Abstract
Objective: Here we report an investigation on the accuracy of the b Test, a measure to identify malingering of cognitive symptoms, in detecting malingerers of mild cognitive impairment.Method: Three groups of participants, patients with Mild Neurocognitive Disorder (n = 21), healthy elders (controls, n = 21), and healthy elders instructed to simulate mild cognitive disorder (malingerers, n = 21) were administered two background neuropsychological tests (MMSE, FAB) as well as the b Test.Results: Malingerers performed significantly worse on all error scores as compared to patients and controls, and performed poorly than controls, but comparably to patients, on the time score. Patients performed significantly worse than controls on all scores, but both groups showed the same pattern of more omission than commission errors. By contrast, malingerers exhibited the opposite pattern with more commission errors than omission errors. Machine learning models achieve an overall accuracy higher than 90% in distinguishing patients from malingerers on the basis of b Test results alone.Conclusions: Our findings suggest that b Test error scores accurately distinguish patients with Mild Neurocognitive Disorder from malingerers and may complement other validated procedures such as the Medical Symptom Validity Test.
Highlights
An increasing number of studies have been published in order to address the phenomenon of malingering and the detection of malingered cognitive symptoms
In the context of cognitive dysfunctions, neuropsychologists and clinical psychologists have increasingly relied on the results of neuropsychological evaluations to inform their opinions regarding the nature, extent, and credibility of claimed cognitive impairments
Mild cognitive impairments are not usually accompanied by daily living impairments and malingerers may be difficult to detect using simple strategies consisting in comparing cognitive test results and daily activities
Summary
An increasing number of studies have been published in order to address the phenomenon of malingering and the detection of malingered cognitive symptoms. A number of investigations (e.g., Sartori et al, 2016b; Walczyk et al, 2018) indicate that malingering typically occurs in three broad domains: psychopathology, cognitive impairment, and medical illness. In the context of cognitive dysfunctions, neuropsychologists and clinical psychologists have increasingly relied on the results of neuropsychological evaluations to inform their opinions regarding the nature, extent, and credibility of claimed cognitive impairments. Clinical and research efforts have led to increasingly sophisticated and effective methods and instruments designed to detect malingering which are typically observed in most medico-legal settings. The more extensive the cognitive dysfunction is displayed, the more monetary compensation is expected and individuals have significant motive to simulate or over-exaggerate symptoms
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