It is not possible to imagine a competent, ethical practitioner of forensic neuropsychology who should not read this book or one who would not routinely use it in day-to-day practice. Kyle Boone has amassed an impressive array of some of the most well respected scholar-clinicians in forensic neuropsychology in a volume that, as nearly as possible, provides cogent summaries of the burgeoning research literature in motivational assessment. With 32 contributors and 20 chapters spanning the range of “disorders” commonly seen in forensic practice and the varied instruments and indices typically utilized for effort testing, Assessment of Feigned Cognitive Impairment: A Neuropsychological Perspective, provides up-to-date reviews of the scientific literature in almost every one of its chapters. Every forensic neuropsychologist will want to have this volume of ‘literature reviews’ close at hand.
As a scientific neuropsychological endeavor, the volume is concerned with human behavior; in this case, the focus is on a particular form of human behavior, feigned illness and its assessment. Part I, Symptom Fabrication, lays the foundations for the volume. In Chapter 1, Stone and Boone trace the history of feigning behavior in the arts and animal behavior. The reader will be interested to know that the phenomenon of feigning behavior is not unique to the human race, as it appears throughout the animal kingdom, and is anthropologically understood for its adaptive value. Chronicled in literature, the visual and performing arts, feigned illness is a well recognized, if not completely well understood human behavior. In Chapter 2 Kingery and Schretlen review the literature on functional neuroimaging and deception. While the frontal lobes rather consistently appear to be implicated, research in the neuroanatomical substrates of deception is rightfully still considered to be in its infancy.
Part II now begins to get down to business with eight chapters devoted to cognitive effort assessment techniques. In Chapter 3 Boone reconsiders the Slick, Sherman, and Iverson (Reference Slick, Sherman and Iverson1999) criteria for a diagnosis of malingered neurocognitive dysfunction (MND). In her discussion, Boone elucidates the historically thorny distinctions between conscious and unconscious motivation, as these conceptualizations bear on understanding the examinees that sit before us, their behaviors, motivations and effort. While the Slick et al. (Reference Slick, Sherman and Iverson1999) criteria have been, and in part still remain, useful guideposts to the forensic neuropsychologist, as our knowledge and theoretical sophistication in the field exponentially grows, shortcomings in the Slick criteria have clearly become more apparent. Boone's discussion and recommendations reflect the perspicacity, wisdom and experience that only come from one of the profession's leading scholar-clinicians. This is a first rate and important chapter, perhaps one of several cornerstones of the volume.
Chapter 4, by Paul Green, presents the literature review on forced choice effort tests, their comparative success in the determination of suspect effort and/or malingering. Green's literature review is extensive and the tables provide a user-friendly organization of several decades of research with numerous tests/measures. Recommendations for the forensic examiner are offered on a range of tests, e.g., Test of Memory Malingering (TOMM; Tombaugh, Reference Tombaugh1997), Word Memory Test (WMT; Green, Reference Green2003), etc., substantially supported with documented research data. Chapter 5 (Nitch & Glassmire) presents the literature on non-forced-choice measure, including the Rey 15-Item Test as well as Dr. Boone's own tests (Dot Counting Test, b Test), among others. As before, recommendations for forensic assessment follow.
In Chapters 6 (Babikian & Boone), 7 (Lu, Rogers & Boone), 8 (Sweet & Nelson) and 9 (Arnold & Boone) the literature reviews using intelligence tests, standard memory tests, executive function measures, and motor and sensory tests are presented, respectively. Summaries and recommendations follow logically from the extensive literature reviews and discussions.
If there is one chapter among the many outstanding chapters in this book that is worth the price of the whole book, it is Chapter 10, “The MMPI-2 Fake Bad Scale in Detection of Noncredible Brain Injury Claims” by Manfred F. Greiffenstein, David Fox, and Paul Lees-Haley. As forensic neuropsychologists may know, the Fake Bad Scale's (FBS; Lees-Haley, English, & Glenn, Reference Lees-Haley, English and Glenn1991) recent incorporation into the MMPI-2 computerized scoring system by Pearson/University of Minnesota Press was not without a good deal of ‘Strum und Drang’ (storm and stress), with a number of criticisms of the scale appearing in the literature. Greiffenstein, Fox, and Lees-Haley provide an exceptionally careful review of the literature on the FBS and systematically scrutinize papers both supportive and critical of its use. Recommendations for the use of the FBS in forensic contexts are presented, with appreciated and realistic caveats concerning potential pitfalls and practical suggestions for cutoffs among demographically diverse groups and differing medial histories. For the many forensic practitioners preparing for depositions and trial, this chapter is invaluable.
Part 3, including Chapters 11 through 20, details cognitive effort assessment in a number of clinical populations, including mild traumatic brain injury (Meyers), pain and fatigue disorders (i.e., Fibromyalgia, Chronic Fatigue Syndrome; Suhr & Spickard), psychiatric disorders (Goldberg, Back-Madruga & Boone), malingered mental retardation (Victor & Boone), epilepsy (Williamson, Drane & Stroup), ADHD and Learning Disability (Alfano & Boone), Multiple Chemical Sensitivity and Mold (McCaffrey & Yantz), ethnic minorities and English as a second language (Salazar, Lu, Wen & Boone), criminal settings (Denney), and future directions (Rohling & Boone). These chapters are rich with extremely thorough literature reviews, important discussion and recommendations for the practitioner. The final chapter by Rohling and Boone points toward the as-yet unanswered questions. One prominently among them is that we don't yet have objective, scientific methods for differentiating malingering from somatoform conditions, a view reflective of the need to revisit criteria and continue the development of testable theoretical models and new assessment techniques.
Compelling in style and breadth, Assessment of Feigned Cognitive Impairment: A Neuropsychological Perspective, must be considered essential reading for forensic neuropsychologists, beginners and journeymen alike. With the research literature so handily summarized, and recommendations for practical use that follow logically, it is likely that this will become a desk-side companion for practitioners. While many issues remain to be understood regarding effort and feigned illness, it is comforting to know that the state of the science is so well represented in this volume.
