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.