The Warrington Recognition Memory Test for Words as a Measure of Response Bias: Total Score and Response Time Cutoffs Developed on “Real World” Credible and Noncredible Subjects

• Published in: Archives of clinical neuropsychology Vol. 25; no. 1; pp. 60 - 70
• Main Authors: Kim, Michelle S., Boone, Kyle B., Victor, Tara, Marion, Sarah D., Amano, Stacy, Cottingham, Maria E., Ziegler, Elizabeth A., Zeller, Michelle A.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.02.2010
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Bias; Biological and medical sciences; Cognition Disorders - physiopathology; Female; Forensic neuropsychology; Head injury; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Malingering - diagnosis; Malingering - psychology; Malingering/symptom validity testing; Medical sciences; Middle Aged; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reaction Time - physiology; Recognition (Psychology) - physiology; Sensitivity and Specificity; Time Factors; Traumas. Diseases due to physical agents; Traumatic brain injury; Vocabulary; Young Adult; Forensic neuropsychology; Traumatic brain injury; Head injury; Malingering/symptom validity testing; Human; Memory disorder; Nervous system diseases; Recognition memory; Word; Cognitive disorder; Memory; Effort; Neuropsychological test; Psychometrics; Cognition; Symptomatology; Response falsification; Language; Simulation; Response time; Head trauma
• ISSN: 0887-6177; 1873-5843; 1873-5843
• DOI: 10.1093/arclin/acp088

Several studies have examined the usefulness of the Warrington Recognition Memory Test–Words as a measure to detect suspect effort, although samples have generally been small and/or comprised of simulators rather than “real world” credible and noncredible patients. The current study examined the Warrington Recognition Memory Test–Words total score and response time of “real world” noncredible patients (as determined by motive to feign, failure on ≥2 independent measures of response bias, low cognitive scores inconsistent with normal ADLs; n = 190) versus credible patients (as determined by no motive to feign, failure of ≤1 measure of response bias; n = 124) derived from an archival database of individuals from the Harbor-UCLA Medical Center, Department of Psychiatry, Outpatient Neuropsychology Service, and the private practice of the second author. Noncredible patients obtained significantly lower total scores and longer times to complete the task. A total correct cutoff of ≤42 was found to have excellent specificity (91.9%) and sensitivity (88.9%), whereas a time cutoff of ≥207″ was associated with 65.5% sensitivity at 90.7% specificity, and when the time cut-score was used in combination with the total score cutoff, an additional 5% of the noncredible participants were captured, raising overall sensitivity to 93.7% (at 87.1% specificity). Thus, the Warrington Recognition Memory Test–Words, although not originally created for the purposes of measuring suspect effort, appears to be an excellent measure for detecting response bias on neuropsychological testing.