Actual versus self-reported scholastic achievement of litigating postconcussion and severe closed head injury claimants

Identifying Examiner-Related Threats to Validity in the Forensic Assessment of Disability

As the number of disability claims increases, so does the demand for forensic disability evaluations. However, an examiner's lack of knowledge and understanding of the nature and nuances of disability evaluations can threaten the validity of these evaluations. Although many threats to validity are outside the control of the examiner, this article identifies eight examiner-related threats to validity in terms of conceptual errors, errors in data collection, and inferential errors. Following this, six suggestions for reducing such threats are presented.

Traumatic brain injury: guidance in a forensic context from outcome, dose-response, and response bias research

Traumatic brain injury (TBI) occurs at a high incidence, involving millions of individuals in the U.S. alone. Related to this, there are large numbers of litigants and claimants who are referred annually for forensic evaluation. In formulating opinions regarding claimed injuries, the present review advises experts to rely on two sets of information: TBI outcome and neuropsychological dose-response studies of non-litigants and non-claimants, and response bias literature that has demonstrated the relatively high risk of invalid responding among examinees referred within a secondary gain context, which in turn has resulted in the development of specific assessment methods. Regarding prospective methods for detecting possible response bias, both symptom validity tests, for measuring over-reporting of symptoms on inventories and questionnaires, and performance validity tests, for measuring insufficient effort on ability tests, are considered essential.

Neuropsychological assessment: principles, rationale, and challenges

Neuropsychological assessments are increasingly in demand for a wide range of patients. This paper offers a survey of the basic aspects of neuropsychological assessment that are of greatest importance for professionals (e.g., psychologists, psychiatrists, social workers, and lawyers) who are not trained in neuropsychological testing, but who refer clients for neuropsychological assessment. This survey could also serve neuropsychologists in their early stages of training, by addressing some of the major issues related to the assessment process. The range of goals that neuropsychological assessment may attain is first outlined. Next, a model is presented that explains the rationale enabling generalization from assessment to real-world functions that are the focus of interest and the target of prediction. Issues that need to be considered before deciding to conduct a neuropsychological evaluation are then introduced, and sources of information available to the assessor are described. A description is provided of what a neuropsychological assessment includes, with an emphasis on its cognitive aspects. Finally, mention is made of some of the difficulties and challenges that must be confronted in the course of a neuropsychological assessment.

Neuropsychological assessment in traumatic brain injury

Traumatic brain injury (TBI) is a neurological injury that can affect the cognitive, emotional, psychological, and physical functioning of an individual. The clinical neuropsychologist working with TBI patients must take a holistic approach when assessing and treating the patient and consider the patient in total, including premorbid and post-incident factors, to formulate a comprehensive and accurate picture of the patient. This approach will guide the clinician regarding multiple types of treatment the patient may require.

Definition, diagnosis, and forensic implications of postconcussional syndrome

Injuries from blows to the head often are manifested only as subjective complaints. Postconcussional syndrome thus can be feigned for financial or psychological gain. The authors review the pathology of brain trauma, symptoms of postconcussional syndrome, and criteria for diagnosis. In addition to somatic deficits, psychological and cognitive problems are common. The likelihood and severity of postconcussional syndrome are greater for women. Malingering may be suspected in cases involving litigation, and tests to detect it are available. Treatment for postconcussional syndrome depends on the specific symptoms. Pharmacotherapies may be helpful, but care should be used in prescribing drugs that could produce deleterious CNS effects.

Methodological Problems in the Neuropsychological Assessment of Effects of Exposure to Welding Fumes and Manganese

Recently, Kaiser (2003) raised concerns over the increase in brain damage claims reportedly due to exposure to welding fumes. In the present article, we discuss methodological problems in conducting neuropsychological research on the effects of welding exposure, using a recent paper by Bowler et al. (2003) as an example to illustrate problems common in the neurotoxicity literature. Our analysis highlights difficulties in conducting such quasi-experimental investigations, including subject selection bias, litigation effects on symptom report and neuropsychological test performance, response bias, and scientifically inadequate casual reasoning.