Detecting malingering in traumatic brain injury: Combining response time with performance validity test accuracy

• Published in: Clinical neuropsychologist Vol. 33; no. 1; pp. 90 - 107
• Main Authors: Kanser, Robert J., Rapport, Lisa J., Bashem, Jesse R., Hanks, Robin A.
• Format: Journal Article
• Language: English
• Published: England Routledge 02.01.2019
• Subjects: Adolescent; Adult; Aged; Brain Injuries, Traumatic - psychology; Female; Humans; Male; malingering; Malingering - diagnosis; Malingering - pathology; Middle Aged; Neuropsychological Tests - standards; performance validity; Reaction Time - physiology; response time; Traumatic brain injury; Young Adult; malingering; performance validity; Traumatic brain injury; response time
• ISSN: 1385-4046; 1744-4144
• DOI: 10.1080/13854046.2018.1440006

Objective: The present study examined the incremental utility of item-level response time (RT) variables on a traditional performance validity test in distinguishing adults with verified TBI from adults coached to feign neurocognitive impairment. Method: Participants were 45 adults with moderate to severe TBI, 45 healthy adults coached to feign neurocognitive impairment (SIM), and 61 healthy adult comparisons providing full effort (HC). All participants completed a computerized version of the Test of Memory Malingering (TOMM-C) in the context of a larger test battery. RT variables examined along with TOMM-C accuracy scores included mean RTs (Trial 1, Trial 2, correct and incorrect trials) and RT variability indices. Results: Several RT indices differed significantly across the groups. In general, SIM produced longer, more variable RTs than HC and TBI. Of the RT indices, average RT for Trial 1 and 2 were the best predictors of group membership; however, classification accuracies were greatly influenced by the groups being compared. Average RT for Trial 1 and 2 showed excellent discrimination of SIM and HC. All RT indices were less successful in discriminating SIM and TBI. Average RT for Trial 1 and 2 added incremental predictive value to TOMM-C accuracy in distinguishing SIM from TBI. Conclusion: Findings contribute to a limited body of research examining the incremental utility of combining RT with traditional PVTs in distinguishing feigned and bona fide TBI. Findings support the hypothesis that combining RT with TOMM-C accuracy can improve its diagnostic accuracy. Future research with other groups of clinical interest is recommended.