Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MALINGERING”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1997

Psycholegal implications of malingered head trauma.

In this article we examine the roles of individuals involved in traumatic head injury claims. These roles are described in terms of their integrated affects on one another, the outcome of the claim, and ultimately, society. Particular focus is on the role of the neuropsychologist as diagnostician, therapist, expert witness, and consultant; however, the roles of the plaintiff, the defendants, the attorneys, the judges, and juries also are addressed. The costs for invalid claims are high and ultimately fall on society in terms of higher health care costs, insurance premiums, and taxes. Because of this impact on society, the responsibility of neuropsychologists who diagnose, treat, and serve as expert witnesses and consultants in head injury claims cannot be underestimated.

Journal Article↗
PubMed2003

Assessing Axis I symptomatology on the SADS-C in two correctional samples: the validation of subscales and a screen for malingered presentations.

The Schedule of Affective Disorders and Schizophrenia-Change Version (SADS-C; Spitzer & Endicott, 1978b) is a brief, highly reliable structured interview with clinical applications to diverse populations. This investigation involved reanalyses of data from 2 earlier studies (Rogers, Grandjean, Tillbrook, Vitacco, & Sewell, 2001; Ustad, Rogers, & Salekin, 1998). Focusing on 2 clinical samples from a metropolitan jail, we investigated its subscales via exploratory and confirmatory factor analysis. A good model fit was found (comparative fit index =.92; robust comparative fit index =.94) for 4 subscales (Dysphoria, Psychosis, Mania, and Insomnia) with good interrater reliability (M intraclass coefficient =.95) and clinical relevance. As a preliminary screen for feigned mental disorders, 2 detection scales (Symptom Combinations and Symptom Selectivity) were moderately successful. By maximizing negative predictive power, the SADS-C detection strategies proved effective at ruling out feigning for mentally disordered offenders with a high likelihood of genuine disorders.

Adult↗
PubMed1992

Malingering detected by forced choice testing of memory and tactile sensation: a case report.

A man with a possible diagnosis of multiple sclerosis was evaluated in connection with his claim for Social Security Disability. Two neurological examinations had revealed essentially normal findings. Neuropsychological testing revealed moderately severe deficits, but testing of his motivation with two forced choice measures, the Portland Digit Recognition Test and a finger graphesthesia procedure, both yielded performances significantly worse than chance. It was concluded that the patient was faking some or all of his deficits, and that his abilities had not been measured accurately. Forced choice testing is a robust procedure for documenting poor motivation.

Journal Article↗
PubMed1997

Detection of malingering on the Luria-Nebraska Neuropsychological Battery: an initial and cross-validation.

A formula for detecting faked LNNB profiles was validated on 68 experimental malingerers and adequately motivated patients matched on education, age, and severity of profile. The formula was then cross-validated on 51 malingerers and 202 patients. The formula yielded a cross-validated 23% false negative rate and a 9% false positive rate, for an overall hit rate of 88%. If normal and profoundly impaired profiles are eliminated from the cross-validation analysis, the false negative rate is 17% and the false positive rate 7%, for an overall hit rate of 91%.

Journal Article↗
PubMed1999

Chronic pain disability exaggeration/malingering and submaximal effort research.

OBJECTIVE: This is the first review of chronic pain (CP) malingering/disease simulation research. The purpose of this review was to determine the prevalence of malingering within CP patients (CPPs), whether evidence exists that malingering can be detected within CPPs, and to suggest some avenues of research for this topic. DESIGN: A computer and manual literature search produced 328 references related to malingering, disease simulation, dissimulation, symptom magnification syndrome, and submaximal effort. Of these, 68 related to one of these topics and to pain. The references were reviewed in detail, sorted into 12 topic areas, and placed into tabular form. These 12 topic areas addressed the following: existence of malingering within the CP setting; dissimulation, identification simulated (faked) facial expressions of pain; identification of malingering by questionnaire; identification of malingered sensory impairment; identification of malingered loss of hand grip strength; identification of submaximal effort by isometric strength testing; identification of submaximal or malingered effort by isokinetic strength testing; identification of submaximal or malingered effort by the method of coefficient of variation; self-deception; symptom magnification syndrome; and miscellaneous malingering identification studies. Each report, in each topic area, was rated for scientific quality according to guidelines developed by the Agency for Health Care, Policy and Research (AHCPR) for rating the level of evidence presented in the reviewed study. The AHCPR guidelines were then used to rate the strength and consistency of the research evidence in each topic area based on the type of evidence the reports represented. All review conclusions were based on the results of these ratings. SETTING: Any medical setting reporting on either malingering or disease simulation, or dissimulation, or submaximal effort and pain. PATIENTS: Normal volunteers, CPPs, or any group asked to produce a submaximal or malingered effort or a malingered test profile. RESULTS: The reviewed studies indicated that malingering and dissimulation do occur within the CP setting. Malingering may be present in 1.25-10.4% of CPPs. However, because of poor study quality, these prevalence percentages are not reliable. The study evidence also indicated that malingering cannot be reliably identified by facial expression testing, questionnaire, sensory testing, or clinical examination. There was no acceptable scientific information on symptom magnification syndrome. Hand grip testing using the Jamar dynamometer and other types of isometric strength testing did not reliably discriminate between a submaximal/malingering effort and a maximal/best effort. However, isokinetic strength testing appeared to have potential for discriminating between maximal and submaximal effort and between best and malingered efforts. Repetitive testing with the coefficient of variation was not a reliable method for discriminating a real/best effort from a malingered effort. CONCLUSIONS: Current data on the prevalence of malingering within CPPs is not consistent, and no conclusions can be drawn from these data. As yet, there is no reliable method for detecting malingering within CPPs, although isokinetic testing shows promise. Claims by professionals that such a determination can be made should be viewed with caution.

Chronic Disease↗
PubMed1996

Assessing dissimulation among Social Security disability income claimants.

Social Security disability income programs have been tested by increasingly politicized concerns regarding widespread fraud among claimants. This study was an initial investigation of malingering among claimants in Los Angeles seeking disability income on psychological grounds. After a review of 100 disability income applications, a population-appropriate instrument was developed from established psychometric indices of malingering. The Composite Disability Malingering Index was completed by 167 disability claimants (possible malingerers), a sex, age and IQ cognate group of 63 psychologically disabled individuals without incentive to malinger (disabled nonmalingerers), and 45 disability examiners with instructions to malinger (instructed malingerers). The mean score of instructed malingerers and the score at the 95th percentile of the disabled nonmalingerers converged, indicating 8 as the critical score. This cutting score found 32 (19%) of disability claimants to be malingering. Self-reported substance abuse history was the only participant variable that significantly predicted higher malingering scores.

Adult↗
PubMedDate not supplied

Is there a relationship between nonorganic physical findings (Waddell signs) and secondary gain/malingering?

This is a structured evidence based review of all available studies addressing the concept of nonorganic findings (Waddell signs) and their potential relationship to secondary gain and malingering. The objective of this review is to determine what evidence, if any, exists for a relationship between Waddell signs and secondary gain and malingering. Waddell signs are a group of 8 physical findings divided into 5 categories, the presence of which has been alleged at times to indicate the presence of secondary gain and malingering. A computer and manual literature search produced 16 studies relating to Waddell signs and secondary gain or malingering. These references were reviewed in detail, sorted, and placed into tabular form according to topic areas, which historically have been linked with the alleged possibility of secondary gain and malingering: 1) Waddell sign correlation with worker compensation and medicolegal status; 2) Waddell sign improvement with treatment; 3) Waddell sign correlation with Minnesota Multiphasic Personality Inventory validity scores; and 4) Waddell sign correlation with physician dishonesty perception. Each report in each topic area was categorized for scientific quality according to guidelines developed by the Agency for Health Care Policy and Research. The strength and consistency of this evidence in each subject area was then also categorized according to Agency for Health Care Policy and Research guidelines. Conclusions of this review were based on these results. There was inconsistent evidence that Waddell signs were not associated with worker's compensation and medicolegal status; there was consistent evidence that Waddell signs improved with treatment; there was consistent evidence that Waddell signs were not associated with invalid paper-pencil test; and there was inconsistent evidence that Waddell signs were not associated with physician perception of effort exaggeration. Overall, 75% of these reports reported no association between Waddell signs and the 4 possible methods of identifying patients with secondary gain and/or malingering. Based on the above results, it was concluded that there was little evidence for the claims of an association between Waddell signs and secondary gain and malingering. The preponderance of the evidence points to the opposite: no association.

Chronic Disease↗
PubMed1997

Psychologists' accuracy in identifying neuropsychological test protocols of clinical malingerers.

Neuropsychology practitioners' accuracy in detecting malingering (based on neuropsychological test data alone) was investigated. Four test protocols had been produced by clinical malingerers who were identified by below-chance forced-choice test (FCT) results. For two of the cases observation/ surveillance data also indicated malingering. Two test protocols had been produced by severely head-injured individuals. Sixty psychologists reviewed a malingered test protocol and 26 reviewed data of a head-injured patient. Error rates (diagnosis of cerebral dysfunction without identifying malingering) ranged from zero to 25% and averaged 10% across the four malingered cases. Eight percent of the psychologists diagnosed malingering in the severely head-injured cases. Psychologists who received FCT data were significantly more confident in their diagnoses than were psychologists who did not receive FCT results, but they were not more accurate. The results suggest that neuropsychologists are capable of accurately detecting malingering, at least for obvious cases.

Journal Article↗
PubMed1999

Detection of malingerers using the Rey Complex Figure and Recognition Trial.

The detection of malingered performance on neuropsychological tests is important for the clinical practitioner. However, malingering is often impossible to detect based on individual test scores. This article suggests that the relation of scores to one another (profile pattern) adds a dimension to identifying malingered performance not available through examination of individual test scores. This article examines Memory Error Patterns (MEPs) of the Rey Complex Figure Test and Recognition Trial (RCFT; Meyers & Meyers, 1995). The patterns were found to be good predictors of malingering. Malingering participants and simulators produce storage and attention MEPs whereas these 2 patterns do not appear in mild brain injury participants who have adequate motivation. Therefore, MEPs on the RCFT appear to be a method that can be used to detect malingered performance. It is important that the validity of the individual neuropsychological test performance used in an assessment be evaluated as part of the interpretation process.

Adult↗
PubMed1998

Clinical symptom presentation in suspected malingerers: an empirical investigation.

To empirically investigate the usefulness and validity of clinical presentation and recent history variables in the detection of malingered psychiatric disorder, 30 criminal defendants involved in forensic evaluations, who had a documented history of psychiatric hospitalization preceding their arrest on the instant offense (low risk of malingering group) and 30 defendants who complained of psychiatric difficulties but had no history of psychiatric hospitalization or treatment (suspected malingering group) were studied. Each subject's mental status was rated, blind to psychiatric history, diagnosis, and psycholegal opinions, on a Likert-like scale for the uncommon nature of their symptom presentation. In addition, the final outcome of the court cases, whether they were found competent to stand trial, not guilty by reason of insanity, or evidenced diminished capacity was determined by obtaining the court disposition in each case. Based on the unusual nature of their presentation, the defendants suspected of malingering were discriminated from the low risk of malingering defendants with a 90 percent rate of correct classification. Suspected malingerers were found to evidence current psychiatric presentations inconsistent with their recent Global Assessment of Functioning, unusual symptom presentation, and hallucinatory experiences rated as atypical for psychiatric disorder. A high proportion of suspected malingerers were found competent to proceed. The results are discussed in terms of the usefulness of clinical identification of malingering.

Adult↗
PubMed1996

Do people with knowledge fake better?

Research on malingering that involves analog methods is frequently criticized for using normal subjects Critics have suggested that analog subjects probably perform differently from clinical Malingerers because of the absence of an identifiable incentive for analog malingerers, and because analog subjects have no opportunity to gain knowledge about the disorder to be malingered In contrast, clinical malingerers have an obvious incentive and may have at least a basic knowledge of the characteristics of the disorder they are feigning In this study, psychology graduate students and faculty were asked to malinger a memory deficit on several brief neuropsychological instruments on the premise that malingering would be difficult to detect in this population because of their supposed sophistication Results indicated that in sophisticated subjects, malingering was relatively easy to detect using indices of pattern of performance on standardized neuropsychological instruments, but more difficult to detect using instruments designed to detect malingering based on probability theory, and on specified knowledge of the effects of brain damage.

Journal Article↗
PubMed1999

P300 scalp amplitude distribution as an index of deception in a simulated cognitive deficit model.

Truth-telling (Truth) and simulated malingering (Malinger) groups were tested in a matching-to-sample procedure in which each sample three-digit number was followed by a series of nine test numbers, only one of which matched the sample. P300 was recorded during test-number presentation. Group analyses revealed differences between the P300s of the groups in unscaled amplitude, but not latency, in response to match and mismatch stimuli. P300 amplitudes at Fz, Cz, and Pz were scaled to remove possible confounding effects of amplitude in tests of the interactions of site with other variables. Significant interactions of both stimulus-type (match vs. mismatch) and group (Truth vs. Malinger) with site were obtained. Within the Malinger group, a significant interaction was obtained (scaled data) between site and response type (honest vs. dishonest). These interactions suggest that deceptive and honest responding are associated with different neurogenerator sets or different sets of P300-overlapping components. In within-individual analyses, 100% of the Truth participants and 87% of the Malinger participants were found to have larger P300 responses at Pz to match stimuli than to mismatch stimuli on the basis of intra-individual bootstrap tests. This represents an improvement in comparison with our related, previous report on a matching-to-sample test using only one test stimulus per sample.

Adolescent↗
PubMed2001

Comparing student and patient simulated malingerers' performance on standard neuropsychological measures to detect feigned cognitive deficits.

Despite the proliferation of studies investigating methods for detecting malingering, important questions that remain unanswered. Specifically, many studies use students to simulate malingering; however, it is unclear whether this is an appropriate analog group. In addition, many studies have focused on the development of cognitive measures designed to detect malingering, rather than pursuing whether current neuropsychological measures are effective. Results of the present investigation suggest that student malingerers are significantly more difficult to detect than non-neurological patients instructed to malinger. The findings also provide further support for the recent evidence that standard neuropsychological measures are useful in detecting malingering.

Adult↗