Psychological Assessment of Symptom and Performance Validity,Response Bias,and Malingering: Official Position of the Association for Scientific Advancement in Psychological Injury and Law

Evidence-based forensic psychological opinions require thorough and accurate information about examinees. Psychometric instruments can facilitate diagnostic decision making, but they rely on examinees to respond honestly to questions and put forth good effort on cognitive tests. Given the strong incentives for examinees in psychological injury cases to minimize prior problems and emphasize postaccident or posttrauma problems, the assessment of validity as part of forensic psychological evaluations is essential. Best practices in forensic psychology have their foundation in ethical principles. The purpose of this position statement is to promote ethical psychological practice in legal contexts by reviewing validity assessment issues and their ethical foundations. Because no previously published document focused specifically on symptom and performance validity assessment in psychological injury evaluations performed in forensic contexts, such a position statement provided by a professional organization devoted to the interface of psychological injury and law was needed to inform and guide practitioners and to educate other interested parties. The position statement emphasizes (a) the need for ethical practice in assessing validity, (b) consideration of factors such as culture and functional limitations, and (c) the importance of adopting a comprehensive, impartial, and scientific approach to validity assessment. The position statement acknowledges areas of differing opinions and the need for further research.     

Cross-Validation of Supplemental Test of Memory Malingering Scores as Performance Validity Measures

Assessment of the validity of neuropsychological test data has become an ensconced aspect of the assessment process. Among the more popular free-standing performance validity measures (PVMs) is the Test of Memory Malingering (Tombaugh 1996). Given the popularity of this measure, a number of researchers (i.e., Trial 1 (Denning, 2012); TOMMe10 (Denning, 2012); Albany Consistency Index (Gunner, Miele, Lynch, & McCaffrey, 2012)) have sought to expand its utility by increasing the number of scoring approaches associated with its administration. This paper aimed to cross-validate prior work by examining the performance of these measures in a mixed clinical sample of veterans referred for neuropsychological evaluation. All five examined measures provided good to excellent discrimination of patients determined to be putting forth poor effort based on failure of two or three alternate measures of performance validity. Traditional scoring approaches revealed high rates of specificity, with lower rates of sensitivity. The newer measures performed well for both sensitivity and specificity at higher base rates. However, predicted performance in low base rate populations (i.e., 0.10) using the newly derived scoring failed to reach predetermined cutoffs for specificity (0.90). Further examination of the cumulative performance of the scoring approaches indicated that administration of only two initial scoring indices was necessary to obtain a high rate of classification.     

Further Validation of the Test of Memory Malingering (TOMM) Trial 1 Performance Validity Index: Examination of False Positives and Convergent Validity

Assessment of performance validity is an essential part of a neuropsychological evaluation, with the inclusion of two or more performance validity tests (PVTs) becoming routine practice. Considering the time to administer multiple tests, there has been some support for use of the Test of Memory Malingering (TOMM) Trial 1 (T1) as an independent, “one and done” PVT. Notably, cutoffs for TOMM T1 need further validation, with an emphasis on minimizing false-positive classifications among those with bona fide cognitive impairment. In a clinically referred sample of 127 veterans, this study examined the role of cognitive impairment in TOMM performance and the utility of a TOMM T1 as an independent PVT. Examinees were administered the TOMM and three additional PVTs as part of a comprehensive neuropsychological battery. Sixty-eight percent of examinees were classified valid (35% of valid examinees were cognitively impaired). TOMM T1?≤?40 had excellent observed sensitivity (83%) and specificity (93%) overall, with minimal false-positive classification. TOMM T1 was also significantly correlated and concordant with other memory-based PVTs. Given score ranges and failure rates for TOMM T1?≤?40 among those with neurological/neurocognitive conditions, scores in the 37–40 range may merit administration of additional TOMM trials to maximize accuracy in identifying valid-cognitively impaired versus noncredible performance. Otherwise, an abbreviated TOMM administration (i.e., only T1) using a cutoff of ≤?40—in conjunction with one or more additional PVTs—may be sufficient for detecting noncredible/invalid test performance in the absence of known or suspected neurological/neurocognitive disorders.     

Trauma and Psychological Injury: Practice, Clinical, Legal, and Ethical Issues

Psychologists need continuing education in areas pertinent to their practice. The area of psychological injury and law presents issues and conundrums that need careful ongoing evaluation for appropriate clinical practice, adherence to ethical standards, and functioning in the legal context. In this article, we prepared a series of vignettes that illustrate these difficulties in the practice, clinical, legal, and ethical spheres related to the area of psychological injury and law. The vignettes, together with accompanying commentaries, are meant for use in workshops, and they aim to educate, stimulate, and provoke. Furthermore, the article has been written with the aim of interaction with readers, in that we seek commentaries from readers both for purposes of publication and use in workshops.     

Symptom Validity Testing for the detection of simulated amnesia: Not robust to coaching

Abstract

Symptom Validity Testing (SVT) has been proposed as a method to assess the veracity of claims of amnesia. Performance below chance levels on a forced choice task is indicative of malingering. Previous research has shown that the Symptom Validity Test is a promising challenge test: at levels of high specificity, it may detect approximately half of those who malinger. The present study investigated the effect of coaching on the sensitivity of the Symptom Validity Test. Participants were instructed to feign complete amnesia and tested about their identity using the Symptom Validity Test. Half of the participants were coached not to perform below chance levels. Results were straightforward: 58% of 19 naive malingerers were detected, but none of 19 coached malingerers were detected. The results show that the Symptom Validity Test is not resistant to coaching.     

The Self-Report Symptom Inventory (SRSI): a New Instrument for the Assessment of Distorted Symptom Endorsement

Self-report instruments to detect distorted symptom reporting play a crucial role in clinical and forensic psychology. Most of the instruments currently available for this purpose only list implausible symptoms, which makes them easily identifiable as symptom validity tests. We developed the Self-Report Symptom Inventory (SRSI), combining five self-report scales of genuine symptoms with five pseudosymptom scales to screen for distorted symptom reporting in various domains (e.g., depression, post-traumatic stress). With a preliminary questionnaire version, we collected data in a heterogeneous sample (N?=?239) and performed an item selection, resulting in the final 107-item version. This version was evaluated in civil forensic patients, inmates of a prison, and a population-based sample; N?=?387). Data show that (a) SRSI pseudosymptom scores correlate highly (≥.80) with other instruments tapping distorted symptom endorsement, notably the Structured Inventory of Malingered Symptomatology; (b) High SRSI pseudosymptom scores tend to correlate with underperformance; and (c) The psychometric features of the SRSI are satisfactory, with internal consistency for the total scales >.90 and retest reliability >.85. The instrument appears to be a promising tool for examining symptom exaggeration, but further work is required, in particular cross-validation with other samples and different methods.     

Ethical, Legal and Risk Management Considerations in the Neuropsychological Assessment of Veterans

This article examines the ethical and regulatory issues facing neuropsychologists practicing within the Department of Veterans Affairs (VA) system, either as Veteran Health Administration neuropsychologists or as consultants. The focus is proactive, with an emphasis on preparation consistent with a positive approach to ethical practice and risk management. Given the sheer magnitude of applicable Federal regulations and guidelines, the scope is limited to an overview of select ethical complexities involved in the professional practice of neuropsychology with veterans within VA settings. The article uses a top-down structure, with each section (a) identifying the relevant core biomedical ethical principles, followed by (b) an elaboration of the relevant ethical requirements as defined by the American Psychological Association’s Code of Ethics, and (c) applicable Federal regulations. Suggestions for translating core ethical principles and relevant ethical requirements into pragmatic action consistent with Federal regulation follow. Topics include (a) establishing professional competence, (b) understanding the type of assessment, (c) understanding consent requirements, and (d) understanding the ethical and regulatory issues in assessing veteran symptom presentation.     

管理胜任力面试测评的有效性研究

影响管理胜任力面试测评有效性的因素是多方面的,因此要提高管理胜任力面试测评有效性需要采用相应的有针对性的方法.分析表明,不同的待测管理胜任力需要有不同的测评模式,不同的测评模式需要有不同测评能力的主试.管理胜任力面试测评的有效性,最终取决于岗位差异对管理胜任力的要求、面试测评的模式及主试的测评能力这三个要素的有效匹配与组合.通常,非结构的测评模式适宜测评高层次岗位的管理胜任力,可用纯经验型的主试;结构化的测评模式适宜测评低层次岗位的管理胜任力,可用纯技术型的主试.     

Traumatic Brain Injury Alters Word Memory Test Performance by Slowing Response Time and Increasing Cortical Activation: An fMRI Study of a Symptom Validity Test

The Word Memory Test (WMT) is an established symptom validity test that relies on verbal memory performance to make inferences about “effort.” Previous studies, using a functional MRI (fMRI) adaptation of the WMT with healthy controls, have shown that successful completion of the WMT relies on a widespread network of neural systems associated with high cognitive effort. Additional studies using the same fMRI paradigm with patients with severe traumatic brain injury (TBI) suggest that increased activation of cortical regions associated with cognitive load are recruited to meet the cognitive challenges that the WMT places on a compromised neural system. This study builds on previous findings as a result of highly uncommon circumstances in which fMRI data on the WMT task were made available from the very same individual both 1 year before and 1 year after sustaining a TBI. Interestingly, the effect of TBI did not appear to impair performance on the WMT in terms of standard accuracy measurements, though response times were notably slower. The main fMRI finding was a significantly stronger and more widespread pattern of activation post-injury, particularly in the frontal and parietal brain regions, suggesting that stronger engagement of these networks was necessary to sustain accurate WMT performance compared to pre-injury testing. This unique source of data, together with previous findings, suggests a more complex relationship between effort and performance levels on the WMT than what is commonly assumed.     

Neuropsychological,Psychological, and Vocational Assessment of High Achievers in a Medicolegal Context

High achievers are a unique subset of persons referred for neuropsychological and psychological assessments in medicolegal contexts, including personal injury, disability, and workers’ compensation cases. Literature in this area is limited and poorly integrated, and neither a conceptual model nor best evidence-informed practices for the assessment of high achievers in the medicolegal context have yet emerged. Construct and methodological issues also hamper the ability of assessors to accurately and fairly assess this specialist group, which is particularly troubling in high-stakes forensic assessments. This paper reviews the current methodological issues involved in the assessment of high achievers and proposes an integrated, multimethod assessment model based on a particular vocational group, namely that of business leaders and entrepreneurs, that draws from available empirical research in different fields of psychological inquiry.     

Ambiguous Measures of Unknown Constructs: The MMPI-2 Fake Bad Scale (aka Symptom Validity Scale, FBS, FBS-r)

The Fake Bad Scale (FBS; Symptom Validity Scale) has fundamental psychometric flaws, interpretive problems, and potentially adverse societal consequences that are not appreciated by Ben-Porath et al. (Psychological Injury and Law 2(1), 62–85, 2009a, b). The FBS was constructed without due consideration to scientifically based guidelines for scale development (Clark and Watson, Psychological Assessment 7, 309–319, 1995; Jackson, Psychological Review 78, 229–248, 1971; Nunnally 1978; Holden and Troister, Canadian Psychology 50, 120–130, 2009). After almost two decades in existence, its face, content, and construct validity have not been established in the empirical literature. Oft-cited discriminant studies that appear to support the FBS are premature because of the scale’s unestablished psychometric foundation. In addition, these studies have significant methodological weaknesses that preclude definitive conclusions about what the scale actually measures. We review these weaknesses and recent legal cases that challenge the scale. We recommend that the FBS’s validity and fairness be addressed in an independent scientific review by the Buros Mental Measurement Test Evaluation System, a non-profit center specializing in the evaluation of commercially available tests.     

政府绩效管理与评估对公务员绩效考核的影响

从20世纪70年代至今,西方国家对公务员绩效考核制度的研究已经比较全面,而我国公务员绩效考核制度的建设尚处于发展阶段。本文分析了目前我国政府绩效评估与管理的实践状况、存在的问题及产生问题的原因,力图从理论上探索出适合我国国情的公务员绩效考核策略和模式,以提高我国公务员绩效考核的科学性、有效性及准确性。     

Ontario Psychological Association Guidelines for Assessment and Treatment in Auto Insurance Claims

The Ontario Psychological Association Guidelines for Assessment and Treatment in Auto Insurance Claims was published on the Ontario Psychological Association website in July, 2010 (Smith, A., and OPA Auto Task Force, 2010, Ontario Psychological Association Guidelines for Assessment and Treatment in Auto Insurance Claims. Ontario Psychological Association, Toronto, Ontario. Retrieved from http://www.psych.on.ca/files/members/OPA_Auto_Practice_Guidelines_July292010_July_30_2010.pdf). Excerpts are reproduced in the journal because of the comprehensive nature of the document. To our knowledge, this is the first time that state or provincial guidelines have included all the major psychological diagnoses in rehabilitation work with motor vehicle accident survivors (chronic pain, post-traumatic stress disorder, traumatic brain injury, depression). Space limitations preclude publishing of the full document, but it should be consulted. The present excerpt focuses on the nature of the psychological injuries and the best practices in treating them, along with cautions for assessment, comorbidities and polytrauma, litigation distress and barriers and complications in recovery.     

证言真实性的审查与判断——陈述有效性评估技术

在证言研究中有一著名的理论假设：即来自于真实经历的证言与经他人教唆或自己幻想产生的证言是有区别的。现代的法庭科学与司法心理学也证实了“亲身经历过的事件记忆与想象记忆有着质的差异”。建立在上述差异基础上所形成的陈述有效性评估技术，专门用于检测言词的准确性，现已经在一些西方国家得以运用，在个别国家还甚至被运用于刑事领域。