Using the yes/no recognition response pattern to detect memory malingering

BACKGROUND Detection of feigned neurocognitive deficits is a challenge for neuropsychological assessment. We conducted two studies to examine whether memory malingering is characterized by an elevated proportion of false negatives during yes/no recognition testing and whether this could be a useful measure for assessment. METHODS Study 1 examined 51 participants claiming compensation due to mental disorders, 51 patients with affective disorders not claiming compensation and 13 patients with established dementia. Claimants were sub-divided into suspected malingerers (n = 11) and non-malingerers (n = 40) according to the Test of Memory Malingering (TOMM). In study 2, non-clinical participants were instructed to either malinger memory deficits due to depression (n = 20), or to perform normally (n = 20). RESULTS In study 1, suspected malingerers had more false negative responses on the recognition test than all other groups and false negative responding was correlated with Minnesota-Multiphasic Personality Inventory (MMPI) measures of deception. In study 2, using a cut-off score derived from the clinical study, the number of false negative responses on the yes/no recognition test predicted group membership with comparable accuracy as the TOMM, combining both measures yielded the best classification. Upon interview, participants suspected the TOMM more often as a malingering test than the yes/no recognition test. CONCLUSION Results indicate that many malingers adopt a strategy of exaggerated false negative responding on a yes/no recognition memory test. This differentiates them from both dementia and affective disorder, recommending false negative responses as an efficient and inconspicuous screening measure of memory malingering.