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. 2019 May 14;9(5):109.
doi: 10.3390/brainsci9050109.

A Laboratory Word Memory Test Analogue Differentiates Intentional Feigning from True Responding Using the P300 Event-Related Potential

John F Shelley-Tremblay  1 , Joshua C Eyer  2 , Benjamin D Hill  3
Affiliations

A Laboratory Word Memory Test Analogue Differentiates Intentional Feigning from True Responding Using the P300 Event-Related Potential

John F Shelley-Tremblay et al. Brain Sci. .

Abstract

Symptom exaggeration and feigned cognitive impairment occur commonly in forensic and medicolegal evaluations. As a result, methods to detect feigned cognitive impairment are an indispensable component of neuropsychological assessments. This study reports the results of two neurophysiological experiments using a forced-choice recognition task built from the stimuli of the Word Memory Test and Medical Symptom Validity Test as well as a new linguistically informed stimulus set. Participant volunteers were instructed either to do their best or to feign cognitive impairment consistent with a mild traumatic brain injury while their brain activity was monitored using event-related potentials (ERP). Experiment 1 varied instructions across individuals, whereas Experiment 2 varied instructions within individuals. The target brain component was a positive deflection indicating stimulus recognition that occurs approximately 300 ms after exposure to a stimulus (i.e., the P300). Multimodal comparison (P300 amplitude to behavioral accuracy) allowed the detection of feigned cognitive impairment. Results indicate that, for correct responses, P300s were equivalent for the simulated malingering and good effort conditions. However, for incorrect responses, feigned impairment produced reliable but significantly reduced P300 amplitudes. Although the P300 is an automatic index of recognition-even when knowledge is hidden-its amplitude appears capable of modulation by feigning strategies. Implications of this finding are discussed for research and clinical applications.

Keywords: P300; clinical neuropsychology; event-related potentials; feigning; malingering.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study 1, Participant Recruitment Chart.
Figure 2
Figure 2
Mean accuracy percentage for each stimulus type by group.
Figure 3
Figure 3
Grand average waveforms for the P3 subtraction wave (Match–Mismatch) for the Full Effort participants (black line) and the Malingering participants (blue line).
Figure 4
Figure 4
Grand average waveforms for P3 for Malingering and Full Effort groups, showing the effects of behavioral response accuracy.
Figure 5
Figure 5
Experiment 2 grand average waveforms for Full Effort correct trials (Green) are not different from Malingering correct trials (Red), which are both different from Malingering incorrect trials (Blue). G15P3C = Grand Average Full Effort P3 Correct; G15MP3C = Grand Average Simulating P3; CorrectG15MP3I = Grand Average Simulating P3 Incorrect.
Figure 6
Figure 6
Experiment 2 grand average waveforms for all Simulating conditions. Note how the incorrect Match condition results in a smaller P3 response than the correct Match condition. G15M2C = Grand Average Simulating Mismatch Correct; G15M3C = Grand Average Simulating Match Correct; G15M2I = Grand Average Simulating Mismatch Incorrect; G15M3I = Grand Average Simulating Match Incorrect.
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References

    1. Larrabee G.J. Detection of Malingering Using Atypical Performance Patterns on Standard Neuropsychological Tests. Clin. Neuropsychol. 2003;17:410–425. doi: 10.1076/clin.17.3.410.18089. - DOI - PubMed
    1. Mittenberg W., Patton C., Canyock E.M., Condit D.C. Base Rates of Malingering and Symptom Exeggeration. J. Clin. Exp. Neuropsychol. 2002;24:1094–1102. doi: 10.1076/jcen.24.8.1094.8379. - DOI - PubMed
    1. Chafetz M., Abrahams J. Green’s MACT helps identify internal predictors of effort in the social security disability exam. Arch. Clin. Neuropsychol. 2005;20:889–890.
    1. Leamy E. Cheating Disability Claimants Cost You: Workers Compensation Fraud Costs Billions A Year. American Broadcasting Company; New York, NY, USA: 2006.
    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Association; Washington, DC, USA: 2013.