Abstract
Background: In this study the identification of exaggerated psychological symptoms of traumatic brain injury (TBI) is suggested as an additional method in strengthening the detection of Malingered Neurocognitive Dysfunction. Objective: The aim of this study was to evaluate the effectiveness of the Personality Assessment Inventory (PAI) in detecting exaggerated psychological symptoms of TBI. Method: A three-group simulation quasi-experimental design was used to compare outcomes on the eleven Clinical scales of the PAI, and three Validity indices: Negative Impression Scale (NIM), Malingering Index (MAL), and Rogers Discriminant Function (RDF). The three participant groups included a TBI group (n=30), a control group (n=30), and a simulator group (n=30). The ability of the Validity indices to detect exaggerators (simulator group), and accurately detect non-exaggerators (TBI and healthy group) was examined. Results: Overall, no evidence of difference was found between the simulator and TBI group on the eleven Clinical scales, or on the NIM index. Differences were found between the TBI and control group, and the simulator and control group, on six of the Clinical scales and the NIM index. No difference was found between all three participant groups on the MAL index. The RDF index yielded a significant difference between the TBI and simulator group. On the whole, all three of the Validity indices, at suggested cut-offs indicating exaggerated psychological symptoms, showed limited ability to accurately detect exaggerators (simulator group), and undesirable to perfect ability to accurately detect non-exaggerators (TBI and control group). Conclusions: The results showed that the TBI group expressed specific psychological difficulties in comparison to the control group, and these difficulties were closely replicated by the simulator group. Results also showed limited utility of the PAI as a measure of detecting exaggerated psychological symptoms of TBI.