ABSTRACT
The purpose of this chapter is to highlight the topic of response validity as one that transcends forensic evaluations, such as personal injury, medical malpractice, disability determination, and worker’s compensation. Adequate effort on the part of an examinee is a necessary underpinning of all neuropsychological evaluations, not just forensic evaluations that are known to have a higher risk of insufficient effort. Differently, we know from the head injury literature (e.g., Bianchini, Greve, & Love, 2003; Boone & Lu, 2003) and personal experience that even individuals with genuine injury may demonstrate insufficient effort or exaggerate their physical or cognitive problems even though genuine illness or injury exists. Phenomenologically, it seems that this behavior may occur among persons who do not believe that they will get their legitimate needs met by their healthcare providers and thus exaggerate their problems and answer questions in a manner that creates an impression of a greater severity of neurological disorder. Other non-injury factors, such as attention and sympathy from significant others and avoidance of responsibility-in the absence of a forensic context-may also contribute to compromised effort among persons with valid neurocognitive deficits.
