ABSTRACT
The use of methods for detecting suboptimal performance (SOP)—instances when an examinee does not perform to the best of his or her ability as directed on neuropsychological tests—has increased greatly over the last 25 years. This is particularly the case among the many clinicians who see cases where secondary gain is a significant issue, such as those involving personal injury litigation, long-term disability, worker's compensation, and criminal prosecution. This trend has been driven in part by increased awareness of the frequency with which SOP may be encountered in practice. For example, a recent survey of neuropsychologists in active practice found that as many as 30% of individuals who present for evaluation in the context of litigation are thought to be feigning impairments (Mittenberg, Patton, Canyock, & Condit, 2002). The increased use of measures of SOP has also been driven by a heightened awareness among those who request and scrutinize neuropsychological assessments of both the frequency of SOP and the increasing variety and utility of detection methods. This has led in turn to increasing requests by referring parties for clinicians to explicitly address SOP and also increasingly stringent evidentiary standards being applied to measures for detecting SOP in the medical–legal arenas where they are most commonly used.
