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Aryal K, Merten T, Akehurst L, Boskovic I. The English-language version of the Self-Report Symptom Inventory: a pilot analogue study with feigned head injury sequelae. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1078-1082. [PMID: 35944507 DOI: 10.1080/23279095.2022.2109158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Questionnaire-based symptom validity tests (SVTs) are an indispensable diagnostic tool for evaluating the credibility of patients' claimed symptomatology, both in forensic and in clinical assessment contexts. In 2019, the comprehensive professional manual of a new SVT, the Self-Report Symptom Inventory (SRSI), was published in German. Its English-language version was first tested in the UK. This experimental analogue study investigated 20 adults simulating minor head injury symptoms and 21 honestly responding participants. The effect sizes of differences between the two groups were large, with the simulating group endorsing a higher number of pseudosymptoms, both on the SRSI and the Structured Inventory of Malingered Symptomatology, and scoring lower on the Reliable Digit Span than the control group. The results are similar to those obtained in previous research of different SRSI language versions, supporting the effort to validate the English-language SRSI version.
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Affiliation(s)
- Kirsten Aryal
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Thomas Merten
- Neurology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Lucy Akehurst
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Irena Boskovic
- Erasmus University Rotterdam, Rotterdam, Netherlands
- Maastricht University, Maastricht, Netherlands
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2
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Ratcliffe LN, Hale AC, Gradwohl BD, Spencer RJ. Preliminary findings from reevaluating the MMPI Response Bias Scale items in veterans undergoing neuropsychological evaluation. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1016-1023. [PMID: 35917583 DOI: 10.1080/23279095.2022.2106571] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Response Bias Scale (RBS) was developed to predict non-credible cognitive presentations among disability claimants without head injury. Developers used empirical keying, which is independent of apparent content, to select items from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) item pool that distinguished between individuals passing or failing performance validity tests (PVTs). No study has examined which of these items would have psychometric value when used in clinical neuropsychological evaluations. This study reexamined items comprising RBS with reference to manifest item content, internal consistency, PVTs, and a symptom validity test (SVT) in a sample of 173 predominately White male veterans (MAGE = 50.70, MEDU = 13.73) in a VA outpatient neuropsychology clinic. Participants completed the MMPI-2 Restructured Form (MMPI-2-RF), PVTs, and an SVT. The 28-item RBS appears to contain three types of items: those that manifestly address cognitive functioning, those that are supported but do not appear to address cognitive functioning, and nine items that were unrelated to cognition and not statistically supported. The 19 empirically supported items, or RBS-19, predicted PVT and SVT failures marginally better than the RBS. Both the RBS and RBS-19 had stronger relationships with SVTs relative to PVTs. Although the removal of the nine problematic items improved the diagnostic accuracy of the scale, it still did not reach the level that is generally considered to be clinically optimal. The RBS-19 offers a measure with improved internal consistency and predictive validity compared to the RBS and warrants additional research.
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Affiliation(s)
- Lauren N Ratcliffe
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
- Department of Clinical Psychology, Mercer University College of Health Professions, Atlanta, GA, USA
| | - Andrew C Hale
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
| | - Brian D Gradwohl
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
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3
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Weymann T, Achenbach J, Guevara JE, Bassler M, Karst M, Lambrecht A. EMG measured reaction time as a predictor of invalid symptom report in psychosomatic patients. Clin Neuropsychol 2024; 38:1210-1226. [PMID: 37917133 DOI: 10.1080/13854046.2023.2276480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
Background: Symptom validity tests (SVTs) and performance validity tests (PVTs) are important tools in sociomedical assessments, especially in the psychosomatic context where diagnoses mainly depend on clinical observation and self-report measures. This study examined the relationship between reaction times (RTs) and scores on the Structured Inventory of Malingered Symptomatology (SIMS). It was proposed that slower RTs and larger standard deviations of reaction times (RTSDs) would be observed in participants who scored above the SIMS cut-off (>16). Methods: Direct surface electromyography (EMG) was used to capture RTs during a computer-based RT test in 152 inpatients from a psychosomatic rehabilitation clinic in Germany. Correlation analyses and Mann-Whitney U were used to examine the relationship between RTs and SIMS scores and to assess the potential impact of covariates such as demographics, medical history, and vocational challenges on RTs. Therefore, dichotomized groups based on each potential covariate were compared. Results: Significantly longer RTs and larger RTSDs were found in participants who scored above the SIMS cut-off. Current treatment with psychopharmacological medication, diagnosis of depression, and age had no significant influence on the RT measures. However, work-related problems had a significant impact on RTSDs. Conclusion: There was a significant relationship between longer and more inconsistent RTs and indicators of exaggerated or feigned symptom report on the SIMS in psychosomatic rehabilitation inpatients. Findings from this study provide a basis for future research developing a new RT-based PVT.
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Affiliation(s)
- Thorben Weymann
- Department of Psychosomatic Medicine, Rehazentrum Oberharz, Clausthal-Zellerfeld, Germany
| | - Johannes Achenbach
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, KRH Klinikum Nordstadt, Hannover, Germany
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, Hannover Medical School, Hannover, Germany
| | - Jasmin E Guevara
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Markus Bassler
- Department of Economics and Social Sciences, University of Applied Science Nordhausen, Nordhausen, Germany
| | - Matthias Karst
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, Hannover Medical School, Hannover, Germany
| | - Alexandra Lambrecht
- Department of Psychosomatic Medicine, Rehazentrum Oberharz, Clausthal-Zellerfeld, Germany
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Boskovic I, Akca AYE, Giromini L. Symptom coaching and symptom validity tests: An analog study using the structured inventory of malingered symptomatology, Self-Report Symptom Inventory, and Inventory of Problems-29. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:626-638. [PMID: 35414324 DOI: 10.1080/23279095.2022.2057856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this pilot and exploratory study, we tested the robustness of three self-report symptom validity tests (SVTs) to symptom coaching for depression, with and without additional information available on the Internet. Specifically, we divided our sample (N = 193) so that each subject received either the Structured Inventory of Malingered Symptomatology (SIMS; n = 64), the Self-Report Symptom Inventory (SRSI; n = 66), or the Inventory of Problems-29 (IOP-29; n = 63). Within each of the three subgroups, approximately one third of participants were instructed to respond honestly (Genuine Condition, nSIMS = 21; nSRSI = 24; nIOP-29 = 26) and approximately two-thirds were instructed to feign depression. One half of the feigners were presented with a vignette to increase their compliance with instructions and were given information about symptoms of depression (Coached Feigning, nSIMS = 25; nSRSI = 18; nIOP-29 = 21), and the other half were given the same vignette and information about symptoms of depression, plus two Internet links to review before completing the test (Internet-Coached Feigning, nSIMS = 18; nSRSI = 24; nIOP-29 = 16). Overall, the results showed that the genuine conditions yielded the lowest total scores on all three measures, while the two feigning conditions did not significantly differ from each other. Looking at the detection rates for all feigning participants, all three measures showed satisfactory results, with IOP-29 performing slightly better than SIMS and SIMS performing slightly better than SRSI. Internet-Coached Feigners scored slightly lower on all three measures than feigners who were coached without the Internet links. Taken together, the results of this preliminary and exploratory study suggest that all three SVTs examined are sensitive to feigned depression even in the presence of symptom coaching, both with and without additional Internet-based information.
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Affiliation(s)
- Irena Boskovic
- Forensic Psychology Section, Clinical Psychology Department, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Forensic Psychology Section, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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5
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Puente-López E, Pina D, Rambaud-Quiñones P, Ruiz-Hernández JA, Nieto-Cañaveras MD, Shura RD, Alcazar-Crevillén A, Martinez-Jarreta B. Classification accuracy and resistance to coaching of the Spanish version of the Inventory of Problems-29 and the Inventory of Problems-Memory: A simulation study with mTBI patients. Clin Neuropsychol 2024; 38:738-762. [PMID: 37615421 DOI: 10.1080/13854046.2023.2249171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/12/2023] [Indexed: 08/25/2023]
Abstract
Objective: The present study aims to evaluate the classification accuracy and resistance to coaching of the Inventory of Problems-29 (IOP-29) and the IOP-Memory (IOP-M) with a Spanish sample of patients diagnosed with mild traumatic brain injury (mTBI) and healthy participants instructed to feign. Method: Using a simulation design, 37 outpatients with mTBI (clinical control group) and 213 non-clinical instructed feigners under several coaching conditions completed the Spanish versions of the IOP-29, IOP-M, Structured Inventory of Malingered Symptomatology, and Rivermead Post Concussion Symptoms Questionnaire. Results: The IOP-29 discriminated well between clinical patients and instructed feigners, with an excellent classification accuracy for the recommended cutoff score (FDS ≥ .50; sensitivity = 87.10% for coached group and 89.09% for uncoached; specificity = 95.12%). The IOP-M also showed an excellent classification accuracy (cutoff ≤ 29; sensitivity = 87.27% for coached group and 93.55% for uncoached; specificity = 97.56%). Both instruments proved to be resistant to symptom information coaching and performance warnings. Conclusions: The results confirm that both of the IOP measures offer a similarly valid but different perspective compared to SIMS when assessing the credibility of symptoms of mTBI. The encouraging findings indicate that both tests are a valuable addition to the symptom validity practices of forensic professionals. Additional research in multiple contexts and with diverse conditions is warranted.
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Affiliation(s)
| | - David Pina
- Applied Psychology Service, Universidad de Murcia, Murcia, Spain
| | | | | | | | - Robert D Shura
- Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC), Salisbury VA Medical Center, Salisbury, NC, USA
| | | | - Begoña Martinez-Jarreta
- Mutua MAZ, Zaragoza, Spain
- Department of Pathological Anatomy, Forensic and Legal Medicine and Toxicology, Universidad de Zaragoza, Zaragoza, Spain
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Ord AS, Martindale SL, Jenks ER, Rowland JA. Subjective cognitive complaints and objective cognitive functioning in combat veterans: Effects of PTSD and deployment mild TBI. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 37991812 DOI: 10.1080/23279095.2023.2280807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
OBJECTIVES (1) Examine the relationship between subjective cognitive complaints and objective cognitive functioning in combat veterans; and (2) evaluate conditional effects of posttraumatic stress disorder (PTSD) and deployment-related mild traumatic brain injury (TBI) within that relationship. METHOD Combat veterans (N = 225, 86.22% male) completed a lifetime TBI interview, a structured interview assessing PTSD symptoms, a neuropsychological assessment battery, and a self-report measure of cognitive symptoms. RESULTS All correlations between subjective cognitive complaints and objective cognitive measures were not statistically significant. Hierarchical linear regression indicated that cognitive performance was not significantly related to cognitive complaints, but both PTSD diagnosis and history of deployment mild TBI explained a significant amount of unique variance in self-reported cognitive symptoms. Interactions between the studied variables were not significant. CONCLUSIONS PTSD and history of deployment mild TBI were uniquely related to cognitive complaints, but cognitive test performance was not. No confounding effects of PTSD or deployment mild TBI were observed in the relationship between cognitive performance and cognitive complaints. This provides support that symptom distress may be a better explanatory factor for perception of lower cognitive functioning than actual cognitive performance.
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Affiliation(s)
- Anna S Ord
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Veterans Integrated Service Networks (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, USA
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Sarah L Martindale
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Veterans Integrated Service Networks (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Elizabeth R Jenks
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Jared A Rowland
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Veterans Integrated Service Networks (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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Orrù G, De Marchi B, Sartori G, Gemignani A, Scarpazza C, Monaro M, Mazza C, Roma P. Machine learning item selection for short scale construction: A proof-of-concept using the SIMS. Clin Neuropsychol 2023; 37:1371-1388. [PMID: 36017966 DOI: 10.1080/13854046.2022.2114548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
Abstract
ObjectiveThis proof-of-concept paper provides evidence to support machine learning (ML) as a valid alternative to traditional psychometric techniques in the development of short forms of longer parent psychological tests. ML comprises a variety of feature selection techniques that can be efficiently applied to identify the set of items that best replicates the characteristics of the original test. MethodsIn the present study, we integrated a dataset of 329 participants from published and unpublished datasets used in previous research on the Structured Inventory of Malingered Symptomatology (SIMS) to develop a short version of the scale. The SIMS is a multi-axial self-report questionnaire and a highly efficient psychometric measure of symptom validity, which is frequently applied in forensic settings. Results State-of-the-art ML item selection techniques achieved a 72% reduction in length while capturing 92% of the variance of the original SIMS. The new SIMS short form now consists of 21 items. ConclusionsThe results suggest that the proposed ML-based item selection technique represents a promising alternative to standard psychometric correlation-based methods (i.e. item selection, item response theory), especially when selection techniques (e.g. wrapper) are employed that evaluate global, rather than local, item value.
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Affiliation(s)
- Graziella Orrù
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Barbara De Marchi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giuseppe Sartori
- Department of General Psychology, University of Padua, Padua, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | | | - Merylin Monaro
- Department of General Psychology, University of Padua, Padua, Italy
| | - Cristina Mazza
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Paolo Roma
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
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Shura RD, Rowland JA, Miskey HM, Ord AS, Magnante AT, Martindale SL. Symptom validity indices in the Posttraumatic Stress Disorder Checklist for DSM-5. J Trauma Stress 2023; 36:919-931. [PMID: 37464588 DOI: 10.1002/jts.22957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 07/20/2023]
Abstract
The use of symptom validity tests (SVTs) is standard practice in psychodiagnostic assessments. Embedded measures are indices within self-report measures. To date, no embedded SVTs have been identified in the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). This research aimed to develop and validate PCL-5 SVTs in two samples of veterans. Participants completed one of two prospective research studies that included cognitive and psychological tests. Participants in Study 1 were veterans (N = 464) who served following the September 11, 2001, terrorist attacks; participants in Study 2 were veterans or service members (N = 338) who had been deployed to Iraq and/or Afghanistan. Both studies included the PCL-5 and the Structured Inventory of Malingered Symptomatology (SIMS), the latter of which served as the criterion for identifying PCL-5 SVTs. For Study 1, two separate SVTs were developed: the PCL-5 Symptom Severity scale (PSS), based on the PCL-5 total score, and the PCL-5 Rare Items scale (PRI), based on PCL-5 items infrequently endorsed at the highest item ratings. At the most conservative SIMS cutoff score, the PSS achieved excellent discrimination for both the Study 1, AUC = .840, and Study 2 samples, AUC = .858, with specific cutoff scores of ≥ 51 and ≥ 56 maximizing sensitivity while maintaining a specificity of .90. The PRI achieved good discrimination, AUCs = .760 and.726, respectively, with a cutoff score of 2 or higher indicated by both studies. The results of these two studies provide provisional support for these two embedded SVTs in the PCL-5.
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Affiliation(s)
- Robert D Shura
- Salisbury VA Healthcare System, Salisbury, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jared A Rowland
- Salisbury VA Healthcare System, Salisbury, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Holly M Miskey
- Salisbury VA Healthcare System, Salisbury, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Anna S Ord
- Salisbury VA Healthcare System, Salisbury, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- School of Psychology and Counseling, Regent University, Virginia Beach, Virginia, USA
| | - Anna T Magnante
- Salisbury VA Healthcare System, Salisbury, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sarah L Martindale
- Salisbury VA Healthcare System, Salisbury, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Rubenzer SJ. Ruling out feigned crime-related amnesia? A response to Acklin (2022). BEHAVIORAL SCIENCES & THE LAW 2023; 41:207-223. [PMID: 37071040 DOI: 10.1002/bsl.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/22/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
In a recent paper, Acklin discussed a case of possible amnesia for a murder in terms of neurobiology, psychoanalysis, and personality assessment. Acklin accepted the defendant's claim of amnesia for the crime as genuine. The considerable literature that takes a skeptical view of crime-related amnesia was not cited, and the possibility of feigning or malingering was "ruled out" with a single sentence that does not withstand scrutiny. A review of the literature on feigned amnesia suggests that it may not be possible to rule out malingering even if the best available tools are used: There has been minimal investigation of most validity tests and estimates of base rates of feigned amnesia for a crime vary widely and make estimates of Negative Predictor Power highly unreliable. Although one cannot know from the information presented if Acklin's defendant legitimately experienced amnesia, feigning could not be ruled out using an interview and the test data cited by Acklin. I call for a moratorium on publication of further articles on crime specific amnesia that do not conscientiously examine other potential explanations and do not use current best practices for assessing negative response bias.
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Orrù G, Ordali E, Monaro M, Scarpazza C, Conversano C, Pietrini P, Gemignani A, Sartori G. Reconstructing individual responses to direct questions: a new method for reconstructing malingered responses. Front Psychol 2023; 14:1093854. [PMID: 37397336 PMCID: PMC10311065 DOI: 10.3389/fpsyg.2023.1093854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The false consensus effect consists of an overestimation of how common a subject opinion is among other people. This research demonstrates that individual endorsement of questions may be predicted by estimating peers' responses to the same question. Moreover, we aim to demonstrate how this prediction can be used to reconstruct the individual's response to a single item as well as the overall response to all of the items, making the technique suitable and effective for malingering detection. Method We have validated the procedure of reconstructing individual responses from peers' estimation in two separate studies, one addressing anxiety-related questions and the other to the Dark Triad. The questionnaires, adapted to our scopes, were submitted to the groups of participants for a total of 187 subjects across both studies. Machine learning models were used to estimate the results. Results According to the results, individual responses to a single question requiring a "yes" or "no" response are predicted with 70-80% accuracy. The overall participant-predicted score on all questions (total test score) is predicted with a correlation of 0.7-0.77 with actual results. Discussion The application of the false consensus effect format is a promising procedure for reconstructing truthful responses in forensic settings when the respondent is highly likely to alter his true (genuine) response and true responses to the tests are missing.
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Affiliation(s)
- Graziella Orrù
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | | | - Merylin Monaro
- Department of General Psychology, University of Padua, Padua, Italy
| | | | - Ciro Conversano
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | | | - Angelo Gemignani
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Giuseppe Sartori
- Department of General Psychology, University of Padua, Padua, Italy
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11
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Fuermaier ABM, Dandachi-Fitzgerald B, Lehrner J. Validity assessment of early retirement claimants: Symptom overreporting on the Beck Depression Inventory - II. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 37116177 DOI: 10.1080/23279095.2023.2206031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVES The Beck Depression Inventory-II (BDI-II) is a commonly used clinical measure; however, it contains no method to assess validity of self-report. The primary objective of this research was to examine the possibility of cut scores on the BDI-II indicating possible invalid symptom report in forensic neuropsychological evaluations. Secondary objectives were to explore the utility of education specific cut scores and the effects of the criterion for invalid symptom report. METHODS Two hundred and seventeen early retirement claimants (age range 19-64 years) presenting for forensic neuropsychological examination were considered for this study. Invalid symptom report was determined based on two independent self-report symptom validity tests. Further, all individuals completed the BDI-II as part of their routine assessment battery. RESULTS Individuals with invalid symptom report (30.9%) showed significantly higher BDI-II scores compared to individuals passing symptom validity assessment. ROC analysis supports the utility of the BDI-II to differentiate valid from invalid symptom report, AUC = 0.822, SE = 0.032, p < .001, 95%-CI = 0.760-0.884. A BDI-II cut score of 38 points reached a desired level of 0.90 specificity with 0.58 sensitivity. Secondary analysis indicated that the recommended cut score may vary depending on the educational level of the examinee. Further, results seem to be largely robust against the chosen criterion for invalid symptom report. CONCLUSION The BDI-II appears to be a useful adjunct embedded validity indicator in forensic neuropsychological evaluations.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Brechje Dandachi-Fitzgerald
- Department of Clinical Psychological Science, University of Maastricht, Maastricht, The Netherlands
- Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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12
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Zago S, Preti AN, Difonzo T, D'Errico A, Sartori G, Zangrossi A, Bolognini N. Two Cases of Malingered Crime-Related Amnesia. Top Cogn Sci 2023. [PMID: 36855315 DOI: 10.1111/tops.12643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 03/02/2023]
Abstract
Amnesia is a frequent claim in major crimes, and it is estimated that the complete or partial absence of memory following a crime ranges from 25% to 50% of total cases. Although some cases may constitute a genuine form of amnesia, due to organic-neurological defects or psychological causes, and possibly combined with a dissociative or repressive coping style after an extreme experience, malingering is still fairly common in offenders. Therefore, one of the main goals in medico-legal proceedings is to find methods to determine the credibility of crime-related amnesia. At present, a number of lie and memory detection techniques can assist the forensic assessment of the reliability of declarative proof, and have been devised and improved over the past century: for example, modern polygraphs, event-related potentials, thermal imaging, functional magnetic resonance imaging, kinematic, and facial analysis. Other ad hoc psychological tests, such as the so-called Symptom Validity Test (SVT) and Performance Validity Test (PVT), as well as the autobiographical Implicit Association Test (aIAT), can also be used. To date, however, there is little evidence or case reports that document their real usefulness in forensic practice. Here, we report two cases of crime-related amnesia, whereby both defendants, who were found guilty of homicide, appeared to exhibit dissociative amnesia but where the application of SVTs, PVTs, and aIAT detected a malingered amnesia.
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Affiliation(s)
- Stefano Zago
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico
| | - Alice N Preti
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano
- School of Medicine, University of Milano-Bicocca
| | - Teresa Difonzo
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico
| | - Annalisa D'Errico
- Neurology Unit, Foundation IRCCS Ca' Granda Hospital Maggiore Policlinico
| | | | - Andrea Zangrossi
- Department of General Psychology, University of Padova
- Padova Neuroscience Center (PNC), University of Padova
| | - Nadia Bolognini
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano
- Department of Psychology and NeuroMI, University of Milano-Bicocca
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13
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Edwards MJ, Yogarajah M, Stone J. Why functional neurological disorder is not feigning or malingering. Nat Rev Neurol 2023; 19:246-256. [PMID: 36797425 DOI: 10.1038/s41582-022-00765-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 02/18/2023]
Abstract
Functional neurological disorder (FND) is one of the commonest reasons that people seek help from a neurologist and is for many people a lifelong cause of disability and impaired quality of life. Although the evidence base regarding FND pathophysiology, treatment and service development has grown substantially in recent years, a persistent ambivalence remains amongst health professionals and others as to the veracity of symptom reporting in those with FND and whether the symptoms are not, in the end, just the same as feigned symptoms or malingering. Here, we provide our perspective on the range of evidence available, which in our view provides a clear separation between FND and feigning and malingering. We hope this will provide a further important step forward in the clinical and academic approach to people with FND, leading to improved attitudes, knowledge, treatments, care pathways and outcomes.
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Affiliation(s)
- Mark J Edwards
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
| | - Mahinda Yogarajah
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.,National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, UK.,Epilepsy Society, London, UK
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Boe EW, Evald L. Symptom and performance validity in neuropsychological assessments of outpatients 15-30 years of age. Brain Inj 2022; 37:1-7. [PMID: 36527248 DOI: 10.1080/02699052.2022.2158222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 09/22/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE It has been suggested that performance validity tests (PVTs) assess the credibility of a patient's objective test performance, symptom validity tests (SVTs) assess the credibility of a patient's subjective complaints, and that PVTs and SVTs are independent measures. The aim of this study was to test this hypothesis and investigate the associations of PVTs and SVTs with cognitive tests and self-reported measures. METHOD Patients 15-30 years of age were consecutively recruited from a neurorehabilitation outpatient clinic. The participants completed a battery of cognitive tests and self-reporting questionnaires as well as the Test of Memory Malingering (TOMM) and the Structured Inventory of Malingered Symptomatology (SIMS). RESULTS Forty-eight neurological patients of various etiologies were included. The TOMM (PVT) was related to cognitive tests across cognitive domains and unrelated to self-reporting measures. The SIMS (SVT) was related to other self-reported measures of perceived stress, anxiety, and depression, though also related to cognitive test of attention and processing speed. The PVT and the SVT were unrelated and hence seemed to measure two different constructs of validity. CONCLUSIONS This study supports the definition of PVTs and SVTs as two independent measures, consequently that both should be applied routinely in neuropsychological assessments.
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Affiliation(s)
- Ellen W Boe
- Hammel Neurorehabilitation Centre and University Research Clinic, Voldbyvej, Hammel, Denmark
| | - Lars Evald
- Hammel Neurorehabilitation Centre and University Research Clinic, Voldbyvej, Hammel, Denmark
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Arin N, Mengchuay J. Assessing symptom exaggeration of psychopathology in incarcerated individuals and mentally ill offenders within forensic contexts. BEHAVIORAL SCIENCES & THE LAW 2022. [PMID: 36451261 DOI: 10.1002/bsl.2603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/20/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
In forensic contexts, there is a high probability that offenders may exaggerate illness to avoid legal punishment. Since very few empirical studies presently exist on this matter in Thailand, the objectives are to explore the prevalence rate of the exaggeration of psychopathological symptoms and to examine the detection strategy response styles for Thai version of the Symptom validity test (SVT-Th). An analysis of the factors that influence symptom exaggeration would also be included. Mixed participants included 608 individuals consisting of 528 Incarcerated individuals and 80 Mentally Ill Offenders (MIOs). SVT-Th indicated the prevalence rates of feigned psychopathology among overall offenders were 8.88%, 3.20% for incarcerated individuals, and 46.30% for MIOs. As expected, the endorsed average scores of the psychopathological symptoms using the Amplifier and Unlikely response style were recorded at similar amounts. Offenders with a history of mental illness exaggerated their symptoms to a greater degree than those without a history of mental illness. With regard to the type of crime and the number of offenses, no discrepancies of statistical significance were found. Interestingly, offenders who committed violent crimes, and with more than four times the number of offenses, were more likely to exaggerate their symptoms than the other subjects.
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Affiliation(s)
- Natthawut Arin
- Faculty of Humanities, Department of Psychology, Chiang Mai University, Suthep, Thailand
| | - Jiraporn Mengchuay
- Department of Corrections, Medical Correctional Hospital, Ministry of Justice, Bangkok, Thailand
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Boress K, Gaasedelen OJ, Croghan A, Johnson MK, Caraher K, Basso MR, Whiteside DM. Replication and cross-validation of the personality assessment inventory (PAI) cognitive bias scale (CBS) in a mixed clinical sample. Clin Neuropsychol 2022; 36:1860-1877. [PMID: 33612093 PMCID: PMC8454137 DOI: 10.1080/13854046.2021.1889681] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/08/2021] [Indexed: 01/27/2023]
Abstract
Objective: This study is a cross-validation of the Cognitive Bias Scale (CBS) from the Personality Assessment Inventory (PAI), a ten-item scale designed to assess symptom endorsement associated with performance validity test failure in neuropsychological samples. The study utilized a mixed neuropsychological sample of consecutively referred patients at a large academic medical center in the Midwest. Participants and Methods: Participants were 332 patients who completed embedded and free-standing performance validity tests (PVTs) and the PAI. Pass and fail groups were created based on PVT performance to evaluate classification accuracy of the CBS. Results: The results were generally consistent with the initial study for overall classification accuracy, sensitivity, and cut-off score. Consistent with the validation study, CBS had better classification accuracy than the original PAI validity scales and a comparable effect size to that obtained in the original validation publication; however, the Somatic Complaints scale (SOM) and the Conversion subscale (SOM-C) also demonstrated good classification accuracy. The CBS had incremental predictive ability compared to existing PAI scales. Conclusions: The results supported the CBS, but further research is needed on specific populations. Findings from this present study also suggest the relationship between conversion tendencies and PVT failure may be stronger in some geographic locations or population types (forensic versus clinical patients).
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Affiliation(s)
- Kaley Boress
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, USA
| | | | - Anna Croghan
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - Marcie King Johnson
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, USA
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, USA
| | - Kristen Caraher
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - Michael R. Basso
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, USA
| | - Douglas M. Whiteside
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, USA
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Niesten IJM, Merckelbach H, Dandachi-FitzGerald B, Jutten-Rooijakkers I, van Impelen A. Experts’ Failure to Consider the Negative Predictive Power of Symptom Validity Tests. Front Psychol 2022; 13:789762. [PMID: 35369141 PMCID: PMC8971289 DOI: 10.3389/fpsyg.2022.789762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Feigning (i.e., grossly exaggerating or fabricating) symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests (SVTs) have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM’s stereotypical yet faulty profile of the “antisocial” feigner. Across three studies, we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students (Study 1, N = 55) and clinical experts (Study 2, N = 42; Study 3, N = 93) a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale (i.e., 50) and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants (i.e., psychology students, N = 92) about the shortcomings of the DSM’s antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1–3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis.
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Affiliation(s)
- Isabella J. M. Niesten
- Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
- Clinical Psychology, Open University of the Netherlands, Heerlen, Netherlands
- *Correspondence: Isabella J. M. Niesten,
| | - Harald Merckelbach
- Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
| | | | | | - Alfons van Impelen
- Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
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Scores in Self-Report Questionnaires Assessing Adult ADHD Can Be Influenced by Negative Response Bias but Are Unrelated to Performance on Executive Function and Attention Tests. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-022-09448-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractSelf-report questionnaires are in widespread use in the assessment of adults with suspected attention-deficit and hyperactivity disorder (ADHD). Notwithstanding the high degree of validity, these questionnaires are considered to possess, their stand-alone use in assessment for adult ADHD may result in false-positive diagnoses due to the risk of negative response bias. Most of the self-report questionnaires in typical use are based on the diagnostic systems DSM-5 or ICD-10. From a neuropsychological point of view, however, testing of various executive function abilities and attentional performance is important in the assessment of adult ADHD. The present study (N = 211) found no evidence linking executive function (working memory and inhibitory processes) and attentional performance (processing speed) to the results of a self-report questionnaire, the ADHS-LE. The number of failures on the three symptom or performance validity tests (SVT/PVT) used provided the sole, and significant, explanation for the response behavior reported on the ADHS-LE. Of these three SVT/PVTs (the German version of the Structured Inventory of Malingered Symptomatology, SIMS, the reliable digit span, and the standard deviation of simple reaction time), only the SIMS was found to be a significant predictor variable. In the clinical context of this study, 32.6% of subjects produced at least one invalid SVT/PVT result. The use of a more conservative criterion—failure on at least two of the three SVT/PVTs deemed to be feigning ADHD—reduced the proportion of participants generating invalid values to 5%.
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Abstract
AbstractAre personality traits related to symptom overreporting and/or symptom underreporting? With this question in mind, we evaluated studies from 1979 to 2020 (k = 55), in which personality traits were linked to scores on stand-alone validity tests, including symptom validity tests (SVTs) and measures of socially desirable responding (SDR) and/or supernormality. As to symptom overreporting (k = 14), associations with depression, alexithymia, apathy, dissociation, and fantasy proneness varied widely from weak to strong (rs .27 to .79). For underreporting (k = 41), inconsistent links (rs − .43 to .63) were found with narcissism, whereas alexithymia and dissociation were often associated with lower SDR tendencies, although effect sizes were small. Taken together, the extant literature mainly consists of cross-sectional studies on single traits and contexts, mostly offering weak correlations that do not necessarily reflect causation. What this field lacks is an overarching theory relating traits to symptom reporting. Longitudinal studies involving a broad range of traits, samples, and incentives would be informative. Until such studies have been done, traits are best viewed as modest concomitants of symptom distortion.
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Giromini L, Young G, Sellbom M. Assessing Negative Response Bias Using Self-Report Measures: New Articles, New Issues. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-022-09444-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractIn psychological injury and related forensic evaluations, two types of tests are commonly used to assess Negative Response Bias (NRB): Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs). SVTs assess the credibility of self-reported symptoms, whereas PVTs assess the credibility of observed performance on cognitive tasks. Compared to the large and ever-growing number of published PVTs, there are still relatively few validated self-report SVTs available to professionals for assessing symptom validity. In addition, while several studies have examined how to combine and integrate the results of multiple independent PVTs, there are few studies to date that have addressed the combination and integration of information obtained from multiple self-report SVTs. The Special Issue of Psychological Injury and Law introduced in this article aims to help fill these gaps in the literature by providing readers with detailed information about the convergent and incremental validity, strengths and weaknesses, and applicability of a number of selected measures of NRB under different conditions and in different assessment contexts. Each of the articles in this Special Issue focuses on a particular self-report SVT or set of SVTs and summarizes their conditions of use, strengths, weaknesses, and possible cut scores and relative hit rates. Here, we review the psychometric properties of the 19 selected SVTs and discuss their advantages and disadvantages. In addition, we make tentative proposals for the field to consider regarding the number of SVTs to be used in an assessment, the number of SVT failures required to invalidate test results, and the issue of redundancy when selecting multiple SVTs for an assessment.
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21
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Examining Base Rates of Symptom Endorsement and the Roles of Sex and Depressive Symptoms on the Structured Inventory of Malingered Symptomology (SIMS) in a Non-clinical Population. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-021-09439-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Shura RD, Ord AS, Worthen MD. Structured Inventory of Malingered Symptomatology: a Psychometric Review. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09432-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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23
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Merten T, Dandachi-FitzGerald B, Boskovic I, Puente-López E, Merckelbach H. The Self-Report Symptom Inventory. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09434-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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24
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Exploring the Structured Inventory of Malingered Symptomatology in Patients with Multiple Sclerosis. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09424-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Modiano YA, Taiwo Z, Pastorek NJ, Webber TA. The Structured Inventory of Malingered Symptomatology Amnestic Disorders Scale (SIMS-AM) Is Insensitive to Cognitive Impairment While Accurately Identifying Invalid Cognitive Symptom Reporting. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09420-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Tierney SM, Webber TA, Collins RL, Pacheco VH, Grabyan JM. Validity and Utility of the Miller Forensic Assessment of Symptoms Test (M-FAST) on an Inpatient Epilepsy Monitoring Unit. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09418-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Praus P, Schwarz S, Reinhard I, Zink M, Dreßing H. [Validity of the "Structured Inventory of Malingered Symptomatology" [SIMS] in the Assessment of Healthy Individuals and Patients with Psychiatric Disorders Outside the Forensic Context]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:100-107. [PMID: 34116581 DOI: 10.1055/a-1493-2782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Assessment of the rate of false-positive results of the Structured Inventory of Malingered Symptomatology (SIMS) in healthy controls and authentic patients outside the forensic or rehabilitative context. METHODS Beyond the SIMS scores, further variables (PANSS, Hamilton scale, MMSE) were obtained. SIMS scores of healthy individuals were compared with the SIMS scores of the different groups of patients. Additionally, correlations between the SIMS scores and other variables were investigated. RESULTS Patients with psychotic disorders (n=30) or depressive episodes (n=32) more frequently achieved SIMS scores >16 as compared to healthy controls. In comparison, patients with amnestic disorders (n=15) had inconspicuous SIMS scores. Depressed patients with positive SIMS results were significantly more likely to be diagnosed with another psychiatric disorder and the scores of these patients on the Hamilton scale were correlated with positive results on 2 subscales of the SIMS (NI, AF). CONCLUSION If this instrument is to applied in clinical practice in the future, further validation of the SIMS is necessary. The specificity of the SIMS seems to be context-related.
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Affiliation(s)
- Peter Praus
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany
| | - Stefan Schwarz
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany
| | - Iris Reinhard
- Abteilung Biostatistik, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany
| | - Mathias Zink
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany.,Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirksklinikum Ansbach, Ansbach, Germany
| | - Harald Dreßing
- Forensische Psychiatrie, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany
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Rogers R, Otal TK, Velsor SF, Pan M. How good are inpatients at feigning Miranda abilities?: An investigation of the Miranda Quiz, Inventory of Legal Knowledge, and Structured Inventory of Malingered Symptomatology. BEHAVIORAL SCIENCES & THE LAW 2021; 39:245-261. [PMID: 33851430 DOI: 10.1002/bsl.2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 01/06/2021] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
The current study represents the first investigation into feigned Miranda abilities using an inpatient population. We investigated the use of a very generic measure (i.e., the Structured Inventory of Malingered Symptomatology, or SIMS) as well as two specialized forensic feigning measures: the Miranda Quiz (MQ) and Inventory of Legal Knowledge (ILK). With a quasi-random assignment, 82 acute inpatients were evenly distributed to "feigning" and "genuine" groups. The recommended SIMS cut score > 14 performed poorly, misclassifying three-quarters of the genuine group as feigning. In general, sensitivities on the specialized scales were constrained by the general lack of severe decrements for the feigning group. However, specificities were strong to outstanding. In particular, the MQ floor effect showed some promise but was limited by its small number of items. The strongest potential was observed for the revised ILK scales, especially the Revised Clinical ILK (RC-ILK). When using single-point cut scores on two prior correctional samples, the RC-ILK produced excellent sensitivities (0.94 and 0.96) and outstanding specificities (0.98 and 0.99). Methodological issues and professional implications were discussed in the context of feigned Miranda abilities.
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Affiliation(s)
- Richard Rogers
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Tanveer K Otal
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Sarah F Velsor
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Minqi Pan
- Department of Psychology, University of North Texas, Denton, Texas, USA
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Boskovic I, Merten T, Merckelbach H. How Plausible Is the Implausible? Students’ Plausibility and Prevalence Ratings of the Self-Report Symptom Inventory. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09409-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractSome self-report symptom validity tests, such as the Self-Report Symptom Inventory (SRSI), rely on a detection strategy that uses bizarre, extreme, or very rare symptoms. Thus, items are constructed to invite respondents with an invalid response style to affirm pseudosymptoms that are usually not experienced by genuine patients. However, these pseudosymptoms should not be easily recognizable, because otherwise sophisticated over-reporters could strategically avoid them and go undetected. Therefore, we tested how well future psychology professionals were able to differentiate between genuine complaints and pseudosymptoms in terms of their plausibility and prevalence.Psychology students (N = 87) received the items of the SRSI online and were given the task to rate each item as to its plausibility and prevalence in the community.Students evaluated genuine symptoms as significantly more plausible and more prevalent than pseudosymptoms. However, 56% of students rated pseudosymptoms as moderately plausible, whereas 17% rated them as moderately prevalent in the general public.Overall, it appears that psychology students are successful in distinguishing bizarre, unusual, or rare symptoms from genuine complaints. Yet, the majority of students still attributed relatively high prima facie plausibility to pseudosymptoms. We contend that if such a trusting attitude is true for psychology students, it may also be the case for young psychology practitioners, which, consequently, may diminish the probability of employing self-report validity measures in psychological assessments.
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Ord AS, Shura RD, Sansone AR, Martindale SL, Taber KH, Rowland JA. Performance validity and symptom validity tests: Are they measuring different constructs? Neuropsychology 2021; 35:241-251. [PMID: 33829824 DOI: 10.1037/neu0000722] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate the relationships among performance validity, symptom validity, symptom self-report, and objective cognitive testing. METHOD Combat Veterans (N = 338) completed a neurocognitive assessment battery and several self-report symptom measures assessing depression, posttraumatic stress disorder (PTSD) symptoms, sleep quality, pain interference, and neurobehavioral complaints. All participants also completed two performance validity tests (PVTs) and one stand-alone symptom validity test (SVT) along with two embedded SVTs. RESULTS Results of an exploratory factor analysis revealed a three-factor solution: performance validity, cognitive performance, and symptom report (SVTs loaded on the third factor). Results of t tests demonstrated that participants who failed PVTs displayed significantly more severe symptoms and significantly worse performance on most measures of neurocognitive functioning compared to those who passed. Participants who failed a stand-alone SVT also reported significantly more severe symptomatology on all symptom report measures, but the pattern of cognitive performance differed based on the selected SVT cutoff. Multiple linear regressions revealed that both SVT and PVT failure explained unique variance in symptom report, but only PVT failure significantly predicted cognitive performance. CONCLUSIONS Performance and symptom validity tests measure distinct but related constructs. SVTs and PVTs are significantly related to both cognitive performance and symptom report; however, the relationship between symptom validity and symptom report is strongest. SVTs are also differentially related to cognitive performance and symptom report based on the utilized cutoff score. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Anna S Ord
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC)
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Giromini L, Pignolo C, Young G, Drogin EY, Zennaro A, Viglione DJ. Comparability and Validity of the Online and In-Person Administrations of the Inventory of Problems-29. PSYCHOLOGICAL INJURY & LAW 2021; 14:77-88. [PMID: 33841609 PMCID: PMC8019979 DOI: 10.1007/s12207-021-09406-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022]
Abstract
While the psychometric equivalence of computerized versus paper-and-pencil administration formats has been documented for some tests, so far very few studies have focused on the comparability and validity of test scores obtained via in-person versus remote administrations, and none of them have researched a symptom validity test (SVT). To contribute to fill this gap in the literature, we investigated the scores of the Inventory of Problems-29 (IOP-29) generated by various administration formats. More specifically, Study 1 evaluated the equivalence of scores from nonclinical individuals administered the IOP-29 remotely (n = 146) versus in-person via computer (n = 140) versus in-person via paper-and-pencil format (n = 140). Study 2 reviewed published IOP-29 studies conducted using remote/online versus in-person, paper-and-pencil test administrations to determine if remote testing could adversely influence the validity of IOP-29 test results. Taken together, our findings suggest that the effectiveness of the IOP-29 is preserved when alternating between face-to-face and online/remote formats.
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Affiliation(s)
- Luciano Giromini
- Department of Psychology, University of Turin, Via Verdi 10, 10123 Torino, TO Italy
| | - Claudia Pignolo
- Department of Psychology, University of Turin, Via Verdi 10, 10123 Torino, TO Italy
| | - Gerald Young
- Glendon College, York University, Toronto, Canada
| | - Eric Y Drogin
- Department of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Alessandro Zennaro
- Department of Psychology, University of Turin, Via Verdi 10, 10123 Torino, TO Italy
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Harris M, Merz ZC. High elevation rates of the Structured Inventory of Malingered Symptomatology (SIMS) in neuropsychological patients. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1344-1351. [PMID: 33662216 DOI: 10.1080/23279095.2021.1875227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current study examined characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a sample of 110 patients at an adult neuropsychology clinic. Subjects with especially high or low suspicion of invalid reporting were identified based on clinician-completed questions. SIMS elevation rates were examined at different cutoffs and between these groups and were correlated with other indicators of validity. High rates of SIMS elevations were found at the standard cutoff (>14) for the total sample (45.5%), low suspicion cases (24.4%), and high suspicion cases (95.7%). Other indicators of invalidity were low (secondary gain = 8.5%, clinical suspicion of exaggeration in interview M = 2.37/5, medical records concerning for invalidity = 2.4%, mixed/poor performance validity = 6.1%). Elevations correlated with clinician concern for over-reporting in interview, subject-reported cognitive concern (r = -.610) and psychological measures (BDI-II r = -.602, PROMIS r = -.409) but not with neuropsychological memory tests or performance validity measures (all p > .23). The SIMS should be interpreted with caution, as elevations appeared largely related to cognitive concern and psychiatric distress rather than true malingering. A cutoff of > 16 could be used in neuropsychological populations, although this is still of modest specificity.
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Affiliation(s)
- Matthew Harris
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Zachary C Merz
- LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, NC, USA
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Wertz M, Mader E, Nedopil N, Schiltz K, Yundina E. [Response distortion or symptom severity? Symptom description by psychiatric patients and sociomedical assessment subjects]. DER NERVENARZT 2020; 92:1163-1171. [PMID: 33337503 DOI: 10.1007/s00115-020-01041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psychiatric disorders are the most frequent cause for premature retirement; however, trying to verify claims of performance deficits due to psychiatric disorders without the actual existence of the latter in sociomedical assessments is problematic. For this reason, differentiation between actual psychiatric disorders with real presence of symptoms and simulated or aggravated symptoms is of importance in sociomedical assessments. In recent years, symptom validity tests (SVT) have been increasingly utilized in psychiatric/psychological assessments; however, knowledge of the validity of these tests and the relation to symptom severity is still lacking. OBJECTIVE This study aimed to compare the validity of different SVTs depending on symptom severity (Structured Inventory of Malingered Symptomatology (SIMS), Word Memory Test (WMT), Symptom Checklist-90-R (SCL-90‑R), Minnesota Multiphasic Personality Inventory‑2 (MMPI-2)). MATERIAL AND METHODS Clinically treated inpatient psychiatric patients (n = 30) were compared with subjects of sociomedical assessments (n = 29) regarding their tendency to simulate or aggravate symptoms. RESULTS It could be shown that the WMT and the SIMS both failed in the differentiation between psychiatric patients and subjects of sociomedical assessments, regarding description of symptoms or (un)restricted performance motivation. Furthermore, 20% of psychiatric patients were classified as false positive in WMT. The results of the SIMS were significantly related to the severity of psychiatric symptoms in SCL-90‑R, therefore the severity of symptoms was assessed rather than the response distortion. CONCLUSION The results underline the importance of further research on SVTs in sociomedical assessments, especially regarding symptom severity and response distortion.
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Affiliation(s)
- Maximilian Wertz
- Abteilung für Forensische Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig Maximilians Universität München, Nußbaumstraße 7, 80336, München, Deutschland.
| | - Eva Mader
- Abteilung für Forensische Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig Maximilians Universität München, Nußbaumstraße 7, 80336, München, Deutschland
| | - Norbert Nedopil
- Abteilung für Forensische Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig Maximilians Universität München, Nußbaumstraße 7, 80336, München, Deutschland
| | - Kolja Schiltz
- Abteilung für Forensische Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig Maximilians Universität München, Nußbaumstraße 7, 80336, München, Deutschland
| | - Elena Yundina
- kbo-Isar-Amper-Klinikum München-Ost, München, Deutschland
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Pina D, Puente-López E, Ruiz-Hernández JA, Godoy-Fernández C, Llor-Esteban B. Cues for feigning screening in whiplash associated disorders. Leg Med (Tokyo) 2020; 48:101810. [PMID: 33254095 DOI: 10.1016/j.legalmed.2020.101810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- David Pina
- External Service of Forensic Sciencies and Techniques - Servicio Externo de Ciencias y Técnicas Forenses (SECyTEF), Murcia, Spain; University of Murcia, Dep. Psychiatry and Social Psychology, Murcia, Spain
| | - Esteban Puente-López
- External Service of Forensic Sciencies and Techniques - Servicio Externo de Ciencias y Técnicas Forenses (SECyTEF), Murcia, Spain.
| | - José Antonio Ruiz-Hernández
- Murciás Institute of Biosanitary Research - Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain; External Service of Forensic Sciencies and Techniques - Servicio Externo de Ciencias y Técnicas Forenses (SECyTEF), Murcia, Spain; University of Murcia, Dep. Psychiatry and Social Psychology, Murcia, Spain
| | | | - Bartolomé Llor-Esteban
- Murciás Institute of Biosanitary Research - Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain; External Service of Forensic Sciencies and Techniques - Servicio Externo de Ciencias y Técnicas Forenses (SECyTEF), Murcia, Spain
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Spencer RJ, Gradwohl BD, Kordovski VM. Initial Validation of Short Forms of the SIMS for Neuropsychological Evaluations. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09394-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Orrù G, Mazza C, Monaro M, Ferracuti S, Sartori G, Roma P. The Development of a Short Version of the SIMS Using Machine Learning to Detect Feigning in Forensic Assessment. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09389-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractIn the present study, we applied machine learning techniques to evaluate whether the Structured Inventory of Malingered Symptomatology (SIMS) can be reduced in length yet maintain accurate discrimination between consistent participants (i.e., presumed truth tellers) and symptom producers. We applied machine learning item selection techniques on data from Mazza et al. (2019c) to identify the minimum number of original SIMS items that could accurately distinguish between consistent participants, symptom accentuators, and symptom producers in real personal injury cases. Subjects were personal injury claimants who had undergone forensic assessment, which is known to incentivize malingering and symptom accentuation. Item selection yielded short versions of the scale with as few as 8 items (to differentiate between consistent participants and symptom producers) and as many as 10 items (to differentiate between consistent and inconsistent participants). The scales had higher classification accuracy than the original SIMS and did not show the bias that was originally reported between false positives and false negatives.
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Kobelt-Pönicke A, Walter F, Lid N, Ramien N. [The Influence of a Statement of Truth on the Authenticity of Complaints]. REHABILITATION 2020; 59:291-297. [PMID: 32869246 DOI: 10.1055/a-1195-7986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Implicit motives have a moderating effect on dishonest answering behaviour during the testing of applicants for disability pensions. Persons would rather act dishonest if they do not have do keep up their positive self-image therefore. OBJECTIVE Does a statement of truth at the beginning of a functional capacity evaluation lead to lower dishonest answering behaviour? METHODS 248 applicants for a disability pension were randomly allocated to giving such a statement either before or after symptom validity tests (SIMS, BEVA). RESULTS The statement of truth affected the SIMS but not the BEVA. The effect depended on the education level. CONCLUSION Moral and social motives have to be taken into account when assessing malingering during a functional capacity evaluation. Higher educated persons refer to other moral standards or take a more individual and case-by-case approach to morally challenging situations.
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Affiliation(s)
- Axel Kobelt-Pönicke
- Deutsche Rentenversicherung Braunschweig-Hannover, Laatzen.,Institut für Psychologie, Abteilung Klinische Psychologie und Psychotherapie, Universität Hildesheim, Hildesheim
| | - Franziska Walter
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Bremen
| | - Naina Lid
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Bremen
| | - Nadia Ramien
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Bremen
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Boskovic I, Merckelbach H, Merten T, Hope L, Jelicic M. The Self-Report Symptom Inventory as an Instrument for Detecting Symptom Over-Reporting. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2020. [DOI: 10.1027/1015-5759/a000547] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The recently developed Self-Report Symptom Inventory (SRSI) intends to provide an alternative approach to the detection of symptom over-reporting. Unlike other measures, the SRSI includes both non-existent symptoms (i.e., pseudosymptoms) and genuine symptoms. Previous research using the German SRSI showed that people who exaggerate their complaints over-endorse both types of symptoms. In the current simulation experiment, we tested whether the Dutch and English SRSI are effective in identifying over-reporting by comparing SRSI scores of an honest group ( n = 51) with those of two experimental simulator groups (pain, n = 54; anxiety, n = 53). The pain and anxiety simulators endorsed significantly more genuine symptoms and pseudosymptoms than honest participants (ηp2 = .50 and ηp2 = .30, respectively). Furthermore, pain and anxiety over-reporters specifically over-endorsed symptoms corresponding to their simulation instructions (Cohen’s ds > 0.77). Using the recommended cut-off score, the SRSI detected 48% of pain over-reporters and 73% of anxiety over-reporters, with areas under the curve (AUC) ranging from .88 to .91. These results indicate that the SRSI is a promising tool for identifying over-reporting, but further research with clinical samples is needed.
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Affiliation(s)
- Irena Boskovic
- Faculty of Psychology and Neuroscience, Forensic Psychology Section, Maastricht University, The Netherlands
- Faculty of Science, Department of Psychology, University of Portsmouth, UK
| | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Forensic Psychology Section, Maastricht University, The Netherlands
| | - Thomas Merten
- Department of Neurology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Lorraine Hope
- Faculty of Science, Department of Psychology, University of Portsmouth, UK
| | - Marko Jelicic
- Faculty of Psychology and Neuroscience, Forensic Psychology Section, Maastricht University, The Netherlands
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van Minnen A, van Dalen B, Voorendonk EM, Wagenmans A, de Jongh A. The effects of symptom overreporting on PTSD treatment outcome. Eur J Psychotraumatol 2020; 11:1794729. [PMID: 33029329 PMCID: PMC7473171 DOI: 10.1080/20008198.2020.1794729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It is often assumed that individuals with posttraumatic stress disorder (PTSD) who overreport their symptoms should be excluded from trauma-focused treatments. OBJECTIVE To investigate the effects of a brief, intensive trauma-focused treatment programme for individuals with PTSD who are overreporting symptoms. METHODS Individuals (n = 205) with PTSD participated in an intensive trauma-focused treatment programme consisting of EMDR and prolonged exposure (PE) therapy, physical activity and psycho-education. Assessments took place at pre- and post-treatment (Structured Inventory of Malingered Symptomatology; SIMS, Clinician Administered PTSD Scale for DSM-5; CAPS-5). RESULTS Using a high SIMS cut-off of 24 or above, 14.1% (n = 29) had elevated SIMS scores (i.e. 'overreporters'). The group of overreporters showed significant decreases in PTSD-symptoms, and these treatment results did not differ significantly from other patients. Although some patients (35.5%) remained overreporters at post-treatment, SIMS scores decreased significantly during treatment. CONCLUSION The results suggest that an intensive trauma-focused treatment not only is a feasible and safe treatment for PTSD in general, but also for individuals who overreport their symptoms.
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Affiliation(s)
- Agnes van Minnen
- Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.,Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Birgit van Dalen
- Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Eline M Voorendonk
- Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.,Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Anouk Wagenmans
- Research Department, Research Department PSYTREC, Bilthoven, The Netherlands
| | - Ad de Jongh
- Research Department, Research Department PSYTREC, Bilthoven, The Netherlands.,Academic Centre for Dentistry Amsterdam (ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.,School of Health Sciences, Salford University, Manchester, UK.,Institute of Health and Society, University of Worcester, Worcester, UK.,School of Psychology, Queen's University, Belfast, Northern Ireland
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Winters CL, Giromini L, Crawford TJ, Ales F, Viglione DJ, Warmelink L. An Inventory of Problems-29 (IOP-29) study investigating feigned schizophrenia and random responding in a British community sample. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2020; 28:235-254. [PMID: 34712094 PMCID: PMC8547855 DOI: 10.1080/13218719.2020.1767720] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Compared to other Western countries, malingering research is still relatively scarce in the United Kingdom, partly because only a few brief and easy-to-use symptom validity tests (SVTs) have been validated for use with British test-takers. This online study examined the validity of the Inventory of Problems-29 (IOP-29) in detecting feigned schizophrenia and random responding in 151 British volunteers. Each participant took three IOP-29 test administrations: (a) responding honestly; (b) pretending to suffer from schizophrenia; and (c) responding at random. Additionally, they also responded to a schizotypy measure (O-LIFE) under standard instruction. The IOP-29's feigning scale (FDS) showed excellent validity in discriminating honest responding from feigned schizophrenia (AUC = .99), and its classification accuracy was not significantly affected by the presence of schizotypal traits. Additionally, a recently introduced IOP-29 scale aimed at detecting random responding (RRS) demonstrated very promising results.
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Affiliation(s)
| | | | | | - Francesca Ales
- Department of Psychology, University of Turin, Torino, Italy
| | - Donald J Viglione
- California School of Professional Psychology, Alliant International University, San Diego, CA, USA
| | - Lara Warmelink
- Department of Psychology, Lancaster University, Lancaster, UK
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Grant AF, Lace JW, Teague CL, Lowell KT, Ruppert PD, Garner AA, Gfeller JD. Detecting feigned symptoms of depression, anxiety, and ADHD, in college students with the structured inventory of malingered symptomatology. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:443-451. [PMID: 32456475 DOI: 10.1080/23279095.2020.1769097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Research consistently shows how easily students can feign symptoms of ADHD on self-report checklists to determine eligibility for curricular and standardized testing accommodations. However, it is unclear how easily students can feign psychological symptoms to accesses academic accommodations, making the assessment of symptom validity important in both populations.Method: Using a between-subjects design, 75 college students were randomly assigned to one of three groups: (1) coached feigning of ADHD, (2) coached feigning of depression and anxiety (DA), and (3) honest responding (HR). Participants completed the Depression, Anxiety, and Stress Scale (DASS-21) and the Structured Inventory of Malingered Symptomatology (SIMS).Results: The SIMS showed 100% specificity, but low sensitivity (36-52%) for detecting feigned symptoms with different cutoffs. Differences on SIMS subtests were apparent by group with elevated scores for the DA group on the Affective Disorders subscale and elevation for the ADHD group on the Low Intelligence and Amnestic subscales. Participants identified as feigning by the SIMS typically reported more severe symptoms than participants not identified on the DASS-21.Conclusions: The SIMS equally classified the feigned ADHD and DA participants for both cutoff scores utilized. Potential reasons for low sensitivity rates are discussed and future research recommendations are made.
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Affiliation(s)
- Alexandra F Grant
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - John W Lace
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Carson L Teague
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Kimberly T Lowell
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Phillip D Ruppert
- Department of Psychiatry, Saint Louis University, St. Louis, MO, USA
| | - Annie A Garner
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Jeffrey D Gfeller
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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Rowland JA, Martindale SL, Spengler KM, Shura RD, Taber KH. Sequelae of Blast Events in Iraq and Afghanistan War Veterans using the Salisbury Blast Interview: A CENC Study. Brain Inj 2020; 34:642-652. [PMID: 32096666 PMCID: PMC9007162 DOI: 10.1080/02699052.2020.1729418] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 01/19/2023]
Abstract
Objective: To comprehensively characterize blast exposure across the lifespan and relationship to TBI.Participants: Post-deployment veterans and service members (N = 287).Design: Prospective cohort recruitment.Main Measures: Salisbury Blast Interview (SBI).Results: 94.4% of participants reported at least one blast event, 75% reported a pressure gradient during a blast event. Participants reported an average of 337.7 (SD = 984.0) blast events (range 0-4857), 64.8% occurring during combat. Across participants, 19.7% reported experiencing a traumatic brain injury (TBI) during a blast event. Subjective ratings of blast characteristics (wind, debris, ground shaking, pressure, temperature, sound) were significantly higher when TBI was experienced and significantly lower when behind cover. Pressure had the strongest association with resulting TBI (AUC = 0.751). Pressure rating of 3 had the best sensitivity (.54)/specificity (.87) with TBI. Logistic regression demonstrated pressure, temperature and distance were the best predictors of TBI, and pressure was the best predictor of primary blast TBI.Conclusion: Results demonstrate the ubiquitous nature of blast events and provide insight into blast characteristics most associated with resulting TBI (pressure, temperature, distance). The SBI provides comprehensive characterization of blast events across the lifespan including the environment, protective factors, blast characteristics and estimates of distance and munition.
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Affiliation(s)
- Jared A. Rowland
- Research & Academic Affairs Service Line, Salisbury VA Medical Center, Salisbury, North Carolina, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, USA
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sarah L. Martindale
- Research & Academic Affairs Service Line, Salisbury VA Medical Center, Salisbury, North Carolina, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, USA
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem,North Carolina, USA
| | - Kayla M. Spengler
- Research & Academic Affairs Service Line, Salisbury VA Medical Center, Salisbury, North Carolina, USA
| | - Robert D. Shura
- Research & Academic Affairs Service Line, Salisbury VA Medical Center, Salisbury, North Carolina, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Katherine H. Taber
- Research & Academic Affairs Service Line, Salisbury VA Medical Center, Salisbury, North Carolina, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, USA
- Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Virginia, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
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Abstract
OBJECTIVE Performance and symptom validity tests (PVTs and SVTs) measure the credibility of the assessment results. Cognitive impairment and apathy potentially interfere with validity test performance and may thus lead to an incorrect (i.e., false-positive) classification of the patient's scores as non-credible. The study aimed at examining the false-positive rate of three validity tests in patients with cognitive impairment and apathy. METHODS A cross-sectional, comparative study was performed in 56 patients with dementia, 41 patients with mild cognitive impairment, and 41 patients with Parkinson's disease. Two PVTs - the Test of Memory Malingering (TOMM) and the Dot Counting Test (DCT) - and one SVT - the Structured Inventory of Malingered Symptomatology (SIMS) - were administered. Apathy was measured with the Apathy Evaluation Scale, and severity of cognitive impairment with the Mini Mental State Examination. RESULTS The failure rate was 13.7% for the TOMM, 23.8% for the DCT, and 12.5% for the SIMS. Of the patients with data on all three tests (n = 105), 13.5% failed one test, 2.9% failed two tests, and none failed all three. Failing the PVTs was associated with cognitive impairment, but not with apathy. Failing the SVT was related to apathy, but not to cognitive impairment. CONCLUSIONS In patients with cognitive impairment or apathy, failing one validity test is not uncommon. Validity tests are differentially sensitive to cognitive impairment and apathy. However, the rule that at least two validity tests should be failed to identify non-credibility seemed to ensure a high percentage of correct classification of credibility.
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Ilgunaite G, Giromini L, Bosi J, Viglione DJ, Zennaro A. A clinical comparison simulation study using the Inventory of Problems-29 (IOP-29) with the Center for Epidemiologic Studies Depression Scale (CES-D) in Lithuania. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:155-162. [DOI: 10.1080/23279095.2020.1725518] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Guste Ilgunaite
- Department of Psychology, Mykolas Romeris University, Vilnius, Lithuania
| | | | - Jessica Bosi
- Department of Psychology, University of Surrey, Guildford, UK
| | - Donald J. Viglione
- California School of Professional Psychology, Alliant International University, San Diego, CA, USA
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Mazza C, Orrù G, Burla F, Monaro M, Ferracuti S, Colasanti M, Roma P. Indicators to distinguish symptom accentuators from symptom producers in individuals with a diagnosed adjustment disorder: A pilot study on inconsistency subtypes using SIMS and MMPI-2-RF. PLoS One 2019; 14:e0227113. [PMID: 31887214 PMCID: PMC6936836 DOI: 10.1371/journal.pone.0227113] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/11/2019] [Indexed: 11/17/2022] Open
Abstract
In the context of legal damage evaluations, evaluees may exaggerate or simulate symptoms in an attempt to obtain greater economic compensation. To date, practitioners and researchers have focused on detecting malingering behavior as an exclusively unitary construct. However, we argue that there are two types of inconsistent behavior that speak to possible malingering-accentuating (i.e., exaggerating symptoms that are actually experienced) and simulating (i.e., fabricating symptoms entirely)-each with its own unique attributes; thus, it is necessary to distinguish between them. The aim of the present study was to identify objective indicators to differentiate symptom accentuators from symptom producers and consistent participants. We analyzed the Structured Inventory of Malingered Symptomatology scales and the Minnesota Multiphasic Personality Inventory-2 Restructured Form validity scales of 132 individuals with a diagnosed adjustment disorder with mixed anxiety and depressed mood who had undergone assessment for psychiatric/psychological damage. The results indicated that the SIMS Total Score, Neurologic Impairment and Low Intelligence scales and the MMPI-2-RF Infrequent Responses (F-r) and Response Bias (RBS) scales successfully discriminated among symptom accentuators, symptom producers, and consistent participants. Machine learning analysis was used to identify the most efficient parameter for classifying these three groups, recognizing the SIMS Total Score as the best indicator.
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Affiliation(s)
- Cristina Mazza
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Graziella Orrù
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Franco Burla
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Merylin Monaro
- Department of General Psychology, University of Padova, Padova, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Marco Colasanti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Paolo Roma
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Ecological Validity of the Inventory of Problems-29 (IOP-29): an Italian Study of Court-Ordered, Psychological Injury Evaluations Using the Structured Inventory of Malingered Symptomatology (SIMS) as Criterion Variable. PSYCHOLOGICAL INJURY & LAW 2019. [DOI: 10.1007/s12207-019-09368-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Merten T, Kaminski A, Pfeiffer W. Prevalence of overreporting on symptom validity tests in a large sample of psychosomatic rehabilitation inpatients. Clin Neuropsychol 2019; 34:1004-1024. [PMID: 31775575 DOI: 10.1080/13854046.2019.1694073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Noncredible symptom claims, regularly expected in forensic contexts, may also occur in clinical and rehabilitation referral contexts. Hidden motives and secondary gain expectations may play a significant role in clinical patients. We studied the prevalence of noncredible symptom report in patients treated for minor mental disorders in an inpatient setting.Method: Five hundred and thirty seven clinical inpatients of a psychosomatic rehabilitation center were studied (mean age: 50.2 years; native speakers of German). They were referred for treatment of depression, anxiety, somatoform disorder, adjustment disorder, and neurasthenia. Results of two symptom validity tests (Structured Inventory of Malingered Symptomatology, SIMS; Self-Report Symptom Inventory, SRSI) and the Beck Depression Inventory-II (BDI-II) were analyzed.Results: At screening level, 34.5% and 29.8% of the patients were found to presumably overreport symptoms on the SIMS and SRSI, respectively. At the standard cut score of the SRSI (maximum false positive rate: 5%), the proportion of diagnosed overreporting was 18.8%. SIMS and SRSI pseudosymptom endorsement correlated at .73. Highly elevated depressive symptom claims with BDI-II scores above 40, found in 9.3% of the patients, were associated with elevated pseudosymptom endorsement. Moreover, extended times of sick leave and higher expectations of disability pension were associated with elevated pseudosymptom endorsement.Conclusions: The prevalence of symptom overreporting in some clinical patient groups is a serious, yet underinvestigated problem. The current estimates yielded a high prevalence of distorted, noncredible symptom claims in psychosomatic rehabilitation patients. The challenges arising to health professionals working in such settings are immense and need more consideration.
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Affiliation(s)
- Thomas Merten
- Department of Neurology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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van Impelen A, Jelicic M, Otgaar H, Merckelbach H. Detecting Feigned Cognitive Impairment With Schretlen’s Malingering Scale Vocabulary and Abstraction Test. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2019. [DOI: 10.1027/1015-5759/a000438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Abstract. Schretlen’s Malingering Scale Vocabulary and Abstraction test (MSVA) differs from the majority of performance validity tests in that it focuses on the detection of feigned impairments in semantic knowledge and perceptual reasoning rather than feigned memory problems. We administered the MSVA to children ( n = 41), forensic inpatients with intellectual disability ( n = 25), forensic inpatients with psychiatric symptoms ( n = 57), and three groups of undergraduate students ( n = 30, n = 79, and n = 90, respectively), asking approximately half of each of these samples to feign impairment and the other half to respond genuinely. With cutpoints chosen so as to keep false-positive rates below 10%, detection rates of experimentally feigned cognitive impairment were high in children (90%) and inpatients with intellectual disability (100%), but low in adults without intellectual disability (46%). The rates of significantly below-chance performance were low (4%), except in children (47%) and intellectually disabled inpatients (50%). The reliability of the MSVA was excellent (Cronbach’s α = .93–.97) and the MSVA proved robust against coaching (i.e., informed attempts to evade detection while feigning). We conclude that the MSVA is not ready yet for clinical use, but that it shows sufficient promise to warrant further validation efforts.
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Affiliation(s)
- Alfons van Impelen
- Forensic Psychology Section, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Marko Jelicic
- Forensic Psychology Section, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Henry Otgaar
- Forensic Psychology Section, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Harald Merckelbach
- Forensic Psychology Section, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
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van den Berg L, de Weerd AW, Reuvekamp HF, van der Meere JJ. The burden of parenting children with frontal lobe epilepsy. Epilepsy Behav 2019; 97:269-274. [PMID: 31254848 DOI: 10.1016/j.yebeh.2019.05.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/14/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Caring for a child with a chronic illness adds stress to the typical parenting stress in healthy developing children. This stress can place a heavy burden on parents and may increase when a child displays problem behavior. In general, parenting and child's behavior problems are associated. Furthermore, externalizing (more outgoing) behavior is reported frequently in children with frontal lobe epilepsy (FLE). Therefore, in this study, we first investigated the burden of parents of children with FLE, and second, we investigated the relation between the experienced burden and reported behavioral problems. The validity of parents' reports on proxy measures as well as duration of epilepsy is taken into account. METHODS Thirty-one parents of children with FLE completed validated questionnaires about behavioral problems and burden of parenting. To examine if parents tend to be inconsistent or unusually negative, we used the two validity scales of the Behavioral Rating Inventory of Executive Function (BRIEF) (Negativity and Inconsistency). RESULTS Only parents of children with FLE who have had epilepsy for 5 years or longer report more problems on the Nijmeegse Vragenlijst voor de Opvoedingssituatie (NVOS) subscales 'Able to manage', 'Child is a burden', and 'Good Interaction' compared with the healthy controls. The subscale 'Child is a burden' significantly predicts scores in about 20% to 49% on the main scales of the Child Behavior Checklist (CBCL), the Global Executive Composite (GEC), and Behavioral Regulation Index (BRI) of the BRIEF. Only 6% of parents scored in the clinical range of the negativity scale of the BRIEF. For the inconsistency scale, this was 45%. CONCLUSION Parents of children with FLE do not report excessive parental burden. Longer duration of epilepsy might be a risk factor in experiencing burden. The findings suggest a link between parental burden and behavioral problems in children with FLE. Externalizing behavioral problems are the most marked behavioral problems, which relate to the parental burden. Parents tend to be inconsistent in their ratings.
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Affiliation(s)
- L van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands; RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands.
| | - A W de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - H F Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - J J van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands
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