Malingering detection: The use of a forced-choice method in identifying organic versus simulated memory impairment

Abstract

Abstract The Hiscock and Hiscock (1989) forced-choice procedure for detecting feigned memory impairment was administered to brain-damaged patients (n=20), psychiatric inpatients (n=20), and two groups of nonpatients. One of these groups was instructed to simulate memory dysfunction (n=29) and the other group was asked to put forth their best effort (n=20). Out of 72 items on the procedure, the mean number correct for each group was as follows: brain-damaged patients = 69.2 (96%); psychiatric inpatients = 71.0 (98%); nonpatients responding honestly = 72 (100%); and nonpatients feigning memory impairment = 43.5 (60%). Statistical comparisons were made among the two patient and simulating groups. The simulators performed significantly worse on this measure than the brain-damaged or psychiatric patients. Only 34% of the simulating group performed significantly below chance; a level which has previously been regarded as necessary in order to consider the possibility of malingering. The results suggest that this test for malingering of memory complaints is easy for individuals with neurologic or psychiatric dysfunction, even for those with significant cognitive impairment, to complete accurately. Even a few errors is sufficient to raise the suspicion that level of effort or motivation may not be optimal.