Disclosure of Neuropsychological Test Data: Official Position of Division 40 (Clinical Neuropsychology) of the American Psychological Association, Association of Postdoctoral Programs in Clinical Neuropsychology, and American Academy of Clinical Neuropsychology*

Development of a measure for assessing malingered incompetency in criminal proceedings: Denney competency related test (D-CRT)

INTRODUCTION

Experts frequently assess competency in criminal settings where the rate of feigning cognitive deficit is demonstrably elevated. We describe the construction and validation of the Denney Competency Related Test (D-CRT) to assess feigned incompetency of defendants in the criminal adjudicative setting. It was expected the D-CRT would prove effective at identifying feigned incompetence based on its two alternative, forced-choice and performance curve characteristics.

METHOD

Development and validation of the D-CRT occurred in described phases. Items were developed to measure competency based upon expert review. Item analysis and adjustments were completed with 304 young teenage volunteers to obtain a proper spread of item difficulty in preparation for eventual performance curve analysis (PCA). Test-retest reliability was assessed with 44 adult community volunteers. Validation included an analog simulation design with 101 jail detainees using MacArthur Competency Assessment Test-Criminal Adjudication and Word Memory Test as criterion measures. Effects of racial/ethnic demographic differences were examined in a separate study of 208 undergraduate volunteers. D-CRT specificity was identified with 46 elderly clinic referrals diagnosed with mild cognitive impairment and dementia.

RESULTS

Item development, adjustment, and repeat analysis resulted in item probabilities evenly spread from .28 to 1.0. Test-retest correlation was good (.83). Internal consistency of items was excellent (KR-20 > .91). D-CRT demonstrated convergent validity in regard to measuring competency related information and as well as malingering. The test successfully differentiated between jail inmates asked to perforfm their best and inmates asked to simulate incompetency (AUC = .945). There were no statistically significant differences found in performance across racial/ethnic backgrounds. D-CRT specificity remained excellent among elderly clinic referrals with significant cognitive compromise at the recommended total score cutoff.

CONCLUSIONS

D-CRT is an effective measure of feigned criminal incompetency in the context of potential cognitive deficiency, and PCA is assistive in the determination. Additional validation using knowns groups designs with various mental health-related conditions are needed.

Threats to the integrity of psychological assessment: The misuse of test raw data and materials

In the practice of psychological assessment there have been warnings for decades by the American Psychological Association (APA), the National Academy of Neuropsychology (NAN), other associations, and test vendors, against the disclosure of test raw data and test materials. Psychological assessment occurs across several different practice environments, and test raw data is a particularly sensitive aspect of practice considering what it implicitly represents about a client/patient, and this concept is further developed in this paper. Many times, test materials are intellectual property protected by copyrights and user agreements. It follows that improper management of the release of test raw data and test materials threatens the scientific integrity of psychological assessment. Here the matters of test raw data, test materials, and different practice environments are addressed to highlight the challenges involved with improper releases and to offer guidance concerning good-faith efforts to preserve the integrity of psychological assessment and legal agreements. The unique demands of forensic practice are also discussed, including attorneys' needs for cross-examination and discovery, which may place psychologists (and other duly vetted evaluators) in conflict with their commitment to professional ethical codes and legal agreements. To this end, important threats to the proper use of test raw data and test materials include uninformed professionals and compromised evaluators. In this paper, the mishandling of test raw data and materials by both psychologists and other evaluators is reviewed, representative case examples, including those from the literature, are provided, pertinent case law is discussed, and practical stepwise conflict resolutions are offered.

Neuropsychological assessment of traumatic brain injury: Current ethical challenges and recommendations for future practice

Numerous ethical challenges may arise over the course of neuropsychological assessment. This paper highlights the ethical considerations associated with neuropsychological assessment of individuals with traumatic brain injury. Issues regarding professional competency, providing and obtaining informed consent, neuropsychological test selection and administration, effectively communicating assessment results, and working as part of a multidisciplinary team are discussed with practical recommendations. Ultimately, a comprehensive understanding of these issues as well as an integration of resources to guide clinical practice will contribute to ethical decision-making and strong professional practice.