Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering

Clinicians tend to overestimate their ability to recognize feigning behavior in psychiatric patients, especially if it concerns patients who have been admitted for observation. Feigning can be either externally motivated (e.g., for financial compensation, known as malingering) or internally motivated (e.g., to assume the “sick role,” known as factitious disorder). Persistent presentation of severe symptoms is usually associated with the factitious disorder. We present two patients with strong external incentives who consistently and convincingly feigned severe psychiatric symptoms during a protracted period of inpatient observation in a specialized center; both were engaged in a procedure for medical asylum. The first case presented with the clinical picture of a psychotic depression with severe motor symptoms, and the second case showed symptoms of a chronic post-traumatic stress disorder with secondary psychotic symptoms. Both cases were thoroughly investigated but feigning was overlooked, and unnecessary and harmful treatment interventions were given. To prevent iatrogenic damage, we recommend a critical attitude that takes malingering as an option into account in settings where patients are often involved in high stake legal procedures. A clinical sign that might indicate feigning is therapy-resistant symptoms. To rule out feigning a comprehensive, multimethod approach is required, but an active stance toward collateral information is essential. Specialized psychological tests may be useful for preliminary screening, but for their use in culturally diverse populations as in refugee mental health more research is needed.     

Recovered memories of childhood sexual abuse: Current findings and their legal implications

Recent research on recovered memories of childhood sexual abuse has shown that there are at least two types of recovered memory experiences: those that are gradually recovered within the context of suggestive therapy and those that are spontaneously recovered, without extensive prompting or explicit attempts to reconstruct the past. By focusing on well‐known imperfections of human memory, we were able to find differing origins for these recovered memory experiences, with people recovering memories through suggestive therapy being more prone to forming false memories, and with people reporting spontaneously recovered memories being more prone to forgetting prior incidences of remembering. Moreover, the two types of recovered memory reports are associated with differences in corroborative evidence, suggesting that memories recovered spontaneously, outside of suggestive therapy, are more likely to correspond to genuine abuse events. In this paper, we summarize recent research on recovered memories and we argue that these scientific findings should be applied in the justice system, but also in clinical practice.     

It was not me: attribution of blame for criminal acts in psychiatric offenders

The current article addresses the psychometric qualities of the German Version of Gudjonsson's Blame Attribution Inventory (GBAI), a self-report scale for measuring attribution of blame for crime. The GBAI was administered to a criminal sample of forensic and criminal inmates (n=107). Findings indicate that the German version of the Gudjonsson Blame Attribution Inventory possesses acceptable test-retest stability and good internal consistency. Factor analysis reproduced the three basic dimensions of the GBAI: external attribution, mental-element attribution, and guilt-feeling attribution. Forensic patients had higher mental-element attribution and guilt-feeling attribution scores than the prison inmates. Interestingly, sexual offenders who were prisoners, showed the lowest guilt-feeling attribution, while sexual offenders who were forensic patients had the highest guilt-feeling attribution scores. Since earlier research reported a tendency of faking good in sexual offenders, we suggest that the forensic sexual offenders may demonstrate a social desirable response tendency in an attempt to gain sympathy and/or earlier parole. All in all, our data show that the German version of the GBAI is a valuable tool for measuring attributional styles of offenders.     

Feigning Hand Preference? A Case Report Preliminary Data

Hand preference may be crucial in the forensic domain, notably in cases where the assailant is known to be left‐handed and the defendant claims to be right‐handed (or vice versa). In such cases, forensic psychologists or physicians may be asked to test the hand preference of the defendant. However, hand preference may be faked. The case described here illustrates this problem and addresses potential solutions. We also present preliminary data showing that a standard instrument for measuring handedness is sensitive to feigning. We conclude that when hand preference is determined, multiple sources of information should be assessed in order to identify possible feigning.     

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.     

‘You didn't take Lucy's skirt off’: The effect of misleading information on omissions and commissions in children's memory reports

Purpose. The current study explored how misleading information affects children's omissions and commissions over time. Method. Fifty‐nine younger (M_age = 4.16) and fifty‐nine older (M_age = 9.44) children were instructed to remove three pieces of clothing from a puppet. Half of them were provided with false evidence that they had removed only two items, while the other half were provided with false evidence that they had removed a fourth piece of clothing. In three neutral interviews separated by 1‐week intervals, children had to report which pieces of clothing they had removed. Results. Overall, omission and commission errors significantly decreased over time, although this pattern was more pronounced for omission errors. Younger and older children were equally likely to make omission errors, whereas commission errors were more typical for younger than for older children. Also, we found that commission errors more readily occur than omission errors. Conclusion. Even when children's memory reports pertain to an event in which they actively participated, misleading information may elicit omission and commission errors, with especially the latter category being very persistent over time.     

SCAN is largely driven by 12 criteria: results from sexual abuse statements

Scientific Content Analysis (SCAN) is increasingly used by investigative authorities to evaluate the credibility of statements made by witnesses and suspects. SCAN, however, lacks a well-defined list of criteria, and does not involve a standardised scoring system. In the current study, we investigated which SCAN criteria are represented in actual statements. To this end, we analysed 82 sexual abuse cases of the Dutch police in which SCAN had been applied. Two independent coders scored the presence of various SCAN criteria in the: (1) written statements from victims, suspects, and witnesses; and also looked at the (2) recommendations for follow-up investigations that were derived from SCAN. Results showed that SCAN is primarily driven by 12 criteria. Results also indicated a low inter-rater agreement for most SCAN criteria, suggesting SCAN is insufficiently developed as a forensic tool. Still, the 12 criteria can be used as a starting point for future research on their psychometric properties.     

Measuring interrogative suggestibility in children: Reliability and validity of the bonn test of statement suggestibility

Abstract

The present paper describes three studies that examined false confessions in the laboratory. Studies 1 (N=56) and 2 (N=9) relied on the by now classic computer crash paradigm introduced by Kassin and Kiechel (Psychological Science, 7, 125–128, 1996). Study 3 (N=12) employed a novel paradigm in which undergraduate participants were falsely accused of exam fraud. Our data indicate that false confessions do occur, even when conditions become more ecologically valid. Furthermore, we explored whether individual differences in compliance, suggestibility, fantasy proneness, dissociation, and cognitive failures are related to false confessions. Of these, only fantasy proneness was associated with false confessions.     

Symptom Overreporting and Recovered Memories of Childhood Sexual Abuse

The authenticity of recovered memories is a much debated issue. Surprisingly, no study has systematically looked at symptom overreporting in people claiming recovered memories of childhood sexual abuse (CSA). In a first sample we administered the Structured Inventory of Malingered Symptomatology (SIMS) to individuals who said they had recovered CSA memories (n=66), individuals who said their CSA had always been accessible (continuous CSA memory group; n=119), and controls who said they had no CSA experiences (n=83). In a second sample individuals reporting recovered (n=45) or continuous (n=45) CSA memories completed the Morel Emotional Numbing Test (MENT). Our aim was to compare these groups with regard to their tendency to overreport symptoms. The results indicate that people with recovered memories do not score higher on the SIMS and the MENT than other CSA survivors suggesting that symptom overreporting is not typical for people reporting recovered memories.