Malingering detected by forced choice testing of memory and tactile sensation: a case report.

A man with a possible diagnosis of multiple sclerosis was evaluated in connection with his claim for Social Security Disability. Two neurological examinations had revealed essentially normal findings. Neuropsychological testing revealed moderately severe deficits, but testing of his motivation with two forced choice measures, the Portland Digit Recognition Test and a finger graphesthesia procedure, both yielded performances significantly worse than chance. It was concluded that the patient was faking some or all of his deficits, and that his abilities had not been measured accurately. Forced choice testing is a robust procedure for documenting poor motivation.