Why one fakes a head injury affects how one fakes a head injury.

Identifying suspect effort in neuropsychological assessments has been investigated in clinical samples and experimental simulation paradigms. While patients' incentives, such as compensation, are commonly thought to impact motivation, other motivational influences, such as attention-seeking, have been largely unexplored. To this end, undergraduates (n=202) were asked to fake a head injury on the Dot Counting Test, California Verbal Learning Test, and Benton Visual Retention Test. Participants were assigned to one of four Motivation conditions (no motivation, avoiding blame, compensation, attention-seeking). Analyses revealed that those with compensation- and attention-seeking motivations performed significantly worse than those with blame avoidance and no motivations, suggesting that type of motivation affects performance on neuropsychological assessment. The relative similarity between compensation-seekers and attention-seekers, however, suggests that the two groups would be difficult to differentiate. Preliminary findings suggest that compensation-seekers may favor errors of omission and attention-seekers may favor errors of commission in their performance; however this finding requires replication.