Detection of insufficient effort using the advanced clinical solutions for the Wechsler memory scale, fourth edition

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Study investigated the ability of the Wechsler Memory Scale, 4th Edition (WMS-IV) and the Advanced Clinical Solutions (ACS) package to distinguish poor performance due to intentional response bias among simulators of traumatic brain injury (TBI) from poor performance due to real TBI. Forty-five survivors of moderate to severe TBI and 39 healthy adults coached to simulate TBI completed the new Word Choice test (WCT) as part of the ACS package as well as the Reliable Digit Span for the Wechsler Adult Intelligence Scale, 4th edition. Results of logistic regression analysis indicated that a five-variable model containing all the ACS variables and a single-variable model using only the WCT were statistically reliable. Comparing predictive accuracy of each model found that adding the WCT to the ACS increased predictive accuracy. Overall, the findings support the use of the WMS-IV in the assessment of response bias. The ACS set of indices did well in discriminating persons with bona fide traumatic brain injury from persons simulating memory dysfunction associated with TBI.

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