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Investigating the M-FAST: psychometric properties and utility to detect diagnostic specific malingering.

This study examined the ability of the M-FAST to differentiate a group of undergraduate students simulating one of four DSM-IV diagnoses (n = 190; schizophrenia, major depressive disorder, bipolar disorder, and posttraumatic stress disorder) and a clinical comparison sample drawn from previous M-FAST studies comprising individuals with the same diagnosis (n = 142). Across all diagnostic conditions, the simulators obtained higher M-FAST total scores than the clinical comparisons, and the rare combinations scale was equal or superior to the total score at differentiating the groups. The M-FAST was most efficient at distinguishing feigned from bona fide schizophrenia. Although the internal consistency of the total score was high (alpha = 0.88), inter-item correlations were lower than values reported in previous research. Lastly, given the importance of base rate considerations in the evaluation of diagnostic instruments, it was notable that the M-FAST was able to identify malingerers even at relatively low base rates.

Adolescent↗

Pain patient profile and the assessment of malingered pain.

This study investigated whether a pain sample and pain simulators could be distinguished on the Pain Patient Profile (P3). Forty patients with a pain condition completed the P3 under normal instructions, while 20 students responded under instructions to feign a pain disorder but to attempt to avoid detection. The simulators did not differ on the P3 Validity Scale compared with the pain group, but scored significantly higher than the pain group on the P3 clinical scales (Depression, Anxiety, Somatization). The simulators were more likely to obtain an abnormal score (T score > 55) on all of the clinical scales. The Depression scale had highest positive and negative predictive power and correctly classified 80% of the participants. The P3 may be a useful screening tool for assessing those feigning pain but requires further research.

Adolescent↗

The post-concussional syndrome: physiogenesis, psychogenesis and malingering. An integrative model.

Current models of post-concussional symptoms after mild head injury rest on the dichotomy between organic and psychogenic factors, which underpins Lishman's formulation; organic genesis and psychologically-driven persistence (Br J Psychiatry 1988; 153: 460-469). Recent prospective neuropsychological and bio-social studies of mild head injury, and perspectives from cognitive behavioural and health psychology, are reviewed. It is argued that the organic-psychogenic conceptualization inadequately explains chronic post-concussional symptoms. Psychosocial and cognitive-behavioural factors and the coping process may influence post-concussional symptoms over their entire time course, in particular the late phase. A multifactorial model of chronic post-concussional symptoms is proposed which integrates biological processes with these factors. It is through the recognition and identification of separate processes that questions about outcome, the limits of the impact of organic and psychosocial factors, the nature of exaggeration, and appropriate therapy, may be resolved.

Adaptation, Psychological↗

Malingering with AIDS.

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Acquired Immunodeficiency Syndrome↗