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At least 19 recordsLinked to original sources
PubMed1990

Development of a new classificatory model of malingering.

Inclusion criteria for the classification of malingering are shaped and largely predetermined by our explanatory theories. Current theories have postulated the motivation to malinger is either the product of underlying psychopathology (pathogenic model) or criminal backgrounds (DSM III-R model). I have proposed a third model that malingering is typically an adaptive response to adverse circumstances which may best be understood in the context of decision theory. Based on this approach I have argued that indices of malingering should be empirically derived and focused on clinical presentation. Finally, I have proposed a preliminary model for the classification of malingerers which combines clinical data with corroborative evidence.

Antisocial Personality Disorder↗
PubMed1986

Characteristics and frequency of malingering among patients with low back pain.

Information on the clinical characteristics and frequency of malingering among patients with low back pain was obtained in a survey mailed to orthopedic surgeons and neurosurgeons in 6 geographic regions of the United States. Working on the assumption that orthopedic surgeons and neurosurgeons are untapped historians of this clinical information, data from 105 respondents were analyzed to determine if a consensus of opinion underlies clinical judgment concerning malingering. The results indicated that agreement increases with clinical symptoms reflecting exaggeration and incongruous behavior. 70% or more of the physicians were in agreement on 6 symptoms fitting these 2 patterns. 60% of the surgeons were also in agreement that malingering is a relatively infrequent condition, occurring in 5% or less of patients with low back pain.

Back Pain↗
PubMed1990

The susceptibility of the Rorschach to malingering: a critical review.

Empirical studies of malingering on the Rorschach are reviewed. Results from these studies are to this point inconsistent and inconclusive. Although several indices are related to malingering in individual studies, no specific malingering pattern has been found that replicates across studies. A methodological problem specific to this literature is discussed and future research designs are recommended.

Humans↗
PubMed1988

The detection of malingering in criminal forensic groups: MMPI validity scales.

Despite the value of the MMPI to the forensic assessment of malingering (exaggeration) of psychopathology, few studies have assessed the accuracy of the MMPI validity scales in criminal forensic populations. We administered the MMPI to 35 insanity defendants undergoing evaluation for fitness to stand trial and/or sanity at the time of the crime, who stood to benefit from being assessed as psychologically disturbed, and 39 subjects previously found not guilty by reason of insanity (NGRI), who did not stand to gain from such an assessment, Insanity defendants showed significantly more malingering than NGRI subjects, p less than .05. Racial differences did not affect the data. These findings support the efficacy of MMPI validity scales in assessing malingering within criminal forensic groups, and support the generalizability of the scales across race.

Adolescent↗
PubMed1987

Mutism, malingering, and competency to stand trial.

Mutism and mental illness have had a long-standing historical relationship with regard to the issue of competence to stand trial. This article reports a defendant who remained mute for 10 months and describes his use of the symptom of mutism in his malingering. Although mutism is frequently used by defendants for malingering, clinicians must have a high index of suspicion for the possibility. We recommend a comprehensive evaluation including neurologic workup, repeat interviews, observation of the defendant at unsuspected times for communicative speech with other inmates, study of handwriting sample, collateral nursing documentation, and, if necessary, Pentothal interviews to establish authenticity of mutism. The authors review the historical background and legal considerations of the relationship between mutism and malingering.

Forensic Psychiatry↗
PubMed1990

The detection of malingering in neuropsychological assessment.

Although malingering, or the manipulation of data by the patient, is a problem commonly faced by neuropsychologists, there has been little systematic investigation of this problem. This paper reviews the literature on the detection of malingering in assessment instruments commonly used by clinical neuropsychologists. Criticism of previous research is discussed, and suggestions are made both for future research and for clinical practice.

Brain Damage, Chronic↗
PubMedDate not supplied

Ocular malingering and hysteria: diagnosis and management.

Confronted with a claim of poor vision in the absence of any apparent pathology, the ophthalmologist must consider the possibility that the patient is malingering or hysterical. The authors define four categories of such patients, and recommend diagnostic approaches for each. Specific diagnostic tests are described, as are methods of managing patients once the diagnosis of malingering or hysteria has been made.

Evoked Potentials↗
PubMed1990

Neuropsychology and malingering: comment on Faust, Hart, and Guilmette (1988)

Faust, Hart, and Guilmette (1988) recently reported on the inability of neuropsychologists to detect malingering in children who were asked to "fake bad" on a battery of neuropsychological measures. Because of methodological issues, implications of their research are not generalizable to the actual clinical setting. Limitations of the questionnaire format in detecting factitious results are discussed along with the inherent bias of such a research design to overinterpret pathology. The competency of the clinical neuropsychologist judges and their selection process are questioned. Last, some guidelines are offered for future research dealing with the issue of detection of malingering in neuropsychological practice.

Child↗
PubMed1990

To say it's not so doesn't prove that it isn't: research on the detection of malingering. Reply to Bigler.

Research that directly examines clinicians' capacity to detect malingering creates doubt about their success in this endeavor and about confident self-appraisals of detective abilities. We argue that Bigler's counterassertions lack supportive evidence or conflict with research on such topics as clinicians' level of training and experience and their judgmental accuracy. We further note that lack of both base rate information and definitive outcome information compound doubts about clinicians' capacity to detect malingering.

Child↗
PubMed1989

Refining the forced-choice method for the detection of malingering.

For seven years following head trauma, a 45-year-old restaurant owner had claimed that he was unable to work because of impaired memory. A specially designed forced-choice memory test yielded performance significantly below the chance level and thus indicated malingering. This case illustrates some means of increasing the utility of forced-choice malingering tests.

Accidents, Occupational↗
PubMed1988

A psychometric study of stereotypes: assessment of malingering in a criminal forensic group.

This research investigates the validity of the stereotype of insanity defendants as malingerers by analyzing the proportions of insanity defendants who exaggerate psychopathology at the pre- and postacquittal stages of the legal process and by assessing the severity of psychopathology among preacquittal defendants. We administered the Minnesota Multiphasic Personality Inventory (MMPI) to 49 insanity defendants evaluated for fitness to stand trial and/or sanity at the time of the alleged crime and to 52 subjects previously found not guilty by reason of insanity. Results indicated: (a) Contrary to the stereotype, a minority (14% to 41%) of insanity defendants clearly malingered, whereas 22% to 39% showed evidence of minimizing psychopathology. (b) Eighty-one percent of these subjects had MMPI profiles suggestive of psychosis, but relatively few showed evidence of primarily antisocial behavior. Thus, the malingering stereotype may be application to only a minority of insanity defendants and is specifically inapplicable to a substantial proportion who minimized psychopathology or showed evidence of psychosis consistent with the claim of insanity.

Adult↗
PubMed1976

[Invalidation of a girl after 7 years of succesfull malingering of a wound (author's transl)].

Provocation of wounds by malingering is one of the most typical artefacts in surgery. In this paper the succesful maintaining of a wound in a girl for over 7 years is demonstrated. In this time the girl underwent 25 surgical operations and was invalidated at the age of 18 years. In patients with non-healing wounds, which cannot be explained by the rules of general pathology, doctors are well advised to think of the possibilities of malingering at an early time.

Adolescent↗
PubMed1991

Iatrogenesis and malingering of multiple personality disorder in the forensic evaluation of homicide defendants.

In this article I have addressed the possibility of iatrogenesis and/or malingering of MPD in 19 individuals who were charged with homicide. Due to the fragmentary nature of most of these case reports, it is not possible to state definitively who had genuine MPD and who did not. There is a strong possibility that a substantial proportion were malingering, however, because of their rather atypical presentations. Data from other sources suggest that the use of hypnosis in individuals accused of homicide may iatrogenically produce MPD-like phenomena when coupled with the defendant's desire to escape criminal responsibility. Finally, I have offered guidelines for the forensic evaluation of homicide defendants in whom MPD is suspected. Although hypnosis should generally be avoided in such defendants if it is used, rather strict guidelines should be followed. Clinicians using hypnosis with such individuals should be forewarned that such use will be strongly challenged in court and could pose an extreme threat to the defense position.

Diagnosis, Differential↗
PubMed1989

Malingering.

Malingering adds to the cost of medicine. Unnecessary tests, exhaustive evaluations, and repeated referrals are part of the cost. In noneconomic terms, malingering erodes trust and confidence in the physician-patient relationship. This article explores means whereby the physician can detect the malingerer. Once the physician is convinced of the disingenuous nature of the symptoms, intervention is indicated. Suggestions for confronting the malingerer are reviewed.

Diagnosis, Differential↗
PubMed1988

Malingering vs. the factitious personality in chiropractic practice.

This article details how to identify and treat the malingering patient, which we feel is seen more often than was originally thought in chiropractic practice. A historical perspective of a malingering vs. a factitious personality is examined. The factitious patient is reviewed in detail with special attention to the classic case of Munchausen syndrome. An extensive treatment plan is discussed, including short- and long-term care. The common characteristics, objective tests and studies are reviewed. We theorize that due to our increasing involvement in Workers' Compensation and personal injury cases our attention should be focused more closely on the possibility of these types of patients entering our office.

Chiropractic↗
PubMed1987

Pattern electroretinogram plus visual evoked potential: a decisive test in patients suspected of malingering.

Along the processing chain in the visual pathway the pattern electroretinogram (PERG) is a better indicator of the peripheral function than the visual evoked potential (VEP). Therefore the PERG and the VEP will be impaired equally by disturbances before the ganglion cell layer (e.g., blurred image or retinal disease) and differently by further centrally located diseases (e.g., tumor compression of the optic nerve). Thus in patients complaining of reduced visual acuity who show disturbed VEP but a normal PERG, malingering can be definitely ruled out. Representative combinations of PERG and VEP findings are described.

Adult↗
PubMed1992

Forced-choice testing provides evidence of malingering.

Assessment of motivation using forced-choice testing is described and illustrated with case reports. Two injured workers with protracted disability complained of numbness and loss of sensation in their fingers. Each patient received a forced-choice, multiple-choice finger graphesthesia test, with a 0.5 probability of guessing correctly on each item. Both patients performed significantly below the chance level, indicating that they had deliberately provided wrong answers. One patient did not exaggerate until the difficulty level of the task was enhanced. Forced-choice testing, particularly with enhancement of difficulty levels, is proposed as a specific measure to detect faked poor performance. Identification of malingering reduces the risk of iatrogenic damage. The subjective complaints of malingerers must be viewed with skepticism.

Accidents, Occupational↗
PubMed1992

Case report: stimulation of severe hypertension as a means of malingering.

Severe hypertension frequently requires hospitalization. Although hospital admission is undesirable for most patients, others are motivated to achieve hospitalization status for secondary gain. The authors present a case of a prison inmate who simulated severe hypertension with a combination of Valsalva's maneuver and arm flexion, on the background of preexisting essential hypertension and mitral valve prolapse. His secondary intent--to avoid his prison duties--classifies him as a malingerer. The differences between this malingering and the psychiatric diagnosis of Munchausen syndrome are discussed. The contributions of essential hypertension and mitral valve prolapse to the self-induced blood pressure elevations also are considered.

Adult↗