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Symptom validity testing – The psychologists new tool
When using psychometric measures to assess disorder or impairment the issue of embellishment, exaggeration or reduced levels of engagement is often now considered. Psychological assessment might sometimes be the primary source of evidence in personal injury claims and because of the dependence on patient cooperation and motivation, it is important to address the question of reduction in effort and malingering.
Whilst specific assessments of symptom validity have existed for many years, their psychometric properties and reliability have been ... more
Symptom validity testing – The psychologists new tool
When using psychometric measures to assess disorder or impairment the issue of embellishment, exaggeration or reduced levels of engagement is often now considered. Psychological assessment might sometimes be the primary source of evidence in personal injury claims and because of the dependence on patient cooperation and motivation, it is important to address the question of reduction in effort and malingering.
Whilst specific assessments of symptom validity have existed for many years, their psychometric properties and reliability have been limited. However, in recent years a number of new, more robust test have been published. These often conform to a ‘recognition memory’ paradigm i.e. showing the patient a stimuli (number strings, words, line drawings, unfamiliar faces) then presenting them with two stimuli, one of which is the same as before, the other different. The patient then has to recall the correct item from before. If the patient performs below the range of probability the finding needs to be explained, either in terms of reduced engagement, effort or embellishment. The cut off scores vary test to test depending on standardisation. Normative data indicates that patient groups with TBI, dementia and other cognitive impairment can frequently pass these tests along with the ‘normal’ population.
Increasingly, psychologists are utilising a range of methods to assessing symptom validity, some ‘embedded’ in a typical psychometric assessment in addition to specific validity tests. This is likely to reduce the likelihood of ‘false positive’ findings by providing a range of evidence, along with subjective assessment of the patient’s presentation and account of their difficulties.