Further investigation of traumatic brain injury versus insufficient effort with the California Verbal Learning Test

The present study replicates and attempts to extend previous research using the California Verbal Learning Test (CVLT) to identify malingerers. Documented moderate and severe traumatic brain injury patients (n = 42) were compared with clinical malingerers identified by criteria other than the CVLT (n = 21), malingering simulators instructed in realistic potential injury sequelae (n = 25), and normal controls (n = 21). Results of discriminant function analyses for high and low base rates are reported, showing similar results. Also, the four individual cutoff scores (Recognition Hits, Discriminability, Total Words Recalled, Long Delay Cued Recall) from Millis, Putnam, Adams, and Ricker (1995) were evaluated with these groups. Similar specificity rates were found with all four variables, while sensitivity rates were slightly lower than that of Millis. Adjusted cutoffs derived from the new samples resulted in slightly improved overall classification rates. Overall, present findings support those of Millis et al. (1995) with regard to the use of the CVLT in detection of malingering. Exploratory use of Total Intrusions and Recognition Hits Compared to Long Delay Free Recall was not promising. Simulators were found to be fairly comparable in performance to actual malingerers, affirming their use in malingering research. (C) 2000 National Academy of Neuropsychology.