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Applied Neuropsychology. Child 2020This manuscript reviews the past history of effort testing in children and adolescents. Results in children and adults are briefly described on tests such as the Word...
This manuscript reviews the past history of effort testing in children and adolescents. Results in children and adults are briefly described on tests such as the Word Memory Test (WMT), the Medical Symptom Validity Test (MSVT), the Nonverbal Medical Symptom Validity Test (NV-MSVT) and Test of Memory Malingering (TOMM). Articles in the Special Issue are also briefly described.
Topics: Adolescent; Child; Humans; Malingering; Memory and Learning Tests; Neuropsychological Tests
PubMed: 32320282
DOI: 10.1080/21622965.2020.1750105 -
The Clinical Neuropsychologist Nov 2021This study was designed to replicate previous research on embedded validity indicators (EVIs) in the Hopkins Verbal Learning Test - Revised (HVLT-R) and introduce a new... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study was designed to replicate previous research on embedded validity indicators (EVIs) in the Hopkins Verbal Learning Test - Revised (HVLT-R) and introduce a new forced choice recognition trial (FCR).
METHOD
Undergraduate research volunteers were randomly assigned ( = 21.7; = 14.5 years, 85% female) to either the control or experimental malingering condition, and were administered a brief battery of neuropsychological tests.
RESULTS
Recognition memory based EVIs (both existing and newly introduced) effectively discriminated credible and non-credible response sets. An FCR ≤11 produced .59 sensitivity and perfect specificity to invalid responding. A Recognition Discrimination (RD) score ≤8 also produced a good combination of sensitivity (.35) and specificity (.96). The FCR trial made unique contributions to performance validity assessment above and beyond previously published EVIs.
CONCLUSIONS
RD achieved ≥.90 specificity at higher cutoffs than previously reported. The newly introduced FCR trial has the potential to enhance the existing arsenal of EVIs within the HVLT-R. However, it must demonstrate its ability to differentiate genuine impairment from non-credible responding before it can be recommended for clinical use.
Topics: Adult; Female; Humans; Male; Malingering; Neuropsychological Tests; Recognition, Psychology; Students; Verbal Learning; Young Adult
PubMed: 32660329
DOI: 10.1080/13854046.2020.1779348 -
PloS One 2018The Paced Auditory Serial Addition Test (PASAT) is widely used to evaluate processing speed and executive function in patients with multiple sclerosis, traumatic brain...
The Paced Auditory Serial Addition Test (PASAT) is widely used to evaluate processing speed and executive function in patients with multiple sclerosis, traumatic brain injury, and other neurological disorders. In the PASAT, subjects listen to sequences of digits while continuously reporting the sum of the last two digits presented. Four different stimulus onset asynchronies (SOAs) are usually tested, with difficulty increasing as SOAs are reduced. Ceiling effects are common at long SOAs, while the digit delivery rate often exceeds the subject's processing capacity at short SOAs, causing some subjects to stop performing altogether. In addition, subjects may adopt an "alternate answer" strategy at short SOAs, which reduces the test's demands on working-memory and processing speed. Consequently, studies have shown that the number of dyads (consecutive correct answers) is a more sensitive measure of PASAT performance than the overall number of correct sums. Here, we describe a 2.5-minute computerized test, the Dyad-Adaptive PASAT (DA-PASAT), where SOAs are adjusted with a 2:1 staircase, decreasing after each pair of correct responses and increasing after misses. Processing capacity is reflected in the minimum SOA (minSOA) achieved in 54 trials. Experiment 1 gathered normative data in two large populations: 1617 subjects in New Zealand ranging in age from 18 to 65 years, and 214 Californians ranging in age from 18 to 82 years. Minimum SOAs were influenced by age, education, and daily hours of computer-use. Minimum SOA z-scores, calculated after factoring out the influence of these factors, were virtually identical in the two control groups, as were response times (RTs) and dyad ratios (the proportion of hits occurring in dyads). Experiment 2 measured the test-retest reliability of the DA-PASAT in 44 young subjects who underwent three test sessions at weekly intervals. High intraclass correlation coefficients (ICCs) were found for minSOAs (0.87), response times (0.76), and dyad ratios (0.87). Performance improved across test sessions for all measures. Experiment 3 investigated the effects of simulated malingering in 50 subjects: 42% of simulated malingerers produced abnormal (p< 0.05) minSOA z-scores. Simulated malingerers with abnormal scores were distinguished with 87% sensitivity and 69% specificity from control subjects with abnormal scores by excessive differences between training performance and the actual test. Experiment 4 investigated patients with traumatic brain injury (TBI): patients with mild TBI performed within the normal range while patients with severe TBI showed deficits. The DA-PASAT reduces the time and stress of PASAT assessment while gathering sensitive measures of dyad processing that reveal the effects of aging, malingering, and traumatic brain injury on performance.
Topics: Adolescent; Adult; Aged; Brain Injuries, Traumatic; Female; Humans; Male; Malingering; Middle Aged; Neuropsychological Tests; Young Adult
PubMed: 29677192
DOI: 10.1371/journal.pone.0178148 -
Fortschritte Der Neurologie-Psychiatrie Dec 2017Assessing symptom validity is essential both in the clinical and medicolegal contexts. If neurological symptoms are demonstrated and/or a patient complains of pain that...
Assessing symptom validity is essential both in the clinical and medicolegal contexts. If neurological symptoms are demonstrated and/or a patient complains of pain that is not or cannot be fully explained by an underlying disease, it is necessary to recognize reliably a possible psychological cause in order to avoid further unnecessary examinations. In the medicolegal context, malingering or exaggeration of complaints for obtaining financial benefit is to be differentiated in a further step. The present overview contains a summary of clinical observations and tests for neurologists and psychiatrists used for symptom validity assessment of sensorimotor symptoms, tremor, gait, equilibrium and visual disturbances as well as pain.
Topics: Humans; Malingering; Nervous System Diseases; Neurologists; Neuropsychological Tests; Psychiatry; Psychophysiologic Disorders; Reproducibility of Results; Symptom Assessment
PubMed: 29117603
DOI: 10.1055/s-0043-118480 -
International Journal of Law and... 2020Feigning suicidality is common among patients in correctional settings, but there has been little discussion on the differences between genuine and feigned presentations... (Review)
Review
Feigning suicidality is common among patients in correctional settings, but there has been little discussion on the differences between genuine and feigned presentations of suicidality. Differentiating suicidality from feigned suicidality is among the riskiest diagnostic challenges. Still, some headway can be made if we compare features of genuine suicidality with those of feigned presentations. To this end, I first describe a typical profile of suicidality. Next, I contrast it with the features that correctional patients who feign suicidality display in California's prison health care system. I also outline the dangers involved in identifying feigned suicidality, and I offer some ways in which to understand feigned suicidality in corrections.
Topics: California; Diagnosis, Differential; Humans; Malingering; Prisoners; Prisons; Suicidal Ideation
PubMed: 32768118
DOI: 10.1016/j.ijlp.2020.101573 -
Applied Neuropsychology. Adult 2021This simulation study aimed to develop and test an embedded symptom validity indicator for use with the Rivermead Post Concussion Symptoms Questionnaire (RPQ). Seven...
This simulation study aimed to develop and test an embedded symptom validity indicator for use with the Rivermead Post Concussion Symptoms Questionnaire (RPQ). Seven mild traumatic brain injury (mTBI) experts assisted in generating a shortlist of 15 atypical postconcussion symptoms. A modified RPQ (mRPQ) was constructed by embedding these items with the 16 standard RPQ items. Eighty-four mTBI simulators completed the mRPQ after random allocation to a symptom-exaggeration condition (ES group; = 46) or simulation-only condition (S group; = 38). They also completed the Test of Memory Malingering (TOMM) and the Recognition Memory Test (RMT), and the groups were re-formed and compared using modified criteria for Malingered Neurocognitive Dysfunction (mMND). There was no significant group by item-type interaction for either grouping methods (i.e. as allocated or as reclassified). Exploratory analyses of the main effects showed that ES group had higher mRPQ scores than the S group, and standard symptoms were endorsed more than atypical symptoms. If further developed, the mRPQ could eventually aid the screening of PCS over-reporting.
Topics: Brain Concussion; Humans; Malingering; Neuropsychological Tests; Post-Concussion Syndrome; Surveys and Questionnaires
PubMed: 34380355
DOI: 10.1080/23279095.2019.1660880 -
Neurocase Oct 2023Dissociative Identity Disorder (DID), formerly Multiple Personality Disorder, involves two or more distinct identities controlling behaviour, stemming from...
Dissociative Identity Disorder (DID), formerly Multiple Personality Disorder, involves two or more distinct identities controlling behaviour, stemming from trauma-related dissociation. Understanding DID's cognitive, neural, and psychometric aspects remains a challenge, especially in distinguishing genuine cases from malingering. We present a case of a DID patient with nine identities, evaluated to rule out malingering. Using the Millon Index of Personality Styles, we assessed the primary and two alternate identities, revealing marked differences. High consistency scores support validity. We suggest employing personality inventories beyond symptomatology to characterise dissociative identities' consistency and adaptation styles, aiding in malingering assessments in future studies.
Topics: Humans; Dissociative Identity Disorder; Malingering; Male; Personality; Adult; Female
PubMed: 38704614
DOI: 10.1080/13554794.2024.2348218 -
Psychological Trauma : Theory,... Jul 2023Individuals with dissociative identity disorder (DID) experience severe and broad-ranging symptoms which can be associated with elevations on measures designed to detect...
BACKGROUND
Individuals with dissociative identity disorder (DID) experience severe and broad-ranging symptoms which can be associated with elevations on measures designed to detect feigning and/or malingering. Research is needed to determine how to distinguish genuine DID from simulated DID on assessment measures and validity scales.
OBJECTIVE
This study examined whether the Miller Forensic Assessment of Symptoms Test (M-FAST), a screening measure of malingering, could differentiate between individuals with DID and DID simulators.
METHOD
Thirty-five individuals with clinical, validated DID were compared to 88 individuals attempting to simulate DID on the M-FAST. A MANCOVA compared the two groups on total M-FAST score and subscales. Univariate ANCOVA's examined differences between the groups. A series of logistic regressions were conducted to determine whether group status predicted the classification of malingering. Utility statistics evaluated how well the M-FAST discerned clinical and simulated DID.
RESULTS
The M-FAST correctly classified 82.9% of individuals with DID as not malingering when using the suggested cut-off score of six. However, utilizing a cut-off score of seven correctly classified 93.6% of all participants and maintained adequate sensitivity (.96) but demonstrated increased specificity (.89).
CONCLUSIONS
The M-FAST shows promise in distinguishing genuine DID when the cut-off score is increased to seven. This study adds to the growing body of literature identifying tests that can adequately distinguish clinical from simulated DID. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Dissociative Identity Disorder; Malingering; Logistic Models; Reproducibility of Results
PubMed: 36656739
DOI: 10.1037/tra0001413 -
The Journal of the American Academy of... Aug 2019Posttraumatic stress disorder (PTSD) can occur after a traumatic experience and can cause severe symptoms that interfere with a person's psychological, physical,...
Posttraumatic stress disorder (PTSD) can occur after a traumatic experience and can cause severe symptoms that interfere with a person's psychological, physical, interpersonal, occupational, and social functioning. It is important to accurately identify genuine cases of PTSD and, as part of the differential diagnosis, to rule out instances of false PTSD. False PTSD diagnoses can adversely affect treatment planning, resource management, and research. The subjective nature of stressors, stereotypic presentation of symptoms, wealth of resources detailing how to malinger PTSD, and the high stakes for individuals involved in criminal, civil, and disability evaluations create challenges for making an accurate diagnosis. This article presents a systematic approach to help clinicians and forensic evaluators distinguish genuine PTSD from false variants of the disorder. It describes the types of false PTSD to be considered as alternative diagnoses, including malingered PTSD (for external gain, such as receiving a disability pension or evading criminal consequences), factitious PTSD (for internal gain, such as assuming the victim or hero/veteran role), and misattributed PTSD (legitimate psychopathology misdiagnosed as PTSD). The authors describe clinical features and psychological testing that may be leveraged to aid in reaching a more valid diagnosis.
Topics: Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Humans; Malingering; Military Health; Motivation; Psychological Tests; Stress Disorders, Post-Traumatic; Veterans
PubMed: 31182437
DOI: 10.29158/JAAPL.003853-19 -
Rheumatology International May 2022Kawasaki disease (KD) is a medium vessel vasculitis that predominantly affects children below 5. Diagnosis of KD is based on the presence of characteristic clinical... (Review)
Review
Kawasaki disease (KD) is a medium vessel vasculitis that predominantly affects children below 5. Diagnosis of KD is based on the presence of characteristic clinical manifestations as there are no definite diagnostic laboratory investigations for the diagnosis of this disease. Presence of atypical clinical features such as myositis often pose diagnostic challenge for the treating physicians. Presence of myositis and severe muscular weakness in KD is distinctly unusual and may lead to delays in diagnosis and administration of definite therapy. We report a 10-year-old boy who presented with fever, rash and proximal muscle and pharyngeal weakness. A clinical possibility of toxic shock syndrome or juvenile dermatomyositis was initially considered. However, he continued to have fever and developed periungual peeling of skin in fingers. Hence, a possibility of KD with myositis was considered. He showed prompt response to intravenous immunoglobulin and methylprednisolone. We also provide a review of similarly reported cases of KD myositis. It is important for clinicians to be aware of this atypical clinical presentation to avoid delays in diagnosis and treatment of KD.
Topics: Child; Dermatomyositis; Fever; Humans; Immunoglobulins, Intravenous; Male; Malingering; Mucocutaneous Lymph Node Syndrome; Myositis
PubMed: 33682025
DOI: 10.1007/s00296-021-04826-2