Cognitive underperformance and symptom over-reporting in a mixed psychiatric sample

Clin Neuropsychol. 2011 Jul;25(5):812-28. doi: 10.1080/13854046.2011.583280.


The current study examined the prevalence of cognitive underperformance and symptom over-reporting in a mixed sample of psychiatric patients (N = 183). We employed the Amsterdam Short-Term Memory Test (ASTM) to measure cognitive underperformance and the Structured Inventory of Malingered Symptomatology (SIMS) to measure the tendency to over-report symptoms. We also administered neuropsychological tests (e.g., Concept Shifting Task; Rey's Verbal Learning Test) and the Symptom Checklist-90 (SCL-90) to the patients. A total of 34% of them failed the ASTM, the SIMS or both tests. ASTM and SIMS scores were significantly, albeit modestly, correlated with each other (r = -.22). As to the links between underperformance, over-reporting, neuropsychological tasks, and the SCL-90, the association between over-reporting on the SIMS and SCL-90 scores was the most robust one. The subsample that only failed on the ASTM performed significantly worse on a compound index of memory performance. Our findings indicate that underperformance and over-reporting are loosely coupled dimensions and that particularly over-reporting is intimately linked to heightened SCL-90 scores.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology
  • Cognition Disorders / etiology*
  • Female
  • Humans
  • Male
  • Malingering / diagnosis
  • Malingering / etiology*
  • Memory, Short-Term / physiology
  • Mental Disorders / complications*
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology*
  • Middle Aged
  • Neuropsychological Tests
  • Prevalence
  • Psychiatric Status Rating Scales
  • Reproducibility of Results
  • Retrospective Studies
  • Verbal Learning / physiology
  • Young Adult