Neuropsychological Test Performance of Successful Brain Injury Simulators

Abstract

This study provided an examination of the performance characteristics of successful brain injury simulators (SBIS). Coached (n = 56) and uncoached (n = 35) brain injury simulators received instructions to fake cognitive impairment; controls were asked to do their best. The Test of Memory Malingering (TOMM) was administered along with standard neuropsychological measures (e.g., Wisconsin Card Sorting Test). The TOMM identified 80% of uncoached and 60% of coached brain injury simulators. SBIS were participants from the brain injury simulation groups whose TOMM performance indicated adequate effort. A total of 32% of all brain injury simulators scored above the TOMM cutoff scores for adequate effort (the SBIS group). Significantly more coached than uncoached participants composed the SBIS group (76% vs. 24%, respectively). SBIS performed significantly worse than controls and significantly better than unsuccessful brain injury simulators on select standard neuropsychological measures. The SBIS scores were lowered compared to controls; in some instances this lowered performance was at a clinically relevant level.

Keywords:

• Dissimulation
• Malingering
• Successful brain injury simulators
• Test of Memory Malingering (TOMM)

ACKNOWLEDGMENTS

Portions of the manuscript were presented at the 2004 Annual Meeting of National Academy of Neuropsychology, Seattle, WA and the 2005 Annual Meeting of the International Neuropsychological Society, St. Louis, MO, USA.

The authors wish to acknowledge the valuable contributions of the following members of The University of Montana Neuropsychology Lab: Jennifer Cragun, Anne Shandera, Sarah Nelson, Jacquelyn Bergstrom, and Curtis Simonds.

Notes

Note. SBIS = successful brain injury simulators; CDBIS = coached detected brain injury simulators; UDBIS = uncoached detected brain injury simulators.

Note. SBIS = successful brain injury simulators; CDBIS = coached detected brain injury simulators; UDBIS = uncoached detected brain injury simulators. Means in the same column that do not share subscripts differ at p < .05.

Note. SBIS = successful brain injury simulators; CDBIS = coached detected brain injury simulators; UDBIS = uncoached detected brain injury simulators. Means in the same column that do not share subscripts differ at p < .05. *In seconds.