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At least 1,531 records · Page 85Linked to original sources
PubMed1992

Symptom-validity testing of feigned sensory or memory deficits: a further elaboration for subjects who understand the rationale.

Symptom-validity testing has been used to detect feigning in patients claiming sensory and memory deficits. Such patients typically give significantly fewer correct responses on forced-choice testing than would be expected by chance. Some subjects have been able to understand the rationale and respond at the chance level. Some have evaded detection by elaborations of the technique which seek evidence of non-randomness in the sequence of correct and incorrect responses. This paper reports the stratagem used by one such subject and a further elaboration of the technique by which it was detected.

Amnesia↗
PubMed1998

Simulating a memory impairment: can amnesics implicitly outperform simulators?

OBJECTIVES: The purpose of this study was to examine the effectiveness of a variety of tests in differentiating simulating test performances from genuine memory-impaired and normal (control) test performances. DESIGN: A simulation design was implemented, based on an analogue design in which normal participants were given experimental instructions to feign a mental impairment and are compared to (a) other normal participants with instructions to perform honestly, and (b) a comparison group, for example, acquired brain-injured persons, with similar instructions. METHOD: Forty individuals comprised the simulating and control group and all participants were randomly assigned to the simulating and control groups. Twenty memory-impaired patients, all of whom had been diagnosed as suffering from a memory impairment following acquired brain damage, participated as the memory-impaired control group. The simulation group was directed to imitate a person with a memory impairment. The primary outcome measure involved identifying those tests, if any, where simulators were significantly different from normal and memory-impaired participants. RESULTS: On 5 of the 15 tasks administered, simulators performed significantly differently from normal and memory-impaired participants. Of these 5 tasks, the coin-in-the-hand, when administered in conjunction with the autobiographical interview, identified 95 per cent of the simulators without misclassifying any of the memory-impaired or normal participants. CONCLUSION: It is suggested that these two tests, when administered jointly, might be of use in clinical settings to assist in the detection of malingerers.

Adult↗
PubMed1998

A new performance-curve method for the detection of simulated cognitive impairment.

OBJECTIVE: To evaluate a new performance-curve method for detecting simulated cognitive impairment. DESIGN: The method was based on quantitative analysis of choice reaction times in a series of eight matching-to-sample tasks of graded complexity, in which participants were required to identify which of two comparison stimuli was identical to a simultaneously presented sample stimulus. The stimuli consisted of arrays of letters, the number of letters ranging from 1 to 10 in the eight tasks. METHODS: Mean reaction times of a standardization group of 20 healthy young adults were used to construct regression equations to describe the behaviour of three test groups: 20 healthy individuals instructed to perform to the best of their ability (non-simulators), 20 healthy individuals instructed to simulate cognitive impairment incurred as a result of a head injury (simulators), and 25 patients with a history of closed head injury (patients). RESULTS: There was a linear relationship between individual participants' latencies and the mean latencies of the standardization sample; the patient group showed steeper slopes, and the simulators higher intercepts, than the non-simulator group. A univariate measure of performance, based on the proportionate increase in latency corresponding to a standard increase in the standardization group's latency was able to identify 14/20 simulators while misclassifying 2/20 non-simulators and 2/25 patients. Other measures, including the number of errors made in the choice reaction time task and in recognition memory tasks, and a performance-curve measure based on Raven's Standard Progressive Matrices, were less successful in identifying simulators. CONCLUSIONS: This new performance-curve method may prove to be a useful addition to tests currently used to diagnose simulated cognitive impairment in clinical and medicolegal settings.

Adolescent↗
PubMed1984

Therapeutic function of diagnostic label 'hysteria'.

Hysterics are not uncommonly believed by others to be deliberate malingerers; they may be accused of being sick for a purpose. Such an assumption has come to be considered as showing naivete on the part of the accusers from the formal psychiatric point of view. The case histories of two hysterical in-patients who conducted themselves 'hysterically' on the ward are cited. It is a noteworthy paradox that their hysterical symptoms faded away when they were able to assume the role of a 'hysteric'. The current report explores the meaning of the diagnostic label of 'hysteria' and the possibility of taking advantage of the very fact that a 'hysteric' can develop into a 'malingerer' through therapy. The authors recommend that the diagnostic label of 'hysteria' be investigated not merely in terms of communication, but also in terms of its therapeutic function.

Adult↗
PubMed1992

The belief in the transmigration of souls: psychotherapy of a Druze patient with severe anxiety reaction.

In this paper the culture-sensitive psychotherapy of a 19-year-old Druze patient with severe anxiety reaction is described. The patient explained his anxiety and his symptoms as stemming from violent death in his former life and subsequent transmigration. The therapists joined the patient's explanatory model and previous traditional healing, adding hypnotic suggestion which relieved the symptoms. The relationship of patient symptomatology to cultural background, multiple personality disorder, possession and dissociation is discussed. The strategic combination of culture-specific and modern psychiatric approaches is advocated in similar cases.

Adult↗
PubMed1975

Disappearing diabetes.

For five years a nurse was treated for diabetes mellitus. She was found to have tampered with her blood and urine tests and later was believed to have fabricated her condition from the outset.

Adult↗