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The Patterns of Performance of Malingerers on Benton Neuropsychological Assessment

Abstract

This study was conducted to provide practical guideline to the clinicians who are assigned to differentiate malingerers precisely from patients with brain injury in clinical setting, searching for the unique patterns of performance of malingerers on each BNA subtest in comparison with those of patients with brain injury and controls. The subjects were 47 malingerers, 98 patients with brain injury and 144 controls(normal adults). 1) The result of the analysis of total level of performance on each subtest showed that malingerers scored significantly lower(or higher) in total score(or total score of error) than controls on all of 12 subtests. In total score malingerers scored significantly lower than patients with brain injury on remaining 9 subtests excepting Temporal Orientation, Serial Digit Learning and Line Orientation. The frequency of normal performance of malingerers was very much lower than that of controls and patients with brain injury on 10 subtests excepting Temporal Orientation and Serial Digit Learning. 2) In the result of analysis of the difference of performance according to the order of items, malingerers showed poor performance on Serial Digit Learning at earlier trial but got more score as the trial was repeated, while patients with brain injury was not improved to the end at up to 12 times-repeated trial. Malingerers tended to have significantly higher rate of failure on the easiest items(1-6) of Facial Recognition, the easiest items(1-6) and the most difficult items(13-16) of Visual Form Discrimination. In Right-Left Orientation, Phantomime Recognition, Finger Localization and Motor Impersistence, malingerers inclined to fail significantly more than patients with brain injury on the most of the items. 3) Malingerers revealed most patterns of error excepting some types of errors belonged to Three-Dimensional Block Construction significantly more often than controls and patients with brain injury. When summarizing the results of this study, it is turned out that malingerers showed worse performance in whole than controls and patients with brain injury on most motor and perception test excepting some subtests belonged to orientation and learning test. Finally, the limitations of this study and suggestions for the following studies were discussed.

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