Faculty Proceedings, Presentations, Speeches and Lectures


Screening for Response Bias with WAIS-III Measures of Incidental Learning

Event Location / Date(s)

San Antonio, TX / October 25-28, 2006

Document Type

Conference Proceeding

Presentation Date


Conference Name / Publication Title

26th Annual Meeting of the National Academy of Neuropsychology



Objective: Numerous methods are available to detect malingering in TBI. One approach uses profile analysis of WAIS-III scores. This study attempts to enhance the usefulness of the WAIS-III for detecting response bias. The digit symbol-coding subtest free and pairing recall scores of non-litigating TBI patients (n = 45) were compared to those of litigating TBI patients (n = 43) suspected of symptom exaggeration.

Method: Participants completed free and paired recall tests, Portland digit recognition test, and test of memory malingering. Persons in the litigating group scoring below the cut offs on PDRT and/or TOMM were identified as malingerers. Correct responses were calculated for free and pairing recall, and individual items. Results: Mean free recall scores were similar across groups, whereas the pairing mean was 6.4 for TBIs and 4.9 for malingerers. The malingerers were more likely to score higher on pairing than on free recall. This pattern had high specificity and low sensitivity for identifying group membership. Ideal cutoffs for response bias were ≤ 4 on pairing and ≤ 5 on free recall. Failure to recall the symbol associated with “2” was observed in 70% of malingerers, but only 44% of TBIs. The overall hit rate was 68%.

Conclusions: When identifying symptom exaggeration, several measures must be used. Results of free and pairing recall tests may be useful to alert the clinician to the need for further assessment, particularly when the initial data is limited.

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