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PubMed1992

The use of indirect memory tests to assess malingered amnesia: a study of metamemory.

Many techniques have been suggested for identifying criminal suspects who are simulating amnesia for the events surrounding a crime. The present research focuses on indirect memory tests as a potential means of discriminating between those who genuinely suffer from amnesia and those who are simulating. Subjects studied a list of words and subsequently performed either a word completion or a fragment completion task. Under normal indirect test instructions, typical priming effects were observed. When subjects were motivated to simulate amnesia for the list, target completion rates were consistently, and sometimes reliably, below baseline completion rates. This finding is contrary to the performance of genuine amnesics, whose performance on indirect tests typically mirrors that of normal subjects. Indirect tests may prove useful in discriminating genuine and simulating amnesics.

Adult↗
PubMed2000

Normative data for the F(p) scale of the MMPI-2: implications for clinical and forensic assessment of malingering.

Data from several clinical samples and the Minnesota Multiphasic Personality Inventory--2 standardization group are presented to familiarize the reader with response patterns of different groups on a new validity scale designed to assist in the identification of exaggeration or fabrication of psychological disturbance. Sensitivity-specificity analyses are included along with suggestions for use of the F(p) Scale with other validity scales. Cautions about setting single cutoff scores are also discussed.

Female↗
PubMed2002

Suspect cognitive symptoms in a 9-year-old child: malingering by proxy?

Even though the veracity of children's claim of psychiatric symptoms has received increased attention in recent years, identification of noncredible neuropsychological symptoms in children has been virtually overlooked in clinical practice and research. A case is presented of a 9-year-old child involved in litigation regarding a head injury sustained when he was struck by a car. Neuropsychological evaluation revealed evidence of feigned cognitive symptoms; the child displayed noncredible performance on several specialized tests designed to discreetly assess effort and an atypical pattern of responses on standard cognitive measures, as well as discrepancies between neuropsychological scores and tests administered in school and the rehab setting. Results demonstrate that children as young as 9 years of age are capable of feigning cognitive impairment, which highlights the need for routine evaluation of effort, irrespective of the age of the patient.

Child↗
PubMed2002

Detecting exaggeration and malingering with the trail making test.

The purpose of this study was to examine whether unusual performance on the Trail Making Test could be indicative of deliberate exaggeration. Participants were 571 patients seen as part of a hospital trauma service who had acute traumatic brain injuries, and 228 patients involved in head injury litigation. As expected, the hospital patients with more severe traumatic brain injuries performed more poorly than the patients with less severe brain injuries on Trails A and Trails B. Cutoff score tables were developed for the patients with acute traumatic brain injuries for the total sample and by injury severity groups. Scores falling at or below the 5th percentile were considered suspicious for possible exaggeration. The performances of the head injury litigants who exaggerated on at least one well-validated symptom validity test were compared to these cutoffs. Very high positive predictive values for individuals with very mild head injuries on Trails A and B were identified (i.e., both 100%); lower positive predictive values were obtained for individuals with more severe head injuries (55.6-60%). The negative predictive values were only moderate (range=66.4-78.2%), and the sensitivity was very low (range = 7.1-18.5%) for all groups. Scores that fall in the range of possible biased responding should be considered "red flags" for the clinician because they likely do not make biological or psychometric sense. However, the sensitivity of the test for deliberate exaggeration is very low, so clinicians who rely on this test in isolation to identify deliberately poor performance will fail to identify the vast majority of cases.

Adult↗
PubMed2003

The other side of malingering: supernormality.

Supernormality refers to the tendency to systematically deny the presence of common symptoms (e.g., intrusive thoughts). The current article describes the psychometric qualities of a 37-item self-report measure of supernormality (i.e., Supernormality Scale; SS). The SS was administered to nonclinical individuals (n=95), noncriminal psychiatric patients (n=28), nonpsychiatric delinquents (n=49), and a heterogeneous sample of forensic patients (n=59). Within the healthy control sample, some employees were instructed to feign supernormal behaviour, while others were asked to respond honestly to SS items. Findings indicate that the SS demonstrates adequate test-retest stability and internal consistency. In the forensic patient sample, elevated SS scores were significant related to denial of intrusive thoughts in a thought suppression paradigm. However, accuracy parameters for the SS (i.e., sensitivity and specificity) showed that there is room for improvement. Nevertheless, our findings indicate that the SS might be a useful research tool for measuring denial of common symptoms.

Adult↗
PubMed1987

When renal colic is really malingering.

Renal colic malingerers feign symptoms of pain and hematuria, usually to obtain parenteral narcotics. These patients must be identified early to minimize waste of time and supplies by emergency department staff. However, they often use clever ploys to avoid undergoing diagnostic procedures that would unmask them and cut off their drug supply. These malingerers must be differentiated from patients with somatization disorders and those with hard-to-diagnose renal disease, which further complicates their detection. Fortunately, the informed physician can usually suspect the truth early and take steps to reach the proper "diagnosis."

Adult↗