-
The Medico-legal Journal 2002
Review
Topics: Diagnosis, Differential; Disability Evaluation; Humans; Malingering; Manuals as Topic; Memory Disorders; Munchausen Syndrome; Psychological Tests
PubMed: 11915575
DOI: 10.1258/rsmmlj.70.1.38 -
Behavioral Sciences & the Law 2006Because the use of deception is an important clinical characteristic of psychopathy, there is intuitive appeal to the idea that psychopathy and malingering are... (Comparative Study)
Comparative Study
Because the use of deception is an important clinical characteristic of psychopathy, there is intuitive appeal to the idea that psychopathy and malingering are associated. There is, however, very little research showing that psychopaths are more likely to malinger. We classified a sample of criminal defendants as high, moderate, or low in psychopathy, based on PCL-R scores, and compared their scores on indices typically used to detect malingering on the MMPI-2, the PAI and the SIRS. The high psychopathy group scored significantly higher on the MMPI-2 F and F-K; the PAI NIM, and the SIRS, but not the MMPI-2 Fb, F(p), or the PAI RDF or Mal, lending some support for the DSM-IV recommendation that malingering should be considered whenever there is a diagnosis of antisocial personality disorder. Logistic regression analysis (LGA) revealed that Factor I but not Factor II of the PCL-R significantly discriminated malingerers from nonmalingerers with 75% correct classification. However, receiver operating characteristic (ROC) analysis revealed that psychopathy ratings had poor sensitivity and specificity in the detection of malingering. Calculation of the percentages of those exceeding accepted cut-offs on each of the malingering measures revealed that a high percentage of severe psychopaths did not attempt to feign psychiatric disorder. The results suggest that psychopathy is not a clinically useful indictor of malingering. The results are discussed in terms of confirmatory bias and the impact such a bias could have on the evaluation of criminal defendants.
Topics: Adult; Criminal Psychology; Humans; Interviews as Topic; Male; Malingering; Medical Audit; Middle Aged; Psychopathology; United States
PubMed: 16705655
DOI: 10.1002/bsl.661 -
The Clinical Neuropsychologist May 2004Two studies were conducted to evaluate potential malingering indexes on the Halstead Category Test. The aim of the first study was that of documenting that groups of... (Comparative Study)
Comparative Study
Two studies were conducted to evaluate potential malingering indexes on the Halstead Category Test. The aim of the first study was that of documenting that groups of individuals with established cognitive impairment did not score positively on the proposed indexes. Of the indexes considered, it was found that these groups made very few errors on subtests I and II of the test and improved their performance on subtest VI relative to V. Subtests I and II are very simple and both subtest V and VI involve the same principle. It was proposed that malingerers would make excessive numbers of errors on subtests I and II, and would not show improvement on subtest VI over subtest V. The second study compared the performance of patients with brain damage to students who were either trained to malinger or encouraged to perform as well as they could on the Category Test. Comparisons were made on the malingering indexes among these groups showing that mean scores of the patients with brain damage on several of the indexes did not differ from those of the students encouraged to do well, but both of these groups did significantly better than the student malingerers. A discriminant analysis of the set of malingering indexes classified 20% of the student malingerers as brain damaged, and 3.4% of the patients with brain damage as malingerers. A stepwise analysis indicated that number of errors on subtests I and II and Total Errors were particularly sensitive to malingering.
Topics: Adult; Analysis of Variance; Brain Damage, Chronic; Case-Control Studies; Cognition; Cognition Disorders; Female; Humans; Male; Malingering; Middle Aged; Neuropsychological Tests; Predictive Value of Tests; Reproducibility of Results; Schizophrenia; Sensitivity and Specificity
PubMed: 15587679
DOI: 10.1080/13854040490501673 -
The American Journal of Psychiatry Dec 2014
Topics: Drama; England; Famous Persons; Folklore; History, 17th Century; Humans; Literature, Modern; Malingering; Medicine in Literature; Mental Disorders
PubMed: 25756768
DOI: 10.1176/appi.ajp.2014.14091149 -
The Clinical Neuropsychologist May 2008The Disability Determinations Service (DDS) obtains evidence about an applicant from sources that may include the Psychological Consultative Examination (PCE), which...
The Disability Determinations Service (DDS) obtains evidence about an applicant from sources that may include the Psychological Consultative Examination (PCE), which usually includes a mental status examination and Wechsler Scale findings. Although evidence for good effort is necessary to validate the findings, psychologists have been officially discouraged from determining effort by the use of formal tests. In Chafetz, Abrahams, and Kohlmaier (2007), indicators of effort within the PCE in WAIS-age (adults) and WISC-age (children) claimants were determined, and a PCE Malingering Rating Scale was developed. In the present study, this new scale was used along with established symptom validity tests (SVTs) to determine base rates and additional predictors of malingering within the PCE. Claimants were apportioned into separate effort groups in a "dose-response" manner: Definite Malingerers, Chance-Level, Fail Both (SVT and Rating Scale), Fail One, Fail Indicators, and Not Fail. Data from separate studies using the Test of Memory Malingering (TOMM), and the Medical Symptom Validity Test (MSVT) were used to assign claimants into separate effort groups. An evidence-based assessment approach utilized these base-rates to calculate post-test odds. Other predictors of effort within the PCE include the presence of conduct disorder symptoms, and the number of other family members on Disability.
Topics: Adolescent; Adult; Analysis of Variance; Child; Disability Evaluation; Eligibility Determination; Female; Humans; Male; Malingering; Predictive Value of Tests; Psychological Theory; Psychometrics; Reproducibility of Results
PubMed: 17853151
DOI: 10.1080/13854040701346104 -
The Journal of the American Academy of... 2007Malingering presents special challenges to the practicing clinician, including diagnostic uncertainty, the confrontation of potentially criminal conduct, and...
Malingering presents special challenges to the practicing clinician, including diagnostic uncertainty, the confrontation of potentially criminal conduct, and countertransference and personal reactions. Maintaining a traditional clinical approach to the patient suspected of malingering enables the therapist to draw analogies to other disorders and utilize customary diagnostic and therapeutic skills. Malingering has long been recognized in the military, and has predictably come to the forefront of clinical practice during a time of war. The art in military medicine is to find a way to make our ethical and fiduciary responsibility to act in the best interest of the patient coincide with the needs of the system. In this context, malingering can also be viewed as an immature or primitive defense in a very stressful situation, and approached accordingly. This article discusses key elements of the history and mental status examination in the clinical assessment of malingering, and therapeutic analogies that offer the possibility of a positive outcome for an otherwise potentially negative encounter.
Topics: Countertransference; Diagnosis, Differential; Humans; Malingering; Severity of Illness Index; Surveys and Questionnaires
PubMed: 17480185
DOI: 10.1521/jaap.2007.35.1.13 -
Assessment Mar 2007This study examined the sensitivity and false-positive error rate of reliable digit span (RDS) and the WAIS-III Digit Span (DS) scaled score in persons alleging toxic...
This study examined the sensitivity and false-positive error rate of reliable digit span (RDS) and the WAIS-III Digit Span (DS) scaled score in persons alleging toxic exposure and determined whether error rates differed from published rates in traumatic brain injury (TBI) and chronic pain (CP). Data were obtained from the files of 123 persons referred for neuropsychological evaluation related to alleged exposure to environmental and industrial substances. Malingering status was determined using the criteria of Slick, Sherman, and Iverson (1999). The sensitivity and specificity of RDS and DS in toxic exposure are consistent with those observed in TBI and CP. These findings support the use of these malingering indicators in cases of alleged toxic exposure and suggest that the classification accuracy data of indicators derived from studies of TBI patients may also be validly applied to cases of alleged toxic exposure.
Topics: Adult; Aged; Expert Testimony; Female; Humans; Insurance, Disability; Male; Malingering; Mental Recall; Middle Aged; Neurotoxicity Syndromes; Occupational Diseases; Problem Solving; Reversal Learning; Serial Learning; Wechsler Scales; Workers' Compensation
PubMed: 17314176
DOI: 10.1177/1073191106295095 -
Indian Medical Journal Dec 1961
Topics: Humans; Malingering
PubMed: 14494715
DOI: No ID Found -
Neurologic Clinics May 1995In clinical situations patient honesty and self-interest usually coincide; however, in legal circumstances patients may be motivated to deceive and may be skilled in... (Review)
Review
In clinical situations patient honesty and self-interest usually coincide; however, in legal circumstances patients may be motivated to deceive and may be skilled in doing so. Research raises doubts about the capacity of health professionals to detect malingering, particularly when there is less known about conditions or expected symptom patterns, more definitive tests are lacking or require patient cooperation, and diagnosis depends substantially on patient self-report. Given the lack of systematic feedback about our judgmental accuracy when deciding the presence or absence of malingering, clinical experience per se provides an inadequate means for identifying and correcting erroneous practices and for determining just how confident we ought to be in our subjective impressions. Thus, in the appraisal of malingering, it is dangerous to place too much dependence on subjective confidence. Methods are discussed that can supplement medical examination and increase the accuracy of malingering detection.
Topics: Diagnosis, Differential; Humans; Malingering; Patient Care Team; Physician-Patient Relations; Sick Role
PubMed: 7643824
DOI: No ID Found -
Journal of Personality Assessment Feb 2007To assess the diagnostic accuracy of the Personality Assessment Inventory (PAI; Morey, 1991) Validity scales for the detection of malingered psychiatric disorders, we...
To assess the diagnostic accuracy of the Personality Assessment Inventory (PAI; Morey, 1991) Validity scales for the detection of malingered psychiatric disorders, we divided a sample of criminal defendants referred for forensic evaluation by the federal courts into malingering and not malingering groups based on their performance on the Structured Interview of Reported Symptoms (Rogers, Gillis, & Bagby, 1990). Logistic regression analyses (LGAs) revealed that there were no differences between the malingering and not malingering groups with respect to age, race, years of education, history of drug abuse, or number of previous felony convictions. LGA with malingering versus not malingering as the criterion revealed that the PAI Negative Impression Management (NIM) scale but not the Rogers Discriminant Function (RDF; Rogers, Sewell, Morey & Ustad, 1996) nor the Malingering index (MAL; Morey, 1996) significantly differentiated the malingering from the not malingering group. Receiver operating characteristics analyses demonstrated acceptable sensitivity and specificity for the NIM scale but not the RDF scale or the MAL index. We discuss the results in terms of the suggested cutoff scores for the PAI Validity scales in detecting criminal defendants who are attempting to feign psychiatric disorder.
Topics: Adult; Georgia; Humans; Malingering; Middle Aged; Personality Assessment; Prisoners; Regression Analysis
PubMed: 17266411
DOI: 10.1080/00223890709336831