A comparison of simulation and known groups in the detection of malingering on the MMPI-2

Three groups of 30 inmates, one instructed to respond honestly, one to fake being mentally ill, and one to fake schizophrenia after being educated to its symptoms, were administered the MMPI-2. These simulation groups were compared to two forensic evaluation groups of 30 pretrial defendants, one believed to be mentally ill and one suspected of malingering based on their psychiatric history, in order to compare the results of simulation with those of the forensic context. The results demonstrated that those instructed to feign psychiatric disorder and those suspected of malingering in the forensic context scored significantly higher on all MMPI-2 validity indicators than did those with a history of psychiatric treatment and those instructed to respond honestly, yet did not differ from each other. These findings suggest that the results of simulation designs are comparable to those obtained from forensic subjects. The F(p) Scale failed to add incrementally to F in discriminating the two defendant groups.     

Validation of an Abbreviated Version of the Structured Interview of Reported Symptoms in Outpatient Psychiatric and Community Settings

This study examined the effectiveness of an abbreviated version of the Structured Interview of Reported Symptoms (SIRS-A) in identifying malingered mental illness. The SIRS-A is comprised of 69 items drawn from the SIRS (R. Rogers et al. 1992, SIRS: Structured Interview of Reported Symptoms: Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.), substantially reducing the administration time. A simulation design was used with three samples; 87 psychiatric outpatients who responded honestly were compared to 29 community-dwelling adults and 24 psychiatric patients instructed to malinger psychopathology. The SIRS-A generated sensitivity comparable to or exceeding that of the SIRS normative data, but specificity was poorer; many genuinely impaired patients were misclassified as malingering. Although these findings suggest the SIRS-A may be an effective means to assess malingering in psychiatric populations, further research assessing the reasons for the elevated false positive rates is necessary.     

Symptom Validity Testing for the detection of simulated amnesia: Not robust to coaching

Abstract

Symptom Validity Testing (SVT) has been proposed as a method to assess the veracity of claims of amnesia. Performance below chance levels on a forced choice task is indicative of malingering. Previous research has shown that the Symptom Validity Test is a promising challenge test: at levels of high specificity, it may detect approximately half of those who malinger. The present study investigated the effect of coaching on the sensitivity of the Symptom Validity Test. Participants were instructed to feign complete amnesia and tested about their identity using the Symptom Validity Test. Half of the participants were coached not to perform below chance levels. Results were straightforward: 58% of 19 naive malingerers were detected, but none of 19 coached malingerers were detected. The results show that the Symptom Validity Test is not resistant to coaching.     

Minimizing culpability increases commission errors in a mock crime paradigm

Purpose. Empirical studies have demonstrated that feigning amnesia undermines memory for a mock crime. Not much is known about the effects of other culpability‐reducing strategies on memory. The present study investigated what strategies participants use when they are instructed to minimize culpability and if these strategies undermine memory to a similar extent as claiming amnesia. Methods. Participants performed a mock crime. Next, they were either instructed to minimize culpability for this mock crime in a simulated interrogation or asked to respond honestly. One week later, memory for the mock crime was tested. Results. None of the participants claimed amnesia when trying to minimize culpability. Conversely, all participants fabricated an alternative account of their role in the crime. Compared with responding honestly on both tests, fabricating an alternative story on the first test undermined memory for the mock crime in terms of commission errors. Correct recall was unaffected. It appeared that this effect was related to story length: the longer the fabricated story, the more the commission errors when telling the truth 1 week later. Conclusions. Fabricating an alternative story (i.e. lying) did not compromise correct recall, but induced more commission errors. The findings are discussed in terms of possible underlying mechanisms.     

Further data on interrogative suggestibility and compliance scores following instructed malingering

Purpose. This study examined whether people can successfully feign high levels of interrogative suggestibility and compliance as measured by the Gudjonsson Suggestibility Scales (GSS) and the Gudjonsson Compliance Scale (GCS) when given instructions to malinger. Methods. Participants (N = 90) were randomly allocated to one of three groups that received: (1) instructions to give into leading questions in order to look vulnerable to suggestions, (2) instructions to be compliant with the examiner, or (3) the standard GSS/GCS instructions. Results. One of the two malingering instructions led to modestly elevated scores of total suggestibility, while subscales remained unaffected. In contrast, both malingering groups obtained highly elevated compliance scores. Conclusions. These findings suggest that heightened suggestibility is rather difficult to malinger, thereby confirming the reliability of the GSS. On the other hand, it might be easier to malingering compliance as measured with the self‐report GCS.     

图形异同判别ERP技术检测伪装认知损害的研究

目的探讨图形异同判别ERP范式对鉴别伪装认知损害的法医学价值。方法 40例健康志愿者在合作和伪装认知损害两种情境下,进行二项必选数字记忆测验(BFDMT)及图形异同判别ERP范式检测,对照组为20例合作的三级脑外伤者。结果三组被试完成相同、无关、相似图形刺激后引出的ERP波均包括N1、P2、N2、P3和N3五个成分,三组样本组间的N2、P3和N3的潜伏期和波幅均存在差异。其中,伪装组相同图形的N3潜伏期与正常组无显著性差异,明显短于外伤组(P<0.01);伪装组无关图形的N3潜伏期较正常组延长,但短于外伤组,波幅较正常组降低(P<0.05);伪装组相似图形的N3潜伏期较正常组和外伤组缩短(P<0.01),波幅较正常组降低(P<0.01)。以N3潜伏期为指标进行判别分析,探查伪装认知损害的敏感性为81.8%、特异性为76.9%、命中率为79.2%。结论图形异同判别范式可引出稳定的特征性ERP成分,其中N3的波幅和潜伏期有显著的组间差异,对判断伪装认知损害有一定的参考价值。     

PTSD symptom reporting and persistent malingering in recipients of state compensation for violent crime victimization: an exploratory study

Previous research suggests that victims of violent crime who have applied for state compensation may persist in malingering after conclusion of the application process. To further explore this topic, the current study investigated differences in PTSD symptomatology between violent crime victims who had received compensation from the Dutch state and those who had been denied such compensation. Potential participants were approached through the Dutch Violent Offences Compensation Fund. Eventually, 125 victims agreed to participate and filled out a set of paper-and-pencil questionnaires. Both univariate and multivariate analyses revealed that recipients of compensation had reported higher symptom levels, than non-recipients but only when they could be qualified as probable malingerers. If compensation recipients could not be qualified as probable malingerers, they had reported lower symptom levels than non-recipients. This suggests that some victims will emotionally benefit from compensation, while others will unconsciously accept it as a validation of initially malingered symptoms. Results were discussed in terms of directions for future research and study limitations.     

The relationship between malingerers' intelligence and MMPI-2 knowledge and their ability to avoid detection

One of the most frequently administered psychometrics is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Occasionally, those participants taking the MMPI-2 will malinger or exaggerate their symptoms. Several malingering detection devices are available, and a significant body of literature exists concerning their efficacy. However, little research is available considering those factors that facilitate successfully evading detection as a malingerer. Some of these studies have identified general intelligence and knowledge of the MMPI-2 as key variables in the likelihood of escaping detection as a malingerer. The extant research considered the utility of general intelligence and knowledge of the MMPI-2 as predictors in avoiding detection as a malingerer. To detect malingering, the two traditional detection devices were employed: the F-Scale and the F - K Index. Results indicate that intelligence and MMPI-2 knowledge contribute significantly to the likelihood of successfully escaping detection as a malingerer.     

Recalled peritraumatic reactions, self-reported PTSD, and the impact of malingering and fantasy proneness in victims of interpersonal violence who have applied for state compensation

The present study explores the associations between three types of peritraumatic reactions (dissociation, distress, and tonic immobility) and posttraumatic stress disorder (PTSD) symptoms in a sample of 125 victims of interpersonal violence who had applied for compensation with the Dutch Victim Compensation Fund (DCVF). In addition, the confounding roles of malingering and fantasy proneness are examined. Results indicate that tonic immobility did not predict PTSD symptom levels when adjusting for other forms of peritraumatic reactions, whereas peritraumatic dissociation and distress did. However, after the effects of malingering and fantasy proneness had been controlled for, malingering is the only factor associated with increased PTSD symptomatology. Implications for policy practice as well as study strengths and limitations are discussed.     

The Verifiability Approach to detection of malingered physical symptoms

Inspired by recent research showing that liars are reluctant to include verifiable details in their accounts, we explored in two studies (N?=?125; N?=?105) whether participants who report fabricated symptoms (‘malingerers’) present fewer verifiable details than participants who report genuine ill-health symptoms. In Study 1, participants were instructed to describe a typical day on which they had experienced a genuine or malingered symptom. Truth tellers’ statements included significantly higher proportions of verifiable details concerning the reported symptoms than malingerers’ statements. Compared with truth tellers, malingerers generated longer statements with more unverifiable details. In Study 2, we informed participants that their statements may be assessed for verifiable or checkable details. Malingerers often mentioned ‘false’ witnesses to provide checkable information and differences between malingerers and truth tellers in statement length, and checkable and uncheckable details were no longer significant. The utility and implications of the Verifiability Approach to detection of malingering are discussed.     

Detection of Malingered ADHD Using the MMPI-2-RF

This study examined the utility of the Minnesota Multiphasic Personality Inventory—2 Restructured Form (MMPI-2-RF) validity scales for detecting feigning and exaggeration of attention-deficit/hyperactive disorder (ADHD) among college students. Under a simulation study design, participants with and without ADHD were assigned to perform honestly or to feign or exaggerate deficits related to ADHD while completing self-report symptom inventories. Participants instructed to feign produced symptom profiles similar to honest clinical profiles and more severe than honest nonclinical profiles. Participants with ADHD instructed to exaggerate produced less severe profiles than those instructed to feign and more severe profiles than clinical controls. MMPI-2-RF scale Fp-r showed potential for use in malingered ADHD detection at a revised cut score, which was significantly lower than the cut score suggested in the test manual; use of the revised cut score will require further validation. Scales F-r, Fs, and FBS-r did not classify well, but should be assessed in future studies of malingered ADHD. Detection of exaggeration was consistently poorer than detection of feigning.     

Do Motivations for Malingering Matter? Symptoms of Malingered PTSD as a Function of Motivation and Trauma Type

Psychological disorders associated with traumatic events, such as post-traumatic stress disorder (PTSD), may be prone to malingering due to the subjective nature of trauma symptomology. In general, symptoms tend to be inflated when an external reward (i.e., compensation) is associated with the claim. The present study was designed to test whether malingered claims of PTSD symptoms differed as a function of the type of trauma being malingered (accident, disaster, sexual assault) and the motivation for malingering (compensation, attention, revenge, no motivation). Participants were randomly assigned into conditions, given malingering instructions, and then asked to complete three measures of trauma symptoms (Impact of Event Scale??Revised; Post-Traumatic Stress Disorder Checklist; Trauma Symptom Inventory). Results indicated that participants in the sexual assault condition produced higher symptom reports on nearly all scales. Revenge and compensation motivations yielded elevated symptom scores. Further, individuals rated high in fantasy proneness and dissociation produced elevated scores on atypical responding and most clinical scales. More research is needed to examine the extent to which different motivations and trauma types influence symptom reporting.     

Neuropsychological and Psychological Aspects of Malingered Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is an anxiety disorder that is frequently encountered in litigation, and as such, there is an increased risk for poor effort on cognitive tests, symptom exaggeration, or frank malingering. These are particularly problematic for accurate diagnosis. This article is divided into four sections. First, we address why individuals malinger PTSD as well as the challenges in detecting an invalid PTSD symptom presentation. Second, we discuss issues of cognitive functioning in PTSD and then the prevalence of and common patterns of poor effort on neuropsychological testing among individuals feigning PTSD. Third, we discuss psychological functioning in PTSD and then the prevalence and patterns of functioning on psychological measures of malingering in this population. Finally, recommendations for detecting invalid PTSD symptom presentations are provided.     

Screening for malingering/exaggeration of psychiatric symptomatology in prison inmates using the PICTS Confusion and Infrequency scales

A sample of 76 federal prison inmates with a history or current complaints of significant psychiatric symptomatology at intake were followed for a period of 4-39 months by a psychologist who rated the inmate as malingering (n=12), substantially exaggerating (n=32), minimally exaggerating (n=23), or honestly reporting (n=9) signs and symptoms of schizophrenia, bipolar disorder, major depression, or severe anxiety disorder. The Confusion-revised (Cf-r) and Infrequency (INF) scales of the Psychological Inventory of Criminal Thinking Styles, which had been administered routinely at intake, revealed that only the INF successfully predicted malingering and exaggeration of psychiatric symptomatology even after pre-existing group differences in age, race, and overall criminal thinking were controlled. These results suggest that the INF scale can potentially serve as an effective initial screening measure for malingering/exaggeration in inmates presenting with mental health complaints.     

Development of a new classificatory model of malingering

Inclusion criteria for the classification of malingering are shaped and largely predetermined by our explanatory theories. Current theories have postulated the motivation to malinger is either the product of underlying psychopathology (pathogenic model) or criminal backgrounds (DSM III-R model). I have proposed a third model that malingering is typically an adaptive response to adverse circumstances which may best be understood in the context of decision theory. Based on this approach I have argued that indices of malingering should be empirically derived and focused on clinical presentation. Finally, I have proposed a preliminary model for the classification of malingerers which combines clinical data with corroborative evidence.     

Detection of Malingered PTSD: An Overview of Clinical,Psychometric, and Physiological Assessment: Where Do We Stand?

ABSTRACT: Posttraumatic stress disorder (PTSD) is a condition that can be easily malingered for secondary gain. For this reason, it is important for physicians to understand the phenomenology of true PTSD and indicators that suggest an individual is malingering. This paper reviews the prevalence of PTSD for both the general population and for specific events, such as rape and terrorism, to familiarize evaluators with the frequency of its occurrence. The diagnostic criteria for PTSD, as well as potential ambiguities in the criteria, such as what constitutes an exposure to a traumatic event, are reviewed. Identified risk factors are reviewed as a potential way to help differentiate true cases of PTSD from malingered cases. The question of symptom overreporting as a feature of the disease versus a sign of malingering is discussed. We then examine how the clinician can use the clinical interview (e.g., SIRS, CAPS), psychometric testing, and the patient's physiological responses to detect malingering. Particular attention is paid to research on the MMPI and the subscales of infrequency (F), infrequency-psychopathology (Fp), and infrequency-posttraumatic stress disorder (Fptsd). Research and questions regarding the accuracy of self-report questionnaires, specifically the Mississippi Scale (MSS) and the Personality Assessment Inventory (PAI), are examined. Validity, usability, and cutoff values for other psychometric tests, checklists, and physiological tests are discussed. The review includes a case, which shows how an individual used symptom checklist information to malinger PTSD and the inconsistencies in his story that the evaluator detected. We conclude with a discussion regarding future diagnostic criteria and suggestions for research, including a systematic multifaceted approach to identify malingering.     

Use of the MMPI-2 Restructured Clinical (RC) Scales in Detecting Criminal Malingering

The purpose of the present study was to assess the effects of criminal malingering on the MMPI-2 Restructured Clinical (RC) scales. Sixty undergraduate students were given the MMPI-2 twice. One administration was conducted according to the MMPI-2 manual, and the other was given with a special set of malingering instructions specific to a prison setting. The two MMPI-2 profiles for each participant were scored for both the Basic and RC scales. Eight participants were eliminated from the data analysis due to validity (VRIN or TRIN) concerns. Data from the remaining 52 participants were analyzed using a 2 × 2 repeated measures ANOVA. Results showed that, as expected, the participants achieved higher MMPI-2 scores in the malingering condition. Also, participants achieved higher scores overall on the Basic scales and a significant interaction showed that participants achieved higher scores on the Basic Scales in the malingering condition than on the RC scales in that condition. These results supported prior research, indicating that malingerers produce elevated RC profiles. However, the present results also suggest that the Basic scales may be more effective in actually detecting malingerers, mainly due to the much lower ceiling on the RC scaled scores. Further implications of these findings for research and clinical work are also discussed.     

Malingered Posttraumatic Stress Disorder (PTSD) and the Effect of Direct Versus Indirect Trauma Exposure on Symptom Profiles and Detectability

Posttraumatic stress disorder (PTSD) is arguably prone to malingering due to its subjective and heterogeneous nature. Various factors can influence PTSD symptom profiles including trauma type and trauma exposure. However, it is unknown whether trauma exposure influences malingered PTSD symptom profiles. We used a malingering simulation design with trauma type controlled to compare (1) PTSD symptom profiles (Posttraumatic Stress Checliklist-5; PCL-5) at the syndrome, symptom cluster, and individual symptom levels and (2) symptom validity profiles (Structured Inventory of Malingered Symptomatology; SIMS) at the overall and subscale level, as a function of direct and indirect trauma exposure. Seventy-three participants were randomly assigned to either the direct (“witnessed” trauma) or indirect (“learned about” trauma) condition. Participants were coached about symptoms and instructed to simulate PTSD. PCL-5 profile analyses revealed that simulators in the direct exposure group reported greater overall PTSD severity. Significant differences were found on cluster D (changes in cognition and mood) and individual symptoms including intrusive thoughts, amnesia, difficulty experiencing positive emotions, and risk-taking. No differences were identified for any other symptom scores nor for the symptom validity profile, except for the SIMS total score (direct: M?=?33.0, SD?=?12.8, indirect: M?=?26.5, SD?=?13.9, t(71)?=?2.06, p?=?.043, d?=?.48). These findings indicate that trauma exposure can influence malingered PTSD profiles at the syndrome, symptom cluster, and individual symptom levels (small effects), but, with one exception for a summary score, it does not produce a detectable difference on symptom validity testing. This study may provide insight for clinicians into the how malingered PTSD profiles can manifest as a result of direct and indirect trauma exposure; however, further research is strongly indicated.     

The PTSD Stressor Criterion as a Barrier to Malingering: DSM-5 Draft Commentaries

This commentary focuses on the proposed changes to the trauma stressor criterion for PTSD for DSM-5, specifically its likely impact on malingering. PTSD is particularly susceptible to malingering because the diagnosis relies so heavily on a patient’s subjective symptoms. Because the traumatic event that is the trigger of the PTSD syndrome is generally based on objective fact and thus often easily corroborated, this element of the diagnosis is usually more challenging to malinger than subjective reports of symptoms. Therefore, one of the main gateways for limiting the misuse of the PTSD diagnosis in forensic settings is the criterion defining the range of qualifying traumas. Proposed changes to criterion A of PTSD in the draft include modifying the types of qualifying trauma by replacing “threat to physical integrity” with “sexual violation,” and clarifying the modes of exposure by replacing the phrase “confronted with” with two criterion: “learning that the event occurred to a close relative or close friend” and “experiencing repeated or extreme exposure to aversive details of the event.” Each of these changes has the potential to significantly broaden the range of qualifying stressors and consequently expand the potential pool of individuals who might be in a position to malinger the disorder. Given the likelihood that the DSM-5 field trials will be unable to provide information relevant to assessing the impact of making these changes in forensic settings, it would be prudent to resist the inclination to tinker with the wording unless other mechanisms are available to ensure that the wording changes do more good than harm.