Access Type

Open Access Dissertation

Date of Award


Degree Type


Degree Name




First Advisor

Lisa J. Rapport

Second Advisor

Russell D. Whitman


Even the most psychometrically sound measures are sensitive to the level of effort put forth by the examinee and their intent. This is especially true for measures of memory functioning that are a common target of negative response bias and withholding effort. The aim of the present study was to develop methods for detecting these behaviors for the current edition of the Wechsler Memory Scale, 4th Edition (WMS-IV) using a community sample of healthy adults coached to simulate traumatic brain injury (TBI) and a sample of bona fide TBI survivors. The primary analytic strategy involved generation of prediction models to classify participants according to group membership via logistic regression and evaluate classification accuracy with receiver operating characteristic (ROC) curves. It was predicted that measures from within the WMS-IV would be able to reliably differentiate between actual and simulated TBI, and furthermore, between well simulated and poorly simulated TBI. The results from this study provide confirming evidence in support of both tested hypotheses. Several key findings can be taken from the present study. First there is strong support for the use of multiple measures of symptom validity interspersed throughout testing. Second, this study provides firm support for the use of the WMS-IV in detecting cases of feigned cognitive impairment and offered several methods to effectively do so. Third, the present study has also shown just how difficult it is to simulate a TBI in a way that is credible. Fourth, these results highlight the similarity of performance profiles between poor effort and intentional negative response bias. Several areas of future research are presented.