ABSTRACT
The accurate interpretation of neuropsychological tests in a non-forensic context typically relies upon a presumption that the examinee is trying his or her best, and has put forth full effort in the examination, much as a student taking other tests, such as an SAT or LSAT examination would have done. However, in contrast to the LSAT where a positive outcome (e.g., admission to law school) usually results from good effort, in a forensic context there may be a reward for putting forth less effort and, therefore, appearing more impaired than is truly the case (e.g., “secondary gain”). In these circumstances, the presumption of “best effort” can and should be routinely questioned. Situations in which secondary gain may occur include avoiding legal sanctions or punishment (e.g., appearing incompetent to stand trial, unable to assist in one’s defense, appearing mentally retarded to avoid the death penalty) or achieving monetary rewards for being impaired cognitively or emotionally (e.g., receiving monetary disability benefits, greater financial award in a civil tort action, etc.).
