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International Journal of Legal Medicine Sep 2021The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated... (Review)
Review
OBJECTIVE
The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs.
METHODS
We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020.
RESULTS
Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed.
CONCLUSIONS
Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.
Topics: Biomechanical Phenomena; Humans; Lie Detection; Malingering; Neuropsychological Tests; Self Report; Symptom Assessment; Whiplash Injuries
PubMed: 33829284
DOI: 10.1007/s00414-021-02589-w -
International Journal of Law and... 2017This journal's third article on PTSD in Court focuses especially on the topic's "court" component. It first considers the topic of malingering, including in terms of its... (Review)
Review
This journal's third article on PTSD in Court focuses especially on the topic's "court" component. It first considers the topic of malingering, including in terms of its definition, certainties, and uncertainties. As with other areas of the study of psychological injury and law, generally, and PTSD (posttraumatic stress disorder), specifically, malingering is a contentious area not only definitionally but also empirically, in terms of establishing its base rate in the index populations assessed in the field. Both current research and re-analysis of past research indicates that the malingering prevalence rate at issue is more like 15±15% as opposed to 40±10%. As for psychological tests used to assess PTSD, some of the better ones include the TSI-2 (Trauma Symptom Inventory, Second Edition; Briere, 2011), the MMPI-2-RF (Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form; Ben-Porath & Tellegen, 2008/2011), and the CAPS-5 (The Clinician-Administered PTSD Scale for DSM-5; Weathers, Blake, Schnurr, Kaloupek, Marx, & Keane, 2013b). Assessors need to know their own possible biases, the applicable laws (e.g., the Daubert trilogy), and how to write court-admissible reports. Overall conclusions reflect a moderate approach that navigates the territory between the extreme plaintiff or defense allegiances one frequently encounters in this area of forensic practice.
Topics: Forensic Psychiatry; Humans; Malingering; Psychiatric Status Rating Scales; Stress Disorders, Post-Traumatic
PubMed: 28366496
DOI: 10.1016/j.ijlp.2017.03.001 -
Psychiatric Services (Washington, D.C.) Feb 2019Malingering is commonly encountered in the psychiatric emergency department, yet little is known about its prevalence, objectives, or effect on patient management. This...
OBJECTIVE
Malingering is commonly encountered in the psychiatric emergency department, yet little is known about its prevalence, objectives, or effect on patient management. This study analyzed characteristics of malingering and patient disposition in a 24/7-staffed comprehensive psychiatric emergency program (CPEP) and created predictive models to understand malingering and its effect on physician decision making.
METHODS
Attending psychiatrists completed questionnaires after comprehensive assessments of 405 patients presenting to the CPEP during the 1-month study, recording suspicion of malingering, symptoms malingered, associated secondary gains, demographic characteristics, and initial disposition decision. Analyses examined characteristics associated with degree of malingering suspicion and disposition.
RESULTS
Malingering was suspected among one-third of patients, and 20% were strongly or definitely suspected of malingering. High suspicion was associated with malingering of multiple symptoms and was likely to result in immediate discharge. Lower suspicion was associated with being held for further observation. Among patients for whom suspicion of malingering was high, malingering was most frequent for suicidal ideation (58%) and depression (39%); malingering was often used to seek hospital admission (54%) and to stay in the CPEP (35%); malingering was sometimes used to seek multiple secondary gains (25%); and malingering often involved multiple symptoms (44%). Patients for whom suspicion was high had an admission rate of 4%. Among patients suspected of malingering, three variables each independently increased the likelihood of hospital admission: seeking social work or housing services, seeking admission, and malingering of suicidal ideation.
CONCLUSIONS
Malingering was prevalent in the psychiatric emergency department, and suspicion of malingering was associated with disposition differences. Disposition was significantly influenced by both suspicion of malingering and the gains sought by patients.
Topics: Adult; Clinical Decision-Making; Depression; Emergency Services, Psychiatric; Female; Humans; Male; Malingering; Middle Aged; New York City; Outcome Assessment, Health Care; Patient Admission; Prevalence; Suicidal Ideation
PubMed: 30526343
DOI: 10.1176/appi.ps.201800140 -
Journal of Psychosocial Nursing and... Apr 1990
Topics: Hospitalization; Humans; Malingering; North Carolina
PubMed: 2332843
DOI: 10.3928/0279-3695-19900401-13 -
The Journal of Clinical Psychiatry Jun 1991
Topics: Attitude of Health Personnel; Humans; Malingering; Mental Disorders; Physician-Patient Relations; Psychiatry
PubMed: 2055905
DOI: No ID Found -
Psychiatric Medicine Sep 1984Malingering is the false and fraudulent simulation or exaggeration of physical and/or psychological symptoms. It is not a mental disorder, but rather a behavior pattern... (Review)
Review
Malingering is the false and fraudulent simulation or exaggeration of physical and/or psychological symptoms. It is not a mental disorder, but rather a behavior pattern that may coexist with objectively diagnosed disease. Whatever form it takes, malingering is defined as conscious, voluntary, goal-directed behavior; the presence of a clearly definable goal differentiates malingerers from those with other forms of factitious illness.
Topics: Humans; Malingering
PubMed: 6400615
DOI: No ID Found -
Current Opinion in Neurology Dec 2009Malingered anterograde amnesia is a phenomenon that has been exhaustively studied, whereas research on retrograde amnesia has tended to focus upon functional and organic... (Review)
Review
PURPOSE OF REVIEW
Malingered anterograde amnesia is a phenomenon that has been exhaustively studied, whereas research on retrograde amnesia has tended to focus upon functional and organic accounts of impairment. The present review explores studies relevant to extending the malingering paradigm to retrograde amnesia.
RECENT FINDINGS
In the period reviewed, very little work has directly addressed the area of malingered retrograde amnesia. Researchers have tended to explain apparent 'anomalies' in memory performance or individual presentation, as manifestations of unconscious or psychological distress-mediated behaviour. In contrast, research with offenders claiming amnesia for their crimes has emphasized that malingered retrograde amnesia can be identified with relevant assessment methods. Brain imaging work too has begun to clearly describe the associated neural processes that underlie deception. It appears that the necessary coalescence of insights from clinical neuropsychology, brain imaging and neurology has reached a critical moment.
SUMMARY
Current and previous studies are reviewed that addresses the assessment of malingered retrograde amnesia and evidences that a critical moment has been reached.
Topics: Amnesia, Retrograde; Brain; Diagnostic Imaging; Humans; Malingering; Neuropsychological Tests
PubMed: 19745730
DOI: 10.1097/WCO.0b013e32833299bb -
The Israel Journal of Psychiatry and... 1993The purpose of this paper is to provide psychiatrists with practical advice on how to detect malingered mental illness. Various types of malingering are defined and the... (Review)
Review
The purpose of this paper is to provide psychiatrists with practical advice on how to detect malingered mental illness. Various types of malingering are defined and the five major purposes of malingering are specified. The research literature on malingering is reviewed. Clinicians must be thoroughly grounded in the phenomenology of true mental disease to detect malingering. Detailed information about hallucinations is reviewed so that faked hallucinations that do not follow typical patterns can be more easily identified. Strategies for approaching persons suspected of malingering are suggested. Features of malingered mutism, mania, depression and mental retardation are described. The differential diagnosis of malingering, post-traumatic stress disorder, conversion disorder, and post-concussion syndromes after trauma is discussed. Clues to malingered psychoses and post-traumatic stress disorders are delineated. Finally, specific indicators of malingered insanity defenses are identified.
Topics: Depressive Disorder; Diagnosis, Differential; Female; Hallucinations; Humans; Intellectual Disability; MMPI; Male; Malingering; Mutism; Patient Admission; Psychiatric Status Rating Scales; Stress Disorders, Post-Traumatic
PubMed: 8270391
DOI: No ID Found -
General Hospital Psychiatry 2006This paper aims to study the detection of individuals malingering posttraumatic stress disorder (PTSD) in criminal and civil situations. (Review)
Review
OBJECTIVE
This paper aims to study the detection of individuals malingering posttraumatic stress disorder (PTSD) in criminal and civil situations.
METHOD
A brief history of PTSD and its rise to prominence in legal circles are discussed. The characteristics of individuals who malinger and particularly those who fake PTSD are discussed. Diagnostic dilemmas inherent to the condition, such as the definition of a traumatic exposure, what constitutes a PTSD flashback and the potential for normal symptom exaggeration, are explored.
RESULTS
The typical presentation of malingered symptoms is presented to help clinicians detect commonly seen malingering patterns. Suggestions for interview techniques, Minnesota Multiphasic Personality Inventory test values and sources of collateral information to help detect malingering are reviewed.
CONCLUSION
The paper concludes with a review of the typical presentations of malingered PTSD symptoms and a reminder that physicians need to distinguish legitimate symptoms from faked or embellished presentations.
Topics: Diagnosis, Differential; Forensic Psychiatry; Humans; MMPI; Malingering; Severity of Illness Index; Stress Disorders, Post-Traumatic
PubMed: 17088169
DOI: 10.1016/j.genhosppsych.2006.08.011 -
Journal of Neurology, Neurosurgery, and... Aug 2012Although most individuals who suffer a mild traumatic brain injury have complete recovery, a number experience persistent symptoms that appear inconsistent with the... (Review)
Review
Although most individuals who suffer a mild traumatic brain injury have complete recovery, a number experience persistent symptoms that appear inconsistent with the severity of the injury. Symptoms may be ascribed to malingering, exaggeration or poor effort on cognitive testing. The purpose of this paper is to propose that previously unconsidered factors, informed by social psychology and behavioural economics, can appear as 'symptom magnification' or 'poor effort', which are incorrectly interpreted as the result of a conscious process. These are complex and multi-determined behaviours with a unique differential diagnosis which have important implications for research, evaluation and treatment.
Topics: Anger; Brain Concussion; Diagnosis, Differential; Humans; Malingering; Neuropsychological Tests; Prognosis; Stereotyping; Stress, Psychological
PubMed: 22696584
DOI: 10.1136/jnnp-2011-302078