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Abstract
Impairment evaluations often occur within an adversarial context that involves a claimant or plaintiff vs a defense or benefits system; this adversarial context may precipitate proposals for observations of a clinical evaluation (eg, by an attorney or attorneys for one or both parties, a court reporter, a clinical expert, other consultant; audio or video also may be recorded). Evaluators, judges, and state workers’ compensation systems sometimes allow such observation, but a century of scientific research has reliably demonstrated that any observation changes an examinee's presentation in ways that are not themselves predictable. Such contamination leaves the evaluation results without a scientifically credible analysis, rendering observed evaluations futile exercises at best and sources of misinformation at worst. This article reviews the research in social psychology regarding “social facilitation and inhibition,” which has identified an extensive list of factors that are affected by observation (eg, complexity or novelty of the issue being evaluated, perceptions of the observer as an evaluator, stranger, or ally, number of observers, and other factors). No mechanism allows an evaluator to systematically account for the effects of all such variables for any given evaluation. When observation is mandatory, the evaluator should clearly document and communicate that a credible direct evaluation was rendered impossible, to the detriment of the referring party and the system as a whole.
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McCaffrey RJ, Lynch JK, and Yantz CL. Third party observers: while all the fuss? J Forensic Neuropsychol. 2005; 4(2): 1–15.
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Lynch JK. Effect of a third-party observer on neuropsychological test performance following closed head injury. J Forensic Neuropsychol. 2005; 4 (2): 17–25, 2005.
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Seta JJ, Wang MA, Crisson JE, and Seta CE. Audience composition and felt anxiety: impact on averaging and summation. Basic and Applied Social Psychology. 1989; (10): 57–72.
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Constantinou M, Ashendorf L, and McCaffrey RJ. When the third-party observer of a neuropsychological evaluation is an audio recorder. The Clinical Neuropsychologist. 2002;(16): 407–412.
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Constantinou M, Ashendorf L, and McCaffrey RJ. Effects of a third-party observer during neuropsychological assessment: when the observer is a video camera. J Forensic Neuropsychol. 2005; 4(2): 39–48.
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Yantz CL, and McCaffrey RJ. Effects of a supervisor's observation on memory test performance of the examinee: third-party observer effect confirmed. J Forensic Neuropsych. 2005; 4(2): 27–38.
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Grindrod D, Paton CD, Knez WL, O'Brien BJ. Six minute walk distance is greater when performed in a group than alone. Br J Sports Med. 2006; Oct; 40(10):876–7.
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Gavett BE, Lynch JK, and McCaffrey RJ. Third party observers: the effect size is greater than you might think. J Forensic Neuropsychol. 2005; 4(2): 49–64.
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Packard RC. Posttraumatic headache: permanency and relationship to legal settlement. Headache. 1992; Nov; 32(10): 496–500.
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Butler J, and Baumeister RF. The trouble with friendly faces: skilled performance with a supportive audience. J Pers and Soc Psychol. 1998; (75): 1213–1230.
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McCaffrey RJ. Some final thoughts and comments regarding the issues of third party observers. J Forensic Neuropsychol. 2005; 4(2): 83–91.
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