Detection

of Response Bias
in Forensic Neuropsychology
Part I
Journal of Forensic Neuropsychology
Volume 2, Numbers 3/4

CONTENTS

Preface xv

A Review of Rey’s Strategies for Detecting Malingered

Neuropsychological Impairment 1
Richard I. Frederick
André Rey was a pioneer in clinical psychology, child clinical psychology, and
neuropsychology. His contributions to the understanding of brain-behavior rela-
tionships were novel, creative, and highly regarded. Rey developed many epony-
mous tests and procedures. Three are relatively well known in American neuro-
psychological literature as “tests of malingering”: The Rey 15-Item Memory Test
(RMT), the Rey Word Recognition Test (WRT), and the Rey Dot Counting Test
(DCT), referred to collectively in this paper as the “Rey malingering tests.” By cit-
ing his original work, this article reports Rey’s method of assessing the validity of
clinical presentation, his instructional sets for each test, and his process of inter-
preting test results. Additionally, this article reviews published research regarding
the efficacy of the Rey malingering tests as they have been used in this country.
Most instructional sets and interpretive strategies generally have not followed
Rey, but have followed those represented as Rey’s by Lezak (1983, 1995).
KEYWORDS. Malingering, neuropsychological assessment, psychological evi-
dence, André Rey

The Portland Digit Recognition Test: A Review

of Validation Data and Clinical Use 27
Laurence M. Binder
The Portland Digit Recognition Test (PDRT) is a valid measure of motivation to
perform poorly on memory tests that is useful in forensic evaluations. Validation
 data and clinical use are described. The PDRT meets standards of the Daubert de-
cision for the admissibility of scientific data into the courtroom by expert wit-
nesses. The PDRT has been tested in scientific studies, results of scientific studies
have appeared in peer-reviewed journals, the error rate is known, and it is well ac-
cepted in the scientific community according to published articles. A survey
showed that 27% of forensic neuropsychologists reported using the PDRT consis-
tently (Essig, Mittenberg, Petersen et al., 2001). Cutoff scores are available with
100 percent specificity, and these cutoff scores have moderate sensitivity for detec-
tion of poor motivation. The strongest psychometric evidence of faking a memory
deficit occurs when a forced choice test result is significantly worse than chance.
Data indicate that worse than chance results occur regularly on the PDRT.
KEYWORDS. Malingering, brain injuries

The Victoria Symptom Validity Test: An Enhanced Test

of Symptom Validity 43
Garrie B. Thompson III
The Victoria Symptom Validity Test (VSVT) is a computer-administered and
scored, two-alternative, forced-choice symptom validity test designed to assess the
validity of a patient’s purported cognitive impairments (Slick, Hopp, Strauss, &
Thompson, 1997). The VSVT benefits from numerous enhancements that increase
its sensitivity beyond that of other earlier symptom validity tests without increas-
ing its administration time or decreasing its specificity. It also has the ability to
generate graphs and reports that can be used to assist the jury and the court in as-
sessing whether a plaintiff’s purported cognitive impairments are valid without
the requirement of an extensive understanding of binomial probability theory. The
VSVT’s reliability and validity is inherent in its use of binomial probability theory,
which has been used in many other well known symptom validity tests, and recent
studies have demonstrated the VSVT’s ability to detect response bias or malinger-
ing. Therefore, the VSVT likely meets the new Daubert standards for the admissi-
bility of scientific evidence presented in a courtroom. Recent studies have also
identified empirically validated cut-off scores for the VSVT that may further serve
to enhance its sensitivity.
KEYWORDS. Victoria Symptom Validity Test, malingering, Daubert decision,
forced-choice test

The Test of Memory Malingering (TOMM) in Forensic

Psychology 69
Tom N. Tombaugh
The Test of Memory Malingering (TOMM) is described with particular emphasis
directed towards the historical setting within which the TOMM was developed.
This includes a review of the criteria for developing a memory malingering test,
and the use of the empirically derived decision along with a discussion of the rela-
tive merits of empirically based vs. statistically based rules for detecting malinger-
ing. Data from a series of five experiments showing the sensitivity of the TOMM to
feigned memory impairments, guidelines for interpretation of TOMM scores, and
answers to frequently asked questions about the TOMM are provided. Finally, the
ability of the TOMM to meet the Daubert guidelines is addressed.
KEYWORDS. Malingering, neuropsychological assessment, TOMM
The Word Memory Test and the Validity
of Neuropsychological Test Scores 97
Paul Green
Paul R. Lees-Haley
Lyle M. Allen III
The Word Memory Test (WMT; Green, Allen, & Astner, 1996) contains measures
that are very sensitive to exaggeration or poor effort but insensitive to all but the
most extreme forms of cognitive impairment. The WMT is unique among symptom
validity tests because of its extensive validation in clinical forensic settings, rather
than relying on simulation research with healthy volunteers. Effort measured by
the WMT predicted 50% of the variance in a total of 30,736 neuropsychological
test results from 904 consecutive patients involved in compensation claims. In
group data, WMT-measured effort was sufficient to eliminate or reverse major ef-
fects, such as the presence of greater impairment in people with severe versus mild
head injuries. The removal of invalid data from people failing the WMT was found
to make a major difference to the conclusions of several studies. Properly inter-
preted, the WMT will meet Daubert challenges.
KEYWORDS. Effort, malingering, brain injury, symptom validity

Review of the Validity Indicator Profile 125

Richard I. Frederick
The Validity Indicator Profile (VIP; Frederick, 1997) is a two-alternative forced-
choice test procedure intended to identify when the results of cognitive and
neuropsychological testing may be invalid because of malingering or other prob-
lematic response styles. The test consists of 100 problems that assess nonverbal
abstraction capacity and 78 word-definition problems. The VIP attempts to estab-
lish whether an individual’s performance in an assessment battery should be con-
sidered representative of his or her true overall capacities (valid or invalid). This
paper reviews the development and cross-validation of the VIP, and the paper dis-
cusses how demonstrations of the construct validity of the VIP support a conclu-
sion that its use as described above fulfills Daubert evidentiary standards. The
author discusses the benefits of using the VIP and identifies some potential chal-
lenges for using the VIP in making decisions about the response styles of individu-
als who are having their cognitive abilities assessed.
KEYWORDS. Malingering, neuropsychological assessment, psychological evi-
dence, effort

Warrington’s Recognition Memory Test in the Detection

of Response Bias 147
Scott R. Millis
Use of Warrington’s Recognition Memory Test (RMT) for the detection of re-
sponse bias and malingering is evaluated. The RMT’s psychometric characteris-
tics are reviewed. A method for using the RMT to detect response bias is presented:
determining the probability of obtaining specific RMT scores; comparing the indi-
 vidual patient’s RMT scores with group data from patients with established neuro-
logic disorders; combining RMT data with other test data; integrating injury
characteristics and psychosocial factors with RMT scores; and use of prevalence
rates with the RMT. RMT data from a sample 90 persons with acute traumatic
brain injury, stratified by injury severity, are presented to provide clinical bench-
marks. The evidentiary reliability of the RMT is also discussed in light of Daubert
factors.
KEYWORDS. Recognition memory test, malingering, psychophysiologic disor-
ders, neuropsychological tests

Detection of Response Bias in Forensic Neuropsychology, Part II,

will follow in Journal of Forensic Neuropsychology, Volume 3,
Numbers 1/2.