Milds Traumatic Brain Injury: PDF OnlyMalingering and malingering-like aspects of mild closed head injuryRuff, Ronald M. PhD1; Wylie, Thomas PhD2; Tennant, Woodrow PhD3Author Information 1Director of Neurobehavioral, Rehabilitation, St Mary's Hospital and Medical Center, Associate Adjunct Professor, Department of Neurosurgery and Psychiatry, University of California at San Francisco, San Francisco, California 2Clinical Neuropsychologist, Department of Psychology Atascadero State Hospital, Atascadero, California 3Clinical Neuropsychologist San Francisco Neuropsychiatric Associates, San Francisco, California Journal of Head Trauma Rehabilitation: September 1993 - Volume 8 - Issue 3 - p 60-73 Buy Abstract Objective techniques such as neuroimaging cannot conclusively document axonal shearing or other trauma resulting from closed brain injury. Consequently, clinicians must rely upon clinical evaluation and psychological and neuropsychological assessment. Because of the subjectivity inherent in these measures, they are susceptible to confounding due to malingering behaviors. Indicators of malingering in mild closed brain injury and approaches to differential diagnosis are discussed. Findings of a study comparing the neuropsychologlcal test results of normal subjects simulating neurological injury with the test results of normal controls, litigants with actual minor brain injury, and nonlitigants with actual minor brain injury are presented. The study concludes that comprehensive multidisciplinary evaluations are required to detect malingering in cases of minor closed brain injury. Guidelines are suggested for the detection and diagnosis of malingering, which continues to represent a major challenge in the assessment of individuals with brain concussion. © Williams & Wilkins 1993. All Rights Reserved.