Doctor of Philosophy (PhD)
Several studies have examined the ability of the Rey 15-Item Memory Test (MFIT) to identify malingering of memory problems among a variety of psychiatric and neurologically impaired populations. The consensus has been that the quantitative scoring method is overly sensitive to genuine memory impairment and lacks sensitivity to simulated amnesia. However, a reexamination of these studies and available data indicates the MFIT is both valid and effective at identifying actual malingerers among civil litigants, and a number of these studies were limited through inappropriate inclusion of severely impaired patients and research designs of questionable validity. Also, the performance of a group for whom malingering of memory complaints is a relevant issue (criminal defendants) has been overlooked. The present study expands upon previous investigations by comparing the MFIT performance of a known group of forensic malingerers to a group of non-malingering pretrial criminal defendants and non-malingering post-trial forensic inpatients, and by examining the utility of a qualitative scoring approach hypothesized to enhance the MFIT’s detection ability.
Using the quantitative method, a low sensitivity of 47.7% was obtained for malingerers. Minimal improvement was found when qualitative scoring was incorporated (56.8%), although confidence in correct identification was increased with very low total scores (<5) and failure to recall at least 3 of the first 6 items. While the quantitative method yielded high specificity for non-malingering post-trial patients (86.7%), this was not the case for the more clinically relevant non-malingering pretrial patients (56.2%). However, specificity was increased for both non-malingering groups through the addition of qualitative scoring. Although both the quantitative and combined quantitative and qualitative scoring methods were found to be accurate at identifying criminal forensic malingerers, neither was found to be more accurate than base rate prediction alone. It is concluded that the lack of effectiveness can be attributed to 1) decreased sensitivity to less blatant forms of malingering, and 2) the adverse impact of lower intelligence and psychiatric symptoms affecting the ability to attend and organize cognitive processes on the MFIT recall for actual patients.
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Release the entire work immediately for access worldwide.
Martin, James A., "Qualitative scoring of the Rey 15-Item Memory Test in a forensic population" (2002). LSU Doctoral Dissertations. 2686.
Mary L. Kelley