Abstract
Neurocognitive response bias is a concern of clinical neuropsychologists, as accurate assessment is not possible if the patient being tested is not putting forth maximum effort during testing. Despite decades of research in this area, very little study has specifically examined the resilience of neuropsychological tests to incomplete effort. When college students asked to feign cognitive deficits are assessed on the Tower Test from the Delis - Kaplan Executive Function System (D-KEFS), they perform similarly to control participants (asked to do their best) on several Tower Test scales and significantly better than those with known clinical deficits. These results suggest that the Tower Test may have some resiliency to neurocognitive response bias.
Highlights
Incomplete effort is of major concern to clinical neuropsychologists, as the validity of cognitive assessment is dubious if the patient is not putting forth their maximum effort.[3]
When considering alternative explanations that may account for these findings, we explored whether the “Fake Bad” and Control Group groups had similar performances on the Tower Test because the Simulator Group did not understand the experimental directions to not do their best and tried their hardest when asked to complete the neuropsychological tests
Research into neurocognitive response bias tends to be centered on its detection
Summary
There has been significant interest in the accuracy of neuropsychological assessment with patients who are not putting forth maximum effort during testing.[1,2] Incomplete effort is of major concern to clinical neuropsychologists, as the validity of cognitive assessment is dubious if the patient is not putting forth their maximum effort.[3]. There has been evidence that even patients with true neurocognitive deficits may bias their responses, when the outcome of neuropsychological evaluation may involve compensation.[8]
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