Rey 15-Item Test Research Articles

The effects of motivation, coaching, and knowledge of neuropsychology on the simulated malingering of head injury

Two student groups, introductory psychology (n=91) and advanced neuroscience (n=34) undergraduates, were asked to malinger a head injury on Rey's 15-Item Test (FIT) and Dot Counting Test (DCT). The participants were randomly assigned to one of three motivation conditions (no motivation given, compensation, avoidance of blame for a motor vehicle accident) and to one of three coaching conditions (no coaching, coaching post-concussive symptoms, coaching symptoms plus warning of malingering detection). Analyses revealed a MotivationxStudent Group interaction on the FIT, indicating that the advanced neuroscience students, particularly when in the compensation condition, malingered the most flagrantly. On the DCT, main effects for motivation and coaching on the qualitative variables and a MotivationxCoaching interaction on the accuracy variables indicated that those in the compensation condition performed the most poorly, and that coaching plus warning only tempers malingering on memory tasks, not timed tasks.

Detecting malingering: a survey of experts’ practices

A survey addressing practices of ‘expert’ neuropsychologists in handling financial compensation claim or personal injury litigation cases was carried out. Potential participants were identified by publication history. Responses were obtained from 24 out of the 39 neuropsychologists who were surveyed. Approximately 79% of the respondents reported using at least one specialized technique for detecting malingering in every litigant assessment. Half stated that they always give specialized tests at the beginning of the assessment. The Rey 15-Item test and the Test of Memory Malingering were the most frequently reported measures. Respondents also reported frequent use of ‘malingering’ indexes from standard neuropsychological tests. Reported base-rates varied, but the majority of respondents indicated that at least 10% of the litigants they assessed in the last year were definitely malingering. Respondents were split on the practice of routinely giving warnings at the outset of assessments that suboptimal performance may be detected. However, when the client’s motivational status was suspect, more than half (58.3%) altered their assessment routine at least on some occasions, by encouraging good effort (70.8%) or administering additional SVTs. A minority directly confronted or warned clients (25%), terminated the examination earlier than planned (16.6%), or contacted the referring attorney immediately (29.2%). Respondents almost always stated some opinion regarding indicators of invalidity in written reports (95%). However, 41.7% rarely used the term ‘malingering’ and 12.5% never used the term. Most respondents (>80%) instead stated that the test results are invalid, inconsistent with the severity of the injury or indicative of exaggeration.

Correlations Among the TOMM, Rey-15, and MMPI-2 Validity Scales in a Sample of TBI Litigants

ABSTRACT The importance of the detection of possible symptom exaggeration/malingering has gained increased attention among neuropsychologists, and as a result, a number of techniques have been developed for the identification of suspected malingering. The goal of this study was to examine the extent towhich several of these commonly used techniques correlate with one another in a clinical sample. Archival data on 97 litigants were analyzed, and scores on the Test of Memory Malingering (TOMM), Rey 15-Item Test (Rey-15), and MMPI-2 validity scales were compared. The MMPI-2 validity scales did not positively correlate with any trial on the TOMM or with the Rey-15, with the exception of the Fb scale which significantly negatively correlated with TOMM trial 1. The results of the present study suggest that the MMPI-2 validity scales are measuring a different construct than tests of malingered memory deficits, and therefore should be interpreted cautiously in forensic evaluations.

Utility of the Trail Making Test in the Assessment of Malingering in a Sample of Mild Traumatic Brain Injury Litigants

The Trail Making Test (TMT) is one of the most commonly administered tests in neuropsychological assessments. It has been shown to be a valid indicator of brain damage due to traumatic brain injury (TBI), as well as a number of other neuropathological conditions. TMT error and ratio scores have been suggested as possible markers of malingering. The present study examined the utility of various TMT scores as malingering measures in 94 TBI litigants. Litigants were divided into those suspected of (n =27) and those not suspected of malingering (n =67) based on scores obtained on the Test of Memory Malingering and/or the Rey 15-Item Test. TMT errors did not discriminate between suspected and nonsuspected malingerers; however, the overall level of performance on the TMT was suppressed in suspected malingerers. The TMT ratio score was significantly lower in litigants suspected of malingering, although the clinical utility of this ratio is minimal. Results of the present study suggest using caution when interpreting TMT scores as markers of malingering in TBI litigants.

Evaluation of malingering cut-off scores for the Rey 15-Item Test: a brain injury case study series

Primary objective : To evaluate the utility of prescribed malingering cut-off scores by examining the Rey Fifteen-Item Test (FIT) responses of persons with severe brain injury. Research design : Series of five case studies. Methods and procedures : The FIT was administered along with standardized neuropsychological and neurobehavioural meausres. Main outcomes and results : Using the standardized scoring protocol, all five patients obtained perfect (15/15 correct) scores on the FIT. All patients exhibited significant impairment on other neuropsychological indices, included measures of memory and attention. Conclusions : Results lend support to the use of higher cut-off scores to identify malingering. Further large-scale research is recommended to ascertain the reliability of FIT scoring procedures, determine cut-off scores for various diagnostic groups and develope age and education adjustments. Implications for use of the FIT in clinical and forensic settings are also discussed.

The Rey 15-Item Recognition Trial: A Technique to Enhance Sensitivity of the Rey 15-Item Memorization Test

Numerous publications on the Rey 15-item Memorization Test have cited limitations primarily in test sensitivity, as well as to some extent in specificity. In the current study, 49 patients with suspect effort, 36 neuropsychology clinic patients not in litigation or attempting to secure disability, 33 learning disabled college students, and 60 normal controls were administered the Rey Test in standard format followed by a recognition trial. A free recall score <9 was found to have excellent specificity (97–100%), although sensitivity was modest (47%). However, use of a combined recall and recognition score (i.e., free recall+[recognition–false positives] <20) substantially increased sensitivity (71%) while maintaining high specificity (=92%).

Performance of Older Depressed Patients on Two Cognitive Malingering Tests: False Positive Rates for the Rey 15-item Memorization and Dot Counting Tests

To our knowledge, no investigations have been undertaken to determine whether depression impacts performance on two commonly used tests to detect malingering of cognitive symptoms, the Rey 15-item Memorization Test and the Rey Dot Counting Test. This is a critical issue because of the high rate of depressive symptoms in patients with neurological conditions. It was hypothesized that depressed individuals, especially those with more severe depression, might be at risk for failing the tests, because these patients exhibit mild deficits in mental speed, visual perceptual/spatial skills, and visual memory, abilities required for successful completion of the malingering tests. However, examination of test performance in 64 older participants with major depression generally revealed very low false positive rates for most test scores, and severity of depression was unrelated to test scores. These results add to accumulating data supporting the validity of these cognitive malingering tests by documenting few false positive identifications.

Amnestic Disturbance and Posttraumatic Stress Disorder in the Aftermath of a Chemical Release

Neuropsychological assessments were performed on 70 patients referred after a Catacarb chemical release in a Northern California town. After appropriate exclusions, the 59 patients used in the final analysis were mostly White (66%), with 56% having some college level education. They were administered the: Wechsler Adult Intelligence Scale-Revised (WAIS-R), Memory Assessment Scale (MAS), Trails A and B, Stroop, Controlled Oral Word Association Test (COWAT), Fingertapping Test, Purdue Pegboard, Dynamometer, Rey 15-Item Test, Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Brief Symptom Inventory (BSI), Beck Depression Index (BDI), Profile of Mood States (POMS), and Impact of Events Scale (IES) scales in addition to a health questionnaire and symptom checklist. Results indicate impaired scores on mnestic function and information processing when compared to Heaton's (1992) normative data, and the MAS norms (Williams, 1991). MMPI-2, BSI, BDI, POMS, and IES results indicate significant elevations on scales of depression, anxiety, anger, and posttraumatic stress disorder (PTSD) symptoms. The more brief tests of affect and mood appear sufficiently sensitive in measuring the dysphoric mood in group research studies. Clinical diagnoses using criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) criteria indicate a prevalence of 54% PTSD and 64% Amnestic or Cognitive disturbance. New onset of dermatological, respiratory, visual, and gastrointestinal symptoms and illnesses are consistent with the chemical exposure, the PTSD may be in reaction to it, and Amnestic/Cognitive disturbance, from both an organic and functional etiology.

Amnestic Disturbance and Posttraumatic Stress Disorder in the Aftermath of a Chemical Release

Neuropsychological assessments were performed on 70 patients referred after a Catacarb chemical release in a Northern California town. After appropriate exclusions, the 59 patients used in the final analysis were mostly White (66%), with 56% having some college level education. They were administered the: Wechsler Adult Intelligence Scale-Revised (WAIS-R), Memory Assessment Scale (MAS), Trails A and B, Stroop, Controlled Oral Word Association Test (COWAT), Fingertapping Test, Purdue Pegboard, Dynamometer, Rey 15-Item Test, Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Brief Symptom Inventory (BSI), Beck Depression Index (BDI), Profile of Mood States (POMS), and Impact of Events Scale (IES) scales in addition to a health questionnaire and symptom checklist. Results indicate impaired scores on mnestic function and information processing when compared to Heaton’s (1992) normative data, and the MAS norms (Williams, 1991). MMPI-2, BSI, BDI, POMS, and IES results indicate significant elevations on scales of depression, anxiety, anger, and posttraumatic stress disorder (PTSD) symptoms. The more brief tests of affect and mood appear sufficiently sensitive in measuring the dysphoric mood in group research studies. Clinical diagnoses using criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition ( DSM-IV; American Psychiatric Association, 1994) criteria indicate a prevalence of 54% PTSD and 64% Amnestic or Cognitive disturbance. New onset of dermatological, respiratory, visual, and gastrointestinal symptoms and illnesses are consistent with the chemical exposure, the PTSD may be in reaction to it, and Amnestic/Cognitive disturbance, from both an organic and functional etiology.

Quantitative and qualitative performance on rey's 15-item test in neurological patients and dissimulators

Abstract Although Rey's (1964) 15-Item Visual Memory Test (FIT) is frequently used to detect malingering of memory impairment, empirically based clinical guidelines for its use remain unclear. Two studies were conducted comparing the performance of neurological patients and subjects instructed to simulate memory impairment (dissimulators) on several quantitative and qualitative variables derived from the FIT. In Study 1, number of rows in proper location best discriminated groups. A cutoff of < 2 rows correct produced a sensitivity of 47% and a specificity of 97%. The same cutoff applied to Study 2 yielded a sensitivity of 64% and specificity of 96%. The cutoff proposed produced higher specificity than other cutoffs indicated in the literature and suggests that cutoffs currently used for the FIT may incorrectly identify a high proportion of neurological patients as malingerers.