The experience of malingering: Test performance, coaching, personal knowledge, strategies, and face validity

Two experiments were designed to assess the performance of control participants and individuals feigning brain damage. Three goals were proposed for Experiment 1: (a) explore strategies utilized by malingerers, (b) examine participants' knowledge regarding head injuries, and (c) investigate the effects of coaching. Sixty-three college students were randomly assigned to the following groups: controls, uncoached malingerers (UM), and coached malingerers (CM). Following test administration, participants completed questionnaires regarding the strategies they used and their knowledge of head injuries. Analyses showed a significant percentage of malingerers used the following strategies: missed many questions, responded slowly, feigned memory loss, missed more difficult than easy items, appeared confused/disinterested, and kept track of responses. Overall, beliefs about head injury sequelae did not affect participants' performance on the tests. Controls obtained significantly higher scores on all tests compared to both malingering groups. CM outperformed the UM only on the malingering tests. Experiment 2 was conducted to examine the impact of providing information regarding the existence of malingering measures. Eighty students were randomly assigned to be either a malingerer or a control participant. Half the malingering and control participants received the information prior to test administration while the other half received the information after completing the tests. Following test administration, participants' beliefs regarding the purpose of each test were obtained. Analyses showed that, overall, receiving information prior to testing did not significantly improve performance. In addition, the information did not impact the face validity of the tests. The malingering measures had good face validity as memory tests and the other measures were accurately viewed as standard neuropsychological tests. These experiments indicate that examining simulators' strategies and knowledge of head injury may be useful in understanding the process of malingering. Coaching may increase performance on malingering tests but not on standard measures. Furthermore, although patients may be aware of the existence of malingering tests, this knowledge may not assist them in distinguishing malingering tests from standard tests and has minimal effect on test performance.