Understanding malingering in children

From the December 2006 issue of the Archives of Clinical Neuropsychology, a new study from Alicia Nagle and colleagues explores what happens when children are instructed to feign cognitive impairment in a learning test:

Thirty-five children ages 6–12 years were asked to complete two alternate forms of the Hopkins Verbal Learning Test-Revised (HVLT-R), once with the instruction to feign cognitive impairment and once instructed to do their best. They were also asked to complete the Test of Memory Malingering (TOMM). Regardless of condition, children performed comparably to adult norms on the TOMM, obtaining a score of 45 or above on Trial 2. Regarding the HVLT-R, differences emerged only when children were initially told to “do their best,” followed by a subsequent trial in which they were told feign impairment. Within this group of participants, children demonstrated significantly lower levels of learning across trials and fewer words recalled in comparison to when they were instructed to do their best. In contrast, no reliable differences on the HVLT-R were observed among children who were initially told to feign impairment and subsequently told to do their best. These results suggest that the elicitation of “feigned” impairment within this age group on the HVLT-R requires the initial provision of an opportunity for optimal performance. [Abstract © 2006 National Academy of Neuropsychology]


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