1.5 CE Credits
Michael Chafetz, Ph.D., ABPP
Algiers Neurobehavioral Resource, LLC
The central question of this workshop is whether negative validity test findings should be used in the aggregate along with positive test findings for the determination of a case of illness-deception (ID), as it was asserted by Frederick (2015) and Black, Necrason, and Omasta (2016). A comparison of the use of validity tests versus other kinds of medical and psychological tests is made, with findings suggesting that ID is fundamentally different from other constructs/diseases in evidence-based medicine, psychology, and neuropsychology because deception about illness involves a deliberate process that may involve coaching, research, and/or focusing the deception on one aspect of functioning (e.g., slowness). A case study is presented to consider how decisions about other medical and neuropsychological problems are enhanced by considering positive and negative findings, how likely findings are to be manipulated by the patient, and how well the assertion that both positive and negative validity test findings must be used together in the aggregate stands up to comparative scrutiny. The fundamental assumption that a negative test finding concerning ID represents good effort is flawed, as it simply represents a lack of evidence of ID which cannot, in turn, be construed as evidence of lack of deception. Commentary is provided on best practice in neuropsychology regarding use of validity tests.
After the session, participants will be able to:
1. Explain how positive and negative test results are used together to determine the probability of a given condition of interest in medicine and psychology.
2. Compare the changes in posterior probabilities from positive versus negative test findings for a condition of interest.
3. Describe how the case example supports using only positive test findings in a determination of illness-deception.
Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate
Dr. Michael Chafetz is a Board Certified clinical neuropsychologist in independent practice in New Orleans. His research interests have focused on the validity of Social Security disability examinations, where he has sought to understand how validity testing operates in low functioning claimants. This research led to an initiative to help the Social Security system produce more accurate assessments. In these endeavors, he consulted with a United States Senator and the Office of the Inspector General to bring attention to this research in the Social Security system. More recently, he consulted with the Swedish Social Security system to help bring about needed changes in assessment. His current research interests include the connection between factitious disorder and malingering and in the probability calculations you will see in this talk.
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