Cogstate Brief Battery: Cognition and the feigning of cognitive impairment in chronic pain.

Chronic pain (CP) is often associated with cognitive impairment. The Cogstate Brief Battery (CBB), a computerized assessment battery, has been studied in several neuropsychiatric disorders but not in CP. Since feigning of cognitive impairment is common in CP, the current study aimed to assess the CBB's utility in differentiating CP patients (n = 64) from healthy participants (n = 33), as well as to assess the effect of simulating cognitive impairment by CP patients on performance in the battery. CP outpatients were randomly assigned to one of two groups: (a) Patients performing the CBB to the best of their ability. (b) Patients simulating cognitive impairment. Independent-samples t-tests indicated that three of four CBB tasks successfully differentiated CP patients from matched healthy controls. Additionally, an analysis of covariance (ANCOVA) indicated that CP patients who simulated cognitive impairment performed more poorly in all four CBB tasks, with the detection task having the strongest discrimination capacity. This is the first study to point toward the usefulness and sensitivity of the CBB for assessment of cognition and detection of feigned cognitive impairment in CP. Further studies are required to validate these preliminary findings and assess the CBB's utility in daily clinical practice.

Eye tracking as a mean to detect feigned cognitive impairment in the word memory test.

Eye movements showed initial promise for the detection of deception and may be harder to consciously manipulate than conventional accuracy measures. Therefore, we integrated an eye-tracker with the Word Memory Test (WMT) and tested its usefulness for the detection of feigned cognitive impairment. As part of the study, simulators (n = 44) and honest controls (n = 41) performed WMT's immediate-recognition (IR) subtest while their eye movements were recorded. In comparison to the control group, simulators spent less time gazing at relevant stimuli, spent more time gazing at irrelevant stimuli, and had a lower saccade rate. Group classification using a scale that combined the eye movement measures and the WMT's accuracy measure showed tentative promise (i.e., it enhanced classification compared to the use of the accuracy measure as the sole predictor of group membership). Overall, integration of an eye-tracker with the WMT was found to be feasible and the eye movement measures showed initial promise for the detection of feigned cognitive impairment. Moreover, eye movement measures proved useful in enhancing our understanding of strategies utilized by the simulators and the cognitive processes that affect their behavior. While the findings are clearly preliminary, we hope that they will encourage further research of these promising psychophysiological measures.

Establishing supplementary response time validity indicators in the Word Memory Test (WMT) and directions for future research.

Response time (RT) measures in the Word Memory Test (WMT) offer to complement information derived from conventional accuracy measures. The current study aimed to validate the findings of Lupu, Elbaum, Wagner, and Braw in which RT variability was assessed, for the first time, in the WMT. A secondary aim was to suggest directions for the future research of RT measures in Forced-Choice Recognition Memory Performance Validity Tests (FCRM-PVTs). The study utilized a simulation research design, with participants performing the WMT's immediate recognition (IR) subtest (N = 59). Mean RTs and a scale which combines accuracy and RT measures, but not variability in RTs, possessed adequate discrimination capacity. Enhanced discrimination capacity was found after discarding the first items' RTs, though the IR-subtest's accuracy measure still showed superiority as a stand-alone validity indicator. The promise of RT measures may, therefore, lie in their ability to illuminate speed-accuracy tradeoffs among examinees with border-zone accuracy scores in FCRM-PVTs. They should, therefore, be regarded as complementary to conventional accuracy measures.