shown to be reliable and valid for assessing depressive symptoms. The centiMax with level anchored ratio data, appears to be highly advantageous as it permits rather precise values of symptom intensity for intra- and interindividual comparisons that could be useful in the diagnostic process and in treatment planning.     

Higher levels of state depression in masculine than in feminine nations

Studies using identical measures have identified different levels of depression in different countries or cultures. Until now, however, explanations for such differences, other than methodological ones, have not been empirically addressed. It was hypothesized and found that soft or feminine nations in which both women and men are offered equal opportunities for the fulfillment of multiple social roles that are associated with good self-rated health would score significantly lower on national depression levels than tough or masculine societies in which such opportunities exist to a clearly lesser extent. Analyses of data collected in 14 nations in Europe (total N>5000) demonstrated that higher scores on Hofstede's national masculinity index and lower ones on national wealth were independent predictors of higher national depression levels. National trait neuroticism did not mediate the relationship between national masculinity and national depression levels.     

Pain and Pain-Related Impairment in Adults with Cystic Fibrosis

The Multidimensional Pain Inventory (MPI) was utilized in a sample of adult outpatients with cystic fibrosis (CF) to assess their perception of pain and its psychosocial consequences. Subsequently, the data were compared to the ratings of pain and pain-related impairment in these patients as perceived by two nurses from the CF treatment team, as well as to a quantitative measure of illness severity. The results of these comparisons demonstrate that the majority of adult outpatients with CF reported experiencing lower levels of pain and pain-related impairment than expected, although the male patients tend to report experiencing significantly less impact in these domains than do the female patients. Additionally, the nurses do not underestimate the degree to which patients, especially males, experience pain and pain-related interference from chronic illness. Finally, there was no significant relationship between patients' self-report of pain severity or pain-related interference and an objective measure of disease severity.