Isn't everything in forensic neuropsychology controversial?
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Forensic Psychiatry↗
Biomedical subjects
D D Fox
Publications and source records attributed to D D Fox.
A comparison of complaints by mild brain injury claimants and other claimants describing subjective experiences immediately following their injury.
This study compares the rate of postconcussive (PCS) symptoms at the time of injury for mild traumatic brain injury (MTBI; N=24) claimants and claimants reporting other forms of injury (OI; N=66). On checklists surveying their complaints immediately after their injury, MTBI and OI claimants reported similar levels of many PCS complaints, e.g., dazed, confused, dizzy, disoriented, trouble concentrating, numbness or loss of sensation, and loss of memory for some of what happened. One in four of the OI samples reported partial loss of consciousness (LOC), and one-third reported loss of memory for some of what happened. About 67% of the MTBI sample reported being confused and 71% dazed, but so did many of the OI sample (52% dazed, 65% confused). The authors suggest that classical PCS complaints experienced immediately after an injury are so nonspecific that they have little diagnostic specificity.
Journal Article↗
Application of the Postconcussive Syndrome Questionnaire with medical and psychiatric outpatients.
The Postconcussive Syndrome Questionnaire (PCSQ; Lees-Haley, 1992) was previously found (Axelrod, Fox, Lees-Haley, Earnest, Dolezal-Wood, & Goldman, 1996) to produce four factors, named Psychological, Somatic, Cognitive, and Infrequency. These four factors of the questionnaire were evaluated across five groups of medical and psychiatric outpatients. The patients were from neurology, mental health, family practice, and internal medicine clinics as well as from a clinic that evaluated new patients to a health maintenance organization. Mental health patients had greater psychological symptoms and fewer health concerns than the other groups. Neurology patients differed from the other groups by having greater Infrequency symptoms. Patients who were referred for their screening evaluation or were seen by internal medicine had fewer overall symptoms than the other three patient groups. The data from this study provide support for the use of the PCSQ as a multifactorial self-report measure of symptom presentation.
Journal Article↗
Interrelationship of MMPI-2 validity scales in personal injury claims.
A sample of MMPI-2s of worker's compensation and personal injury cases (N = 289) was gathered to examine the relationship of various indicators of exaggeration. Intercorrelations of the F, F-K, the MMPI Dissimulation Scale-revised (Ds-r), total of obvious minus subtle scales (O-S), Fake Bad Scale (FBS), VRIN, and TRIN were computed and the relative sensitivity of each score calculated using various cut-offs. Factor analysis suggests that malingering may take the form of inconsistent responding as well as symptom exaggeration. Patients evaluated at the request of plaintiff attorneys showed a seemingly greater degree of symptom exaggeration and inconsistent responding than did those referred by defense counsel.
Accidents, Occupational↗
Normative problems for the Wechsler Memory Scale-revised logical memory test when used in litigation.
A sample of 100 neuropsychologically normal worker's compensation claimants was evaluated with the Trail Making Test, the Logical Memory Test of the Wechsler Memory Scale-Revised (WMS-R) (immediate and delayed) and the (MMPI) to determine the appropriateness of the Logical Memory norms for individuals in litigation. Results indicate these claimants performed below normal, possibly due to depression or poor motivation while age and education were not important factors. The danger of using such norms uncritically in litigation cases is discussed.
Journal Article↗
Neuropsychological false positives in litigation: trail making test findings.
100 workers' compensation claimants with no known history of brain injury and no claim for neuropsychological impairment were administered a generally accepted neuropsychological screening instrument, the Trail Making Test, to consider the possibility that the presence of litigation may be reflected in neuropsychological test scores. On Trails A and B, respectively, 40% and 36% of subjects scored in the impaired range. Clinicians are urged to interpret the results of the Trail Making Test cautiously when a patient is in litigation. Suggestions for research are offered.
Adult↗
MMPI subtle-obvious scales and malingering: clinical versus simulated scores.
Subtle-obvious scale discrepancies on the Minnesota Multiphasic Personality Inventory were compared for pathology simulators and clinical groups to test the hypothesis that subtle-obvious scores help differentiate simulators. Total obvious minus subtle T score discrepancy greater than 100 discriminated the student malingerers and produced few false positives among clinical populations such as psychiatric inpatients and outpatients. The hypothesis that these clinical patients score high on these indices of malingering as a baserate or as a cry for help was rejected. These data suggest that there are differences between simulators and clinical patients, which are detectable by use of subtle-obvious scores, and that this procedure bears further exploration.
Adult↗
Psyllium therapy in the irritable bowel syndrome. A double-blind trial.
A randomized, double-blind trial of a psyllium preparation was initiated in 77 patients with painful irritable bowel syndrome. Sixty-patients finished and submitted symptom data for 8 weeks while taking placebo (n = 34) or psyllium (n = 26). Increase in normal stools and decrease in pain severity (p less than 0.05) occurred equally in both groups. Subjective improvement was reported by 24 of 34 patients on placebo and 20 or 26 on psyllium (p greater than 0.05). Five symptom variables were significantly correlated (p less than 0.05) with patient's subjective global assessment (R = 0.64). Discriminant analysis of Minnesota Multiphasic Personality Inventory variables yielded overall rates of correct prediction of 66.1% for whether patients got "much better" and 77.9% for whether they voluntarily dropped from the study. A major placebo effect occurs in patients with painful irritable bowel syndrome and is probably responsible for the efficacy of psyllium. Personality factors influence the magnitude of therapeutic response and whether patients discontinue treatment within 8 weeks.
Clinical Trials as Topic↗