Abstract
The Forced Choice Test (FCT) can be used to detect malingered loss of memory or sensory deficits. In this test, examinees are presented with two stimuli, one correct and one incorrect, in regards to a specific event or a perceptual discrimination task. The task is to select the correct answer alternative, or guess if it is unknown. Genuine impairment is associated with test scores that fall within chance performance. In contrast, malingered impairment is associated with purposeful avoidance of correct information, resulting in below chance performance. However, a substantial proportion of malingerers intentionally randomize their responses, and are missed by the test. Here we examine whether a ‘runs test’ and a ‘within test response ‘bias’ have diagnostic value to detect this intentional randomization. We instructed 73 examinees to malinger red/green blindness and subjected them to a FCT. For half of the examinees we manipulated the ambiguity between answer alternatives over the test trials in order to elicit a response bias. Compared to a sample of 10,000 cases of computer generated genuine performance, the runs test and response bias both detected malingered performance better than chance.
Highlights
The detection rates estimates outlined above corresponds to the prevalence of the specific strategies malingerers employ to avoid detection
An examinee may, for example, think that on trials with strong opacity, the difference between the two objects is so clear that even red/green blind participants will perceive the difference, and select the correct alternative. This would result in a correlation between correct/incorrect answers and opacity, and this correlational response bias can serve as a new criterion designed to detect intentional randomization
This study examined the diagnostic value of correct total scores, the runs test and the response bias criteria to detect malingered red/green blindness in examinees who utilize level 2 strategies, i.e., who randomize between correct and incorrect answers, in a Forced Choice Test
Summary
The detection rates estimates outlined above corresponds to the prevalence of the specific strategies malingerers employ to avoid detection. We test whether a new criterion that produces a performance curve as a function of the perceived – but not the actual – difficulty, is sensitive to level 2 strategy users, i.e. those who randomize between correct and incorrect answers. An examinee may, for example, think that on trials with strong opacity, the difference between the two objects is so clear that even red/green blind participants will perceive the difference, and select the correct alternative This would result in a correlation between correct/incorrect answers and opacity, and this correlational response bias can serve as a new criterion designed to detect intentional randomization. We expect the runs test - based on the number of alternations between correct and incorrect - to detect malingerers using a level 2 strategy better than chance, with higher alternation rates indicating malingered performance (Hypothesis 2). We refer to this bias as response bias, and expect this to detect malingerers better than chance (Hypothesis 3)
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