Presenting the consequences of feigning: Does it diminish symptom overendorsement? An analog study

Feigning causes personal and societal consequences, in both civil and criminal context. We investigated whether presenting the consequences of feigning can diminish symptom endorsement in feigned Posttraumatic Stress Disorder (PTSD). We randomly allocated non-native English speaking undergraduates (N = 145) to five conditions: 1) Truth tellers (n = 31), 2) Civil context feigners (n = 27), 3) Civil context warned feigners (n = 26), 4) Criminal context feigners (n = 29), and 5) Criminal context warned feigners (n = 32). All feigning groups received a vignette depicting a situation in which claiming PTSD would be beneficial. One vignette referred to the personal injury claim, whereas the second was about the aggravated assault charges. Additionally, one feigning group from each setting received information about the consequences of feigning (i.e., warned feigners). After receiving the instructions, all participants were administered the Self-Report Symptom Inventory (SRSI), a measure of symptom endorsement. Truth tellers endorsed fewer symptoms than all feigning groups, which mostly did not differ. Yet, criminal warned feigners (59%) were significantly less frequently detected on the SRSI as overreporters than other feigning groups (86.2%-89%). Hence, emphasizing the negative consequences of overreporting may diminish symptom endorsement, but only in high-stake situations. The implications and limitations (e.g., online measure administration) of this work are discussed.

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

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.

How Plausible Is the Implausible? Students’ Plausibility and Prevalence Ratings of the Self-Report Symptom Inventory

Some 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.

Consistency does not aid detection of feigned symptoms, overreporting does: Two explorative studies on symptom stability among truth tellers and feigners

Practitioners always want to exclude the possibility that a patient is feigning symptoms. Some experts have suggested that an inconsistent symptom presentation across time (i.e., intraindividual variability) is indicative of feigning. We investigated how individuals with genuine pain-related symptoms (truth tellers; Study 1 n = 32; Study 2 n = 48) and people feigning such complaints (feigners; Study 1 n = 32; Study 2 n = 28) rated the intensity of their symptoms across a 5-day period. In both studies, feigners reported on all 5 days significantly higher symptom intensities than people with genuine complaints, but the two groups did not differ with regard to symptom (in)consistency. Thus, persistently inflated, rather than inconsistent, reports of symptom intensity over time are suggestive of feigning. The implications and limitations of our work are discussed.

Verifiability and Symptom Endorsement in Genuine, Exaggerated, and Malingered Pain

The current study has investigated whether pure malingering, in which reported symptoms are nonexistent, partial malingering, in which existent symptoms are exaggerated, and genuine symptoms could be differentiated by applying the verifiability approach (VA) and the Self-Report Symptom Inventory (SRSI). The logic behind the VA is that deceivers’ statements contain more non-verifiable information, whereas truth tellers’ accounts include more verifiable details. The SRSI taps into over-reporting by including a mix of genuine symptoms and implausible complaints (pseudosymptoms). We checked if participants (N = 167) allocated to one of three conditions (pure malingerers vs. exaggerators vs. truth tellers) can be differentiated in their pain symptom reports’ (non)verifiability and symptom endorsement. Findings revealed that deceptive reports were lengthier than truthful statements. However, this difference was not produced by a discrepancy in non-verifiable details, but rather by a higher production of verifiable information among malingerers and exaggerators. Thus, contrary to previous findings, our results indicate that pain reports rich in verifiable information should raise doubt about their veracity. Further, truth tellers endorsed less symptoms of the SRSI than exaggerators, but not than pure malingerers. Pure malingerers and exaggerators did not differ in symptom endorsement. Thus, our findings revealed that when compared with truth tellers, exaggerators exhibited stronger over-reporting tendencies than (pure) malingerers. However, due to inconsistent findings, further investigation of the efficacy of these methods in differentiation between exaggerated and malingered reports is required.