Assessment of Cognitive Symptom Validity in Acquired Brain Injury

McMakin, I., MacDonald, C., Brown, C., Dorris, L. , Kelly, T.P. and Wright, I. (2011) Assessment of Cognitive Symptom Validity in Acquired Brain Injury. Annual Meeting of the British Paediatric Neurology Association, Edinburgh, UK, 26-28 Jan 2011. pp. 27-68. (doi: 10.1111/j.1469-8749.2010.03866.x)

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Aim: The formal assessment of symptom validity is increasingly regarded as good practice in the neuropsychological assessment of adult patients presenting with cognitive complaints after head injury. Typical assessment tools include relatively easy memory tests for which pass rates are expected to be hig h, even in patients with significant neuropathology . Such assessments are more rarely conducted in the paediatric population and it is often ass umed that rates of poor effort or exag ge rated symptoms are lower or more readily detect ed without recourse to formal tests. We report two recent studies exploring the use of effort testin g in paediatric neuropsychological assessment. Methods and Results: In stu dy 1, non-injured children were ask ed to simula te rates of underperforman ce. While symp tom validity tests appeared sensiti ve to underperformance in young children, patterns of simulated underperformance dif fered qualitatively and quantitatively betw een young (6– 8- y-olds) and older child ren (9–11-y-old s). In study 2, Symptom Validity Tests were used with a clinically referred sam ple of chil dren and adolescents wit h acquir ed brain injury. The prevalence of likely invalid or exaggerated un derperformance was examined in a group at identified risk of malingering (i.e. those with clear evid ence of external incentive to underperform such as an active medico-legal compensat ion clai m, school avoidance or other clear sec ondary gain – Slick and Sherman, in press) versus those assessed at lo w risk. Conclusion: The application of formal symptom validity testi ng within paediatric practice is discussed with consid- eratio n given to both the practical and the ethical dimen- sions of using this approach in the assessment of children and young people.

Item Type:Conference or Workshop Item
Additional Information:Abstract published in Developmental Medicine and Child Neurology 53(S1):48.
Glasgow Author(s) Enlighten ID:Dorris, Professor Liam
Authors: McMakin, I., MacDonald, C., Brown, C., Dorris, L., Kelly, T.P., and Wright, I.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:Developmental Medicine & Child Neurology

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