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PubMed2004

Discriminating malingered from genuine civilian posttraumatic stress disorder: a validation of three MMPI-2 Infrequency scales (F, Fp, and Fptsd).

The Infrequency-Posttraumatic Stress Disorder scale (Fptsd), recently created for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), has demonstrated incremental validity over other MMPI-2 scales in malingered posttraumatic stress disorder (PTSD) detection. Fptsd was developed with combat-exposed PTSD patients, potentially limiting its use with PTSD patients in general. The current study evaluated the MMPI-2's F, Infrequency-Psychopathology scale (Fp), and Fptsd scales in discriminating genuine civilian PTSD among 41 adult victims of child sexual abuse from a group of 39 students instructed to simulate PTSD. Analyses demonstrated Fptsd's incremental validity over F but not over Fp. Based on the two studies examining Fptsd, Fptsd may be more appropriate for combat trauma victims, and Fp may be more appropriate for civilian trauma victims.

Adolescent↗
PubMed2005

Sensitivity and specificity of reliable digit span in malingered pain-related disability.

The reliable digit span (RDS) performance of chronic pain patients with unambiguous spinal injuries and no evidence of exaggeration or response bias (n = 53) was compared to that of chronic pain patients meeting criteria for definite malingered neurocognitive dysfunction (n = 35), and a group of nonmalingering moderate-severe traumatic brain injury (TBI) patients (n = 69). The results demonstrated that scores of 7 or lower were associated with high specificity (> .90) and sensitivity (up to .60) even when moderate to severe TBI are included. Multiple studies have demonstrated that RDS scores of 7 or lower rarely occur in TBI and pain patients who are not intentionally performing poorly on cognitive testing. This study supports the use of the RDS in detecting response bias in neuropsychological patients complaining of pain as well as in the assessment of pain-related cognitive impairment in patients whose primary complaint is pain.

Adult↗
PubMed2005

The impact of cognitive and psychiatric impairment of psychotic disorders on the test of memory malingering (TOMM).

The author analyzes the scores of inpatient psychiatric patients with varying degrees of cognitive impairment who met criteria for a psychotic disorder on the following tests: the Test of Memory Malingering (TOMM), the California Verbal Learning Test-Second Edition, Conner's Continuous Performance Test-Second Edition, and the Brief Psychiatric Rating Scale-Expanded Version. Group 1 consisted of psychotic-disordered patients with significant concentration problems (concentration impersistence = 29). Group 2 consisted of psychotic disordered patients without significant concentration problems (no concentration impairment = 21). Although psychotic patients with concentration problems showed greater variability across TOMM trials, both groups obtained mean scores above 45 on Trial 2 and the retention trial on the TOMM. These findings indicate that cognitive impairment associated with psychosis generally does not negatively impair TOMM performance to such a level that would produce a false positive on the TOMM. Implications for forensic assessment, study limitations, and future directions are discussed.

Adult↗
PubMed1999

Malingering and mild brain injury: how low is too low.

The purpose of this study was to investigate potential validity markers for 4 commonly used neuropsychological tests. Participants were divided into 5 groups: moderate/severe brain injury (n = 27), mild brain injury--nonlitigating (n = 35), normal controls (n = 30), mild brain injury--litigating (n = 49), and malingering "actors" (n = 20). Participants completed a flexible neuropsychological battery that included the 4 tests of interest (Judgment of Line Orientation, Token Test, Dichotic Listening, and 20-item forced choice). Results demonstrated cutoff levels on all 4 tests below which people with mild brain injury would not be expected to fall. The fact that some litigants, but no nonlitigants, fell below these cutoff levels suggests these tests and their cutoff levels may be used appropriately as internal validity markers. There was 100% specificity and 95% sensitivity found when all 4 tests were used together (1-test criteria) to separate litigants, nonlitigants, and actors. It is suggested that further examination of these tests and other neuropsychological tests, be completed so that, eventually, all neuropsychological tests will have internal validity markers.

Adult↗
PubMed2000

Can head injury patients simulate malingering?

In the past few years, there have been many simulation studies on the efficacy of symptom validation tests. These typically involved nonclinical participants. This line of research was limited because the impact of the experience of head injury was not examined. Researchers failed to understand whether individuals with head injury would feign cognitive deficits on symptom validation tests as well as their nonclinical counterparts did. This study was designed to investigate simulation of memory deficits among the head injured on the Portland Digit Recognition Test (PDRT; Binder, 1993). Head injury patients, with and without corroborated brain damage, and a group of controls were involved to resemble clinical populations. Results showed that false negative rates ranged from 67% to 84% when participants were asked to feign memory difficulty on the PDRT. Head injury patients, regardless of corroboration of brain damage, were equally capable of feigning memory deficits on the PDRT as their nonclinical counterparts. Findings suggest that the additive value of symptom validity tests, such as the PDRT, can be limited for their use as malingering tests.

Adult↗
PubMed2001

How low is too low, revisited: sentence repetition and AVLT-recognition in the detection of malingering.

Sentence Repetition (SR) and Rey Auditory Verbal Learning Test-Recognition Task (AVLT-R) scores of 5 groups of examinees (severe traumatic brain injury [TBI], mild TBI nonlitigants, normal controls, mild TBI litigants, and actors) were compared with the intent of determining cutoffs for the detection of malingering. Cutoff scores were set below the minimum of the severe TBI group, resulting in a specificity of 100% for both tests. At this level of specificity, the AVLT-R detected 10 of the 20 known actors (50% sensitivity), whereas SR correctly identified 14 of the 20 actors (70% sensitivity). Among litigants with mild injury, 12.24% were identified by the AVLT-R and 6.12% by SR as malingerers. These findings are similar to those found utilizing a variety of other common neuropsychological instruments. Employing commonly used neuropsychological tests as measures of motivation is both practical and clinically useful.

Accidents, Traffic↗
PubMed2005

Hit rates of adequate performance based on the test of memory malingering (TOMM) Trial 1.

The Test of Memory Malingering (TOMM) is a method of identifying patients who may be exerting poor effort during neuropsychological testing. This study seeks to examine whether TOMM Trial 1 scores are useful in identifying patients whose overall TOMM performance does not indicate obvious poor effort. Hit rates of adequate performance on Trial 2 and the Retention Trial were calculated based on a fixed criterion of 45 or greater on Trial 1. Archival data were collected from a sample of 77 mild traumatic brain injured litigants and compared to each clinical sample described in the TOMM test manual (Tombaugh, 1996). Results show a hit rate of 100% for each group. Findings reveal that adequate Trial 1 scores predict adequate Trial 2 and Retention Trial scores, suggesting that patients scoring 45 or greater on Trial 1 are not likely to be suspected of poor effort based on overall TOMM performance.

Adult↗
PubMed2006

Are we honestly studying malingering? A profile and comparison of simulated and suspected malingerers.

Malingering research typically uses analog simulation design or differential prevalence design among "real" patients. Both have been criticized for methodological limitations in external and internal validity, respectively. Samples of simulated malingerers were compared to suspected malingerers to examine generalizability of analog findings. Overall results support the use of simulation designs. Furthermore, it was demonstrated that stringent selection of suspected malingerers maintains internal validity of the differential prevalence design. A second focus, to determine if demographic matching of simulated malingerers is necessary, showed that matching on age and race is not necessary.

Achievement↗
PubMed2006

Ethical issues associated with the assessment of exaggeration, poor effort, and malingering.

The use of effort tests is standard practice in forensic neuropsychology. There is a tremendous amount of good information available in test manuals and the research literature regarding the proper and responsible use of these tests. However, it is clear that there are numerous ethical issues and considerations associated with the assessment of exaggeration, poor effort, and malingering. Many of these issues are discussed, and recommendations are provided.

Forensic Psychiatry↗
PubMed1980

Faking psychosis on the Rorschach: can expert judges detect malingering?

The susceptibility of the Rorschach to faking of psychological disturbance has been subject to few studies, all of which have significant methodological deficiences. Faking of psychosis was examined in this study by using Rorschach experts as judges to blindly evaluate both faked and actual psychotic protocols. The faked protocols came from role-informed and role-uninformed individuals who were asked to specifically malinger paranoid schizophrenia on the Rorschach. The results indicated that the expert judges were unable to detect the faked psychotic protocols regardless of whether the faker was or was not role-informed. However, significantly more role-informed faked protocols received psychotic designations than both the role-uninformed faked and actual psychotic protocols. Expert clinical judgments o- the Rorschach are apparently very susceptible to faking of serious disturbance.

Adolescent↗
PubMed1988

Susceptibility of Rorschach distress correlates to malingering.

This study examined whether faking depression can affect Rorschach variables associated with distress. Fifty-eight nondepressed undergraduates were randomly assigned to experimental and control groups of 29 subjects each. All subjects took the Minnesota Multiphasic Personality Inventory (MMPI) Depression Scale, Rorschach Inkblot Test, and Beck Depression Inventory (BDI) under standard administration procedures. Immediately before taking the Rorschach and BDI, experimental group subjects were: (a) instructed to fake depression, (b) provided with a clinical description of the disorder, and (c) offered a cash incentive for the most convincing test display of depression. These conditions increased scores on the BDI, p less than .0001, Morbid Special Score, p less than .05, Bl, p less than .005, and reduced R, p less than .05, but affected no determinants. Power to detect a clinically significant effect of faking on the sum of gray-black determinants was .99 (alpha = .05). Major implications are: (a) abnormal frequencies of determinants should not be attributed to malingering, and (b) Rorschach content measures of depression are affected by impression management strategies.

Adult↗
PubMed1994

Detecting malingered and defensive responding on the MMPI-2 in a forensic inpatient sample.

The purpose of this study was to examine the effectiveness of the various validity scales and indices on the MMPI-2 to detect malingered (fake-bad), and defensive (fake-good) responding. The entire sample consisted of 165 college students who completed the MMPI-2 under one of three conditions--fake-bad, fake-good, or respond honestly--and 173 forensic inpatients who completed the test as part of a routine evaluation. To detect faking-good and faking-bad, cutting scores for the validity scales and indices were established from the fake-good and fake-bad groups and were compared to the honest and patient groups. Corresponding sensitivity and specificity rates were then determined. Four validity indicators appeared to be moderately effective-at detecting fake-bad profiles: F, F--K, the MMPI-2 version of revised Gough Dissimulation Scale, and Wiener's Obvious-Subtle index, whereas the fake-good indicators were much less effective--only F--K and the Obvious-Subtle index appeared to have moderate utility.

Adolescent↗
PubMed1994

The susceptibility of the Rorschach Inkblot Test to malingering of combat-related PTSD.

The ability of subjects to alter their responses on the Rorschach and self-report measures to fake the symptoms of combat-related Posttraumatic Stress Disorder (PTSD) was investigated. Subjects were 40 White male undergraduates, randomly assigned to either a control or role-informed malingerer group, and 20 White Vietnam veterans with PTSD. Subjects were administered the Rorschach, MMPI-2 validity scales, and Mississippi Scale for Combat-Related PTSD. Results indicated that malingerers were able to achieve scores similar to the PTSD patients on the Mississippi Scale and some Rorschach variables. However, they evidenced significant differences on the MMPI-2 validity scales and several important Rorschach variables. Malingerers typically gave responses that were overly dramatic and less complicated, less emotionally restrained, and indicated an exaggerated sense of impaired reality testing as compared to PTSD patients. Behavioral differences were also noted between the groups. Findings are discussed in the context of the study's limitations and the practical detection of malingered PTSD in clinical settings.

Adult↗
PubMed2005

The validity and clinical utility of the MMPI-2 Malingering Depression scale.

In this study, we examined the validity and clinical utility of the MMPI-2 (Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) Malingering Depression scale (Md) in relation to the MMPI-2 F scales (F, F(B), F(P)) to detect feigned depression. Overall, the F(B) scale and the F/F(P) scale combination were the best single predictors, although the Md scale did discriminate successfully cases of feigned depression from patients with bona fide depression. The Md scale added predictive capacity over the F scales, and the F(B) scale and the F/F(P) scale combination added predictive capacity over the Md scale; however, the actual increase in the number of cases predicted was minimal in each instance. In sum, although the Md scale is able to detect accurately feigned depression on the MMPI-2 (predictive validity), it does not confer a distinct advantage (incremental validity) over the existing standard validity scales-F, F(B), and F(P).

Adult↗
PubMed2006

Development and validation of the Malingering Discriminant Function Index for the MMPI-2.

The predictive capacity of the MMPI-2 (Butcher et al., 2001) "fake-bad" validity scales (F, FB, and FP) is diminished when respondents have knowledge (i.e., coached) about the operating characteristics of these scales. In this investigation, we endeavored to develop a MMPI-2 fake bad validity index that would be less vulnerable to validity-scale knowledge. Applying discriminant function procedures, we derived a set of weighted Clinical and Content scales that reliably distinguished large samples of validity-scale coached undergraduate research participants instructed to feign mental illness (n = 534) from psychiatric patient samples (n = 590). We subsequently validated this Malingering Discriminant Function Index (M-DFI) in independent samples of research participants (n = 230) and patients (n = 300) and showed relatively less attenuation in predictive capacity compared with F, FB, and FP across uncoached and validity scale coached feigning conditions.

Adolescent↗
PubMed2001

Simulated malingering in pain patients: a study with the Pain Patient Profile.

OBJECTIVE: To investigate the utility of the Pain Patient Profile (P3) in detecting those who are faking or exaggerating complaints of pain while attempting to avoid detection. METHOD: A control group of pain patients ('Pain Controls'; PC; N = 62) was compared with a general clinical group who did not report pain but were instructed to simulate malingered pain ('General Rehabilitation Simulators', GR, N = 34); and a group whose primary problem was chronic pain who were instructed to exaggerate the extent of their pain and related problems ('Pain Simulators' PS; N = 26). RESULTS: Both groups of simulating participants reported significantly higher scores on all clinical scales (anxiety, depression, somatization) compared with non-simulating control participants and were more likely to obtain an abnormal T-score on the clinical scales. The validity scale was able to differentiate the PS group from the PC group, but the GR group was not differentiated from the PC group by the validity scale. CONCLUSIONS: The results indicate that with further study, the P3 may be a useful adjunct to the clinical assessment of symptom magnification in pain claimants.

Adult↗
PubMed1997

Head injury and malingering: current research.

Expert witnesses and attorneys, involved in head injury cases wherein malingering is suspected, rely on current research findings from the scholarly literature. This article presents a multidatabase search strategy for a successful review of research articles in this area.

Abstracting and Indexing↗
PubMed1989

Malingering traumatic mental disorder on the Beck Depression Inventory: cancerphobia and toxic exposure.

The revised Beck Depression Inventory is widely used to measure severity of depression, and it is often used in personal injury litigation as evidence of trauma. However, the potential vulnerability of the inventory to malingering has not been assessed. Of a group of 52 untrained volunteers, 96% were able to fake depression on the inventory and 58% successfully faked extremely severe depression. Users are cautioned against treating Beck's inventory as a literal measuring instrument in contexts where manipulation of responses is a potential issue.

Adolescent↗