Assessment of Malingering and Falsification: Continuing to Push the Boundaries of Knowledge in Research and Clinical Practice

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Major progress has been made in the assessment of cooperation with neuropsychological assessment and the evaluation of effort and falsification. However, various critical problems remain, along with areas in which we can continue to expand the boundaries of knowledge and thereby improve diagnostic and predictive accuracy. For example, although current methods can improve diagnostic accuracy across a range of cases, a significant subset of cases create substantially greater challenges and susceptibility to error. Numerous potential sources of error in effort assessment are reviewed, and factors in research studies, such as the extreme group problem, that can markedly overrepresent accuracy rates obtained in usual forensic applications, leading to a range of adverse consequences. Other key issues and challenges include overreliance on impressionistic methods as opposed to scientifically verified procedures for integrating results across measures and evaluating the impact of insufficient effort on other tests; co-presentation of true injury and falsification, a frequent issue that has been minimally studied, can markedly alter assumptions about base rates, and result in the simultaneous occurrence of true-positive and false-positive errors; susceptibility to coaching and identification of underlying detection strategies, especially in the age of the Internet; and limits in knowledge about generalization of methods to different classes and severity of neuropsychological injures, and especially to diverse groups. Research on multicultural issues in effort assessment is a critical and, at present, largely unmet need that merits far greater attention. Numerous suggestions are presented for assessment and research strategies that may help to enhance knowledge across the various areas covered in the chapter, such as methods to increase generalization to clinical practices, especially for evaluating more challenging cases, for diminishing vulnerability to examinee’s knowledge of detection strategies, and for managing ambiguity in group assignment in research studies through such methods as mixed group validation.

Publication Title, e.g., Journal

Detection of Malingering during Head Injury Litigation, Third Edition