Magnification of symptoms or nonoptimal effort on neuropsychological tests, within the context of head injury litigation, can have several independent or related underlying causes. Therefore, detecting exaggeration does not automatically indicate that the individual is malingering. This article reviews the evaluative and differential diagnostic process and provides the clinician with suggestions regarding assessment methods. A forensic evaluation that does not include careful consideration of possible negative response bias should be considered incomplete.
Assistant Professor, Department of Psychiatry, University of British Columbia, Vancouver, Canada, Coordinator of Psychology Services, Neuropsychiatry Units, Riverview Hospital, Port Coquitlam, Canada (Iverson)
Department of Neurology, Oregon Health Sciences University, Portland, Oregon, Independent Practice, Beaverton, Oregon (Binder)
Address correspondence to Grant Iverson, PhD, Department of Psychiatry, 2255 Wesbrook Mall, University of British Columbia, Vancouver, BC V6T-2A1 Canada.
The authors thank Jennifer Cronin for her assistance with manuscript preparation.