MALINGERING 1995-6

During the last couple of years clinical research on cognitive deficits[1] has further refined methods for detecting malingering - medically "the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives"[2].

Normal subjects could accurately malinger post-concussive symptoms[3] However, even with coaching they were unable to simulate neuropsychological performance patterns of MTBI patients.

Clinical researchers[4] identified 5 tests which, when combined, were able to identify experimental malingering of memory deficits, with a high degree of certainty. Any one of the tests singly gave a highly variable results, but the full battery proved a powerful instrument.

PRACTICE POINT Without usurping the Court's prerogative, neuropsychologists now have reliable tools for identifying malingering of cognitive deficits

A South African university team[5] collated 17 items from the research literature and their own practice into a clinical routine which can distinguish confidently between real and malingered psychiatric illness.

Electromyography, recording electrical activity in muscles, gives identical electrodiagnositc results in Conversion Syndrome (Medical Litigation News Volume 2, Issue 2) and malingering. The experienced neurologist can, however, distinguish between the two by the client's response to the testing[6].

PRACTICE POINT The origin of bizarre symptoms without anatomical explanation can be identified with more confidence

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