Objective: To determine whether patients who were given a Deterrence Theory-based handout immediately prior to neuropsychological evaluation would exert adequate effort on testing with greater frequency than patients who were given an informational handout. Method: All outpatients seen for clinical evaluation in a VA Neuropsychology Clinic were randomly given one of two handouts immediately prior to evaluation. The “Intervention” handout emphasized the importance of trying one's hardest, explicitly listed consequences of valid and invalid responding, and asked patients to sign and initial in several places. The “Control” handout provided general information about neuropsychological evaluation. Patients were excluded from analyses if they were diagnosed with Major Neurocognitive Disorder or could not read the handout. Medical Symptom Validity Test (MSVT) was used to determine performance validity. Results: Groups did not differ on age, education, or litigation status. Preliminary results for all 143 patients showed no effect of handout on passing vs. failing MSVT (chi-square = 1.60, n.s.). Excluding patients who received Intervention handout but did not sign and initial it completely, thus not receiving the full “dose” of intervention, revealed that 31 of 49 (63%) Intervention patients passed MSVT, compared to 40 of 72 (56%) Control patients (chi-square = 0.72, n.s.). Among patients seeking disability benefits, 7 of 11 (64%) Intervention but only 7 of 18 (39%) Control passed MSVT (chi-square = 1.68, p = 0.18). Conclusion: This brief, no-cost intervention might be of some utility in decreasing the occurrence of inadequate effort on neuropsychological evaluation. We continue to collect data to clarify whether a significant effect is present.
An Intervention to Decrease the Occurrence of Inadequate Effort on Neuropsychological Evaluation
Arch Clin Neuropsychol (2015) 30 (6): 485.
25 August 2015
D Horner; Effort-4
An Intervention to Decrease the Occurrence of Inadequate Effort on Neuropsychological Evaluation. Arch Clin Neuropsychol 2015; 30 (6): 485. doi: 10.1093/arclin/acv046.24
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Sensitivity and specificity of the Rey Dot Counting Test in patients with suspect effort and various clinical samples