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The Rise and Rise of Profile Validity Testing in Neuropsychology - Dr Tim Hull, Consultant Clinical Neuropsychologist, Clinical Director, NPP Psychology, and Independent Practice

28/09/17. Neuropsychological Assessment and Personal Injury Cases - Neuropsychological assessment has been with us for a long time. It has many clinical uses, but it has come particularly to the fore in medico legal reporting. A Neurologist or a Psychiatrist may carry out brief tests of cognitive functioning but a neuropsychological assessment will produce a far more detailed analysis of an injured person's cognitive impairment and will relate that to any damage they may have to their brain. A neuropsychologist can then use this information to comment upon their current impairment and prognosis and hence to assist in establishing quantum. This can be useful in cases involving traumatic brain injury but also in clinical negligence cases if the person has suffered for example a stroke or a hypoxic injury due to alleged negligence.

Profile Validity (or Effort) Testing

In the good (or not so good) old days, the psychologist always assumed that all the people they were testing were applying themselves fully to the assessment process. This often produced inaccurate results as a number of factors can affect test performance. Organic problems, in the form of brain damage or neurological disease, can affect test performance but a number of other factors, discussed below, may also depress test scores. It is important, whether the assessment is carried out in a clinical or a medicolegal context, to take a view on whether any depressed test scores are likely to be due to brain damage or may be due in part to other factors. This affects both their causation and choice of treatment.

For a note on terminology, the original tests were marketed as tests of effort but, as interpretation has improved, they are now more likely to be referred to as tests of profile validity. This is in effect what they do: they tell the neuropsychologist whether the profile is valid.

In Personal Injury Cases

Most neuropsychologists will administer one or more tests of profile validity as part of any neuropsychological assessment. If "passed", they allow the psychologist to be confident that the profile is valid. However, if they are "failed" then this may cause difficulties both for the assessment and more generally. The defendant may claim that the claimant is in some way less than honest about their impairments and this may...

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