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Legal Medicine (Tokyo, Japan) Feb 2021The objective of this work is to evaluate the ability of a series of possible feigning indicators, extracted from relevant literature in the field, to discriminate...
The objective of this work is to evaluate the ability of a series of possible feigning indicators, extracted from relevant literature in the field, to discriminate between clinical patients with genuine symptomatology and instructed malingerers. A sample of 273 participants divided into two groups was used for this study: 153 whiplash associated disorder patients who were evaluated at a multidisciplinary medical center in the region of Murcia (Spain), between December 2017 and March 2019 and 120 healthy controls with malingering instructions, students of the Faculty of Medicine of the University of Murcia. In order for researchers to evaluate the indicators included in the study, a 22-step checklist (CDS) was developed, consisting of 22 criteria divided into 5 dimensions. Our results show that 18 of 22 indicators could discriminate between groups. Dimension 2 "Attitude toward the situation of illness" presented the greatest capacity for discrimination. In general terms, malingerers express a much more negative experience of the condition than the clinical patients.
Topics: Adolescent; Adult; Cues; Female; Forensic Medicine; Humans; Lie Detection; Male; Malingering; Mass Screening; Middle Aged; Spain; Whiplash Injuries; Young Adult
PubMed: 33254095
DOI: 10.1016/j.legalmed.2020.101810 -
The Journal of the American Academy of... Mar 2021The Spanish Inquisition was founded in 1478 by the Catholic monarchs and operated with the goal of controlling heresy in society. Religion was omnipresent, and Jewish...
The Spanish Inquisition was founded in 1478 by the Catholic monarchs and operated with the goal of controlling heresy in society. Religion was omnipresent, and Jewish (Jews who had converted to Christianity) who continued to observe Jewish practices were many of the accused. In cases in which the defendant was thought to have mental illness, the Inquisition's physicians were to evaluate the person and provide reports and expert evidence. Those defendants who were found to have genuine mental illness were generally freed or transferred to specific hospitals for those with mental illness. Case examples elucidate the methods used by the Spanish Inquisition physicians to differentiate mental illness from malingering and heresy. Physicians also treated inmates and participated in evaluations regarding the appropriateness of torture. Understanding the events of the Spanish Inquisition and the role of physicians holds relevance for contemporary forensic psychiatry.
Topics: Catholicism; Forensic Psychiatry; History, 15th Century; History, 16th Century; Humans; Malingering; Mental Disorders; Physician's Role; Physicians; Prisoners; Spain; Torture
PubMed: 33246986
DOI: 10.29158/JAAPL.200052-20 -
Der Nervenarzt May 2016Mild traumatic brain injury (mTBI) is a frequent neurological disorder following a closed head injury. It is often accompanied by temporary changes of consciousness as... (Review)
Review
Mild traumatic brain injury (mTBI) is a frequent neurological disorder following a closed head injury. It is often accompanied by temporary changes of consciousness as well as cognitive, emotional and physical symptoms. These symptoms subside in the vast majority of affected persons within a few weeks; however, in recent years it has become increasingly more apparent that functionally significant long-term effects can remain after an initially diagnosed mTBI. In these cases mental disorders, such as impairment of cognitive and emotional functions as well as somatic disorders play an important role. This article presents the frequency, diagnosis, therapy and possible mechanisms of cognitive and emotional dysfunction after mTBI, including medicolegal aspects.
Topics: Brain Concussion; Diagnosis, Differential; Expert Testimony; Guideline Adherence; Humans; Malingering; Neurocognitive Disorders; Neuropsychological Tests; Risk Assessment
PubMed: 27119532
DOI: 10.1007/s00115-016-0119-8 -
The Medico-legal Journal Jun 2023
Topics: Humans; Malingering; Physicians
PubMed: 37018116
DOI: 10.1177/00258172231152053 -
Applied Neuropsychology. Adult 2015This study examined the influence of psychopathy and intelligence on malingering in a simulated malingering design. We hypothesized that participants high in both traits...
This study examined the influence of psychopathy and intelligence on malingering in a simulated malingering design. We hypothesized that participants high in both traits would be more adept at evading detection on performance validity tests (PVTs). College students (N = 92) were first administered the Wechsler Test of Adult Reading, a reading measure that estimates intelligence, and the Psychopathic Personality Inventory-Short Form under standard conditions. They were then asked to imagine as if they had suffered a concussion a year ago and were instructed to fake or exaggerate symptoms in a believable fashion to improve their settlement as part of a lawsuit. Participants were subsequently administered a brief neuropsychological battery that included the Word Memory Test, Rey 15-Item Test with Recognition, Finger-Tapping Test, and Digit Span from the Wechsler Adult Intelligence Scale-Fourth Edition. Moderated multiple regressions with hierarchical entry were conducted. Intelligence, psychopathy, and the interaction of intelligence and psychopathy were not related to performance on any of the PVTs. In other words, participants who scored higher on intelligence and psychopathy did not perform differently on these measures compared with other participants. Though a null finding, implications of this study are discussed in terms of the broader research and clinical literature on malingering.
Topics: Adult; Antisocial Personality Disorder; Female; Humans; Intelligence; Intelligence Tests; Male; Malingering; Neuropsychological Tests; Personality Inventory; Psychometrics; Regression Analysis; Reproducibility of Results; Statistics as Topic; Young Adult
PubMed: 25402508
DOI: 10.1080/23279095.2014.920842 -
Praxis Jun 2017
Review
Topics: Adult; Chronic Disease; Diagnosis, Differential; Disability Evaluation; Expert Testimony; Health Status; Humans; Male; Malingering; Medical History Taking; Physical Examination; Prisoners; Referral and Consultation; Switzerland
PubMed: 28635394
DOI: 10.1024/1661-8157/a002729 -
Emergency Medicine Clinics of North... Feb 2024Malingering is the intentional production of false or grossly exaggerated symptoms motivated by internal and external incentives. The true incidence of malingering in... (Review)
Review
Malingering is the intentional production of false or grossly exaggerated symptoms motivated by internal and external incentives. The true incidence of malingering in the emergency department is unknown because of the difficulty of identifying whether patients are fabricating their symptoms. Malingering is considered a diagnosis of exclusion; a differential diagnosis framework is described to guide emergency physicians. Several case studies are presented and analyzed from a medical ethics perspective. Practical recommendations include use of the NEAL (neutral, empathetic, and avoid labeling) strategy when caring for patients suspected of malingering.
Topics: Humans; Malingering; Diagnosis, Differential
PubMed: 37977749
DOI: 10.1016/j.emc.2023.06.018 -
Journal of the International... Aug 2018The aim of this study was to investigate the relationship of psychological variables to cognitive performance validity test (PVT) results in mixed forensic and...
OBJECTIVES
The aim of this study was to investigate the relationship of psychological variables to cognitive performance validity test (PVT) results in mixed forensic and nonforensic clinical samples.
METHODS
Participants included 183 adults who underwent comprehensive neuropsychological examination. Criterion groups were formed, that is, Credible Group or Noncredible Group, based upon their performance on the Word Memory Test and other stand-alone and embedded PVT measures.
RESULTS
Multivariate logistic regression analysis identified three significant predictors of cognitive performance validity. These included two psychological constructs, for example, Cogniphobia (perception that cognitive effort will exacerbate neurological symptoms), and Symptom Identity (perception that current symptoms are the result of illness or injury), and one contextual factor (forensic). While there was no interaction between these factors, elevated scores were most often observed in the forensic sample, suggesting that these independently contributing intrinsic psychological factors are more likely to occur in a forensic environment.
CONCLUSIONS
Illness perceptions were significant predictors of cognitive performance validity particularly when they reached very elevated levels. Extreme elevations were more common among participants in the forensic sample, and potential reasons for this pattern are explored. (JINS, 2018, 24, 735-745).
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cognitive Dysfunction; Disability Evaluation; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Malingering; Middle Aged; Neuropsychological Tests; Psychomotor Performance; Young Adult
PubMed: 29704907
DOI: 10.1017/S1355617718000218 -
The Clinical Neuropsychologist May 2016This study synthesized research evaluation of the effectiveness of the over-reporting validity scales of the Minnesota Multiphasic Personality Inventory-2-Restructured... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study synthesized research evaluation of the effectiveness of the over-reporting validity scales of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) for detecting intentionally feigned over-endorsements of symptoms using a moderated meta-analysis.
METHOD
After identifying experimental and quasi-experimental studies for inclusion (k = 25) in which the validity scales of the MMPI-2-RF were compared between groups of respondents, moderated meta-analyses were conducted for each of its five over-reporting scales. These meta-analyses explored the general effectiveness of each scale across studies, as well as the impact that several moderators had on scale performance, including comparison group, study type (i.e. real versus simulation), age, education, sex, and diagnosis.
RESULTS
The over-reporting scales of the MMPI-2-RF act as effective general measures for the detection of malingering and over endorsement of symptoms with individual scales ranging in effectiveness from an effect size of 1.08 (Symptom Validity; FBS-r) to 1.43 (Infrequent Pathology; Fp-r), each with different patterns of moderating influence.
CONCLUSIONS
The MMPI-2-RF validity scales effectively discriminate between groups of respondents presenting in either an honest manner or with patterned exaggeration and over-endorsement of symptoms. The magnitude of difference observed between honest and malingering groups was substantially narrower than might be expected using traditional cut-scores for the validity scales, making interpretation within the evaluation context particularly important. While all over-reporting scales are effective, the FBS-r and RBS scales are those least influenced by common and context specific moderating influences, such as respondent or comparison grouping.
Topics: Humans; MMPI; Malingering; Reproducibility of Results
PubMed: 27214667
DOI: 10.1080/13854046.2016.1187769 -
Journal of the International... Mar 2023Assessing performance validity is imperative in both clinical and research contexts as data interpretation presupposes adequate participation from examinees. Performance...
OBJECTIVE
Assessing performance validity is imperative in both clinical and research contexts as data interpretation presupposes adequate participation from examinees. Performance validity tests (PVTs) are utilized to identify instances in which results cannot be interpreted at face value. This study explored the hit rates for two frequently used PVTs in a research sample of individuals with and without histories of bipolar disorder (BD).
METHOD
As part of an ongoing longitudinal study of individuals with BD, we examined the performance of 736 individuals with BD and 255 individuals with no history of mental health disorder on the Test of Memory Malingering (TOMM) and the California Verbal Learning Test forced choice trial (CVLT-FC) at three time points.
RESULTS
Undiagnosed individuals demonstrated 100% pass rate on PVTs and individuals with BD passed over 98% of the time. A mixed effects model adjusting for relevant demographic variables revealed no significant difference in TOMM scores between the groups, = .07, = .07, = .31. On the CVLT-FC, no clinically significant differences were observed ( < .001).
CONCLUSIONS
Perfect PVT scores were obtained by the majority of individuals, with no differences in failure rates between groups. The tests have approximately >98% specificity in BD and 100% specificity among non-diagnosed individuals. Further, nearly 90% of individuals with BD obtained perfect scores on both measures, a trend observed at each time point.
Topics: Humans; Neuropsychological Tests; Bipolar Disorder; Longitudinal Studies; Malingering; Memory and Learning Tests; Reproducibility of Results
PubMed: 35403599
DOI: 10.1017/S1355617722000145