Symptom validity and neuropsychological assessment: a survey of practices and beliefs of neuropsychologists in six European countries

Arch Clin Neuropsychol. 2013 Dec;28(8):771-83. doi: 10.1093/arclin/act073. Epub 2013 Sep 18.


During the last decades, symptom validity has become an important topic in the neuropsychological and psychiatric literature with respect to how it relates to malingering, factitious disorder, and somatoform complaints. We conducted a survey among neuropsychologists (N = 515) from six European countries (Germany, Italy, Denmark, Finland, Norway, and the Netherlands). We queried the respondents about the tools they used to evaluate symptom credibility in clinical and forensic assessments and other issues related to symptom validity testing (SVT). Although the majority of the respondents demonstrated technical knowledge about symptom validity, a sizeable minority of the respondents relied on outdated notions (e.g., the idea that clinicians can determine symptom credibility based on intuitive judgment). There is little consensus among neuropsychologists on how to instruct patients when they are administered SVTs and how to handle test failure. Our findings indicate that the issues regarding how to administer and communicate the SVT results to patients warrant systematic research.

Keywords: Effort; Malingering; Neuropsychology; Survey; Symptom validity.

MeSH terms

  • Attitude of Health Personnel*
  • Europe
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Malingering / diagnosis
  • Neuropsychological Tests* / standards
  • Predictive Value of Tests*
  • Reproducibility of Results
  • Somatoform Disorders / diagnosis
  • Symptom Assessment / psychology*