Assessment of validity and response bias in neuropsychiatric evaluations.

Background: Forensic neuropsychiatric assessment requires thorough consideration of malingering and response bias. Neuropsychiatric evaluations are complicated due to the multiple domains in which symptoms and impairment present. Moreover, symptom exaggeration in these evaluations can also present along various symptom domains (e.g., psychological, neurocognitive, somatic). Consequently, steps must be taken to ensure adequate coverage of response bias across all three domains of function.

Purpose: The following article reviews the conceptualization of malingering in neuropsychiatric settings, as well as various approaches and measures that can be helpful in the assessment of malingering and response bias.

Conclusions: Forensic neuropsychiatric assessment requires thorough consideration of malingering and response bias. These evaluations are complicated due to the multiple domains in which symptoms and impairment present. Performance and symptom validity measures should be routinely included in these evaluations. Collaboration between psychiatry and psychology can provide the optimal multi-method approach needed for thorough neuropsychiatric assessment in forensic cases. We illustrate our points with two case studies from forensic traumatic brain injury neuropsychiatric evaluations.