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The prevalence of underperformance,as defined by a positive score on the malingering test,was 61%(95%CI:45-77)in the context of litigation,and 29% (95%CI:18-40)in the outpatient clinic(p=0.003).Furthermore,the scores on the memory and concentration test of malingering post-whiplash patients(n= 43)and non-malingering post-whiplash patients(n=65)were compared with the scores of patients with closed head injury(n=20)and normal controls(n=46). The malingering post-whiplash patients scored as low as the patients with closed head injury on most tests.The prevalence of malingering or cognitive underperformance in late post-whiplash patients is substantial, particularly in litigation contexts.It is not warranted to explain the mild cognitive disorders of whiplash patients in terms of brain damage,as some authors have done.The cognitive complaints of non-malingering post- whiplash patients are more likely a result of chronic pain,chronic fatigue,or depression. |
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