Evaluating Effort with the Word Memory Test and Category Test-Or Not

Abstract

ABSTRACT As more techniques sensitive to the effects of poor effort are validated, clinicians are faced with the choice of which techniques to use and what to do in the case of discrepancies. We compared the groups identified by the Booklet Category Test (BCT) criteria published by Tenhula and Sweet (1996) and the effort-sensitive measures of the Word Memory Test (WMT; Green, Allen & Astner, 1996) in a large sample seeking compensation after suffering head injuries of varying levels of severity. Results revealed substantial differences between the groups identified by each technique as putting forth suboptimal effort. The groups identified by the WMT scored in a manner similar to samples identified by other investigators exhibiting poor effort. In contrast, the classifications based upon the Category Test decision rules appear to be confounded by true neurocognitive impairment, particularly in individuals who have suffered more severe brain injuries. Caution is warranted in using the Category Test decision rules to identify poor effort in compensation-seeking samples.