1
|
Rohling ML, Binder LM, Larrabee GJ, Langhinrichsen-Rohling J. Forced choice test score of p ≤ .20 and failures on ≥ six performance validity tests results in similar Overall Test Battery Means. Clin Neuropsychol 2024; 38:1193-1209. [PMID: 38041021 DOI: 10.1080/13854046.2023.2284975] [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: 06/04/2023] [Accepted: 11/13/2023] [Indexed: 12/03/2023]
Abstract
Objective: To determine if similar levels of performance on the Overall Test Battery Mean (OTBM) occur at different forced choice test (FCT) p-value score failures. Second, to determine the OTBM levels that are associated with failures at above chance on various performance validity (PVT) tests. Method: OTBMs were computed from archival data obtained from four practices. We calculated each examinee's Estimated Premorbid Global Ability (EPGA) and OTBM. The sample size was 5,103 examinees with 282 (5.5%) of these scoring below chance at p ≤ .20 on at least one FCT. Results: The OTBM associated with a failure at p ≤ .20 was equivalent to the OTBM that was associated with failing 6 or more PVTs at above-chance cutoffs. The mean OTBMs relative to increasingly strict FCT p cutoffs were similar (T scores in the 30s). As expected, there was an inverse relationship between the number of PVTs failed and examinees' OTBMs. Conclusions: The data support the use of p ≤ .20 as the probability level for testing the significance of below chance performance on FCTs. The OTBM can be used to index the influence of invalid performance on outcomes, especially when an examinee scores below chance.
Collapse
|
2
|
Rohling ML, Demakis GJ, Langhinrichsen-Rohling J. Lowered cutoffs to reduce false positives on the Word Memory Test. J Clin Exp Neuropsychol 2024; 46:67-79. [PMID: 38362939 DOI: 10.1080/13803395.2024.2314736] [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: 09/17/2023] [Accepted: 01/11/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To adjust the decision criterion for the Word Memory Test (WMT, Green, 2003) to minimize the frequency of false positives. METHOD Archival data were combined into a database (n = 3,210) to examine the best cut score for the WMT. We compared results based on the original scoring rules and those based on adjusted scoring rules using a criterion based on 16 performance validity tests (PVTs) exclusive of the WMT. Cutoffs based on peer-reviewed publications and test manuals were used. The resulting PVT composite was considered the best estimate of validity status. We focused on a specificity of .90 with a false-positive rate of less than .10 across multiple samples. RESULTS Each examinee was administered the WMT, as well as on average 5.5 (SD = 2.5) other PVTs. Based on the original scoring rules of the WMT, 31.8% of examinees failed. Using a single failure on the criterion PVT (C-PVT), the base rate of failure was 45.9%. When requiring two or more failures on the C-PVT, the failure rate dropped to 22.8%. Applying a contingency analysis (i.e., X2) to the two failures model on the C-PVT measure and using the original rules for the WMT resulted in only 65.3% agreement. However, using our adjusted rules for the WMT, which consisted of relying on only the IR and DR WMT subtest scores with a cutoff of 77.5%, agreement between the adjusted and the C-PVT criterion equaled 80.8%, for an improvement of 12.1% identified. The adjustmeny resulted in a 49.2% reduction in false positives while preserving a sensitivity of 53.6%. The specificity for the new rules was 88.8%, for a false positive rate of 11.2%. CONCLUSIONS Results supported lowering of the cut score for correct responding from 82.5% to 77.5% correct. We also recommend discontinuing the use of the Consistency subtest score in the determination of WMT failure.
Collapse
|
3
|
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.
Collapse
Affiliation(s)
- Thomas Merten
- Department of Neurology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | | | | |
Collapse
|
4
|
Gervais RO, Ben-Porath YS, Wygant DB, Green P. Development and Validation of a Response Bias Scale (RBS) for the MMPI-2. Assessment 2016; 14:196-208. [PMID: 17504891 DOI: 10.1177/1073191106295861] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study describes the development of a Minnesota Multiphasic Personality Inventory (MMPI-2) scale designed to detect negative response bias in forensic neuropsychological or disability assessment settings. The Response Bias Scale (RBS) consists of 28 MMPI-2 items that discriminated between persons who passed or failed the Word Memory Test (WMT), Computerized Assessment of Response Bias (CARB), and/or Test of Memory Malingering (TOMM) in a sample of 1,212 nonhead-injury disability claimants. Incremental validity of the RBS was evaluated by comparing its ability to detect poor performance on four separate symptom validity tests with that of the F and FP scales and the Fake Bad Scale (FBS). The RBS consistently outperformed F, FP, and FBS. Study results suggest that the RBS may be a useful addition to existing MMPI-2 validity scales and indices in detecting symptom complaints predominantly associated with cognitive response bias and overreporting in forensic neuropsychological and disability assessment settings.
Collapse
|
5
|
Malcore SA, Schutte C, Van Dyke SA, Axelrod BN. The Development of a Reduced-Item Structured Inventory of Malingered Symptomatology (SIMS). PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9214-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Lippa SM, Pastorek NJ, Romesser J, Linck J, Sim AH, Wisdom NM, Miller BI. Ecological Validity of Performance Validity Testing. Arch Clin Neuropsychol 2014; 29:236-44. [DOI: 10.1093/arclin/acu002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Peck CP, Schroeder RW, Heinrichs RJ, VonDran EJ, Brockman CJ, Webster BK, Baade LE. Differences in MMPI-2 FBS and RBS Scores in Brain Injury, Probable Malingering, and Conversion Disorder Groups: A Preliminary Study. Clin Neuropsychol 2013; 27:693-707. [DOI: 10.1080/13854046.2013.779032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
8
|
Oh CH, Lim HK, Chung J, Yoon SH, Park HC, Park CO. The psychopathological influence of congenital heart disease in Korean male adolescents: an analysis of multiphasic personal inventory test results. Yonsei Med J 2012; 53:1107-12. [PMID: 23074109 PMCID: PMC3481384 DOI: 10.3349/ymj.2012.53.6.1107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the psychopathological influence of congenital heart disease (CHD) in Korean 19-year-old males. MATERIALS AND METHODS The authors compared the Korean military multiphasic personal inventory (KMPI) military profiles of 211 CHD cases (atrial septal defect, ventricular septal defect, patent ductus arteriosus, or combined CHD) with the KMPI profiles of 300 normal controls. The CHD group was also divided according to whether or not the subjects had undergone open cardiac surgery in order to evaluate the psychopathological effects of an operation among the subjects. RESULTS A decreased result on the faking-good response scale and an increased result on the faking-bad response were observed in the CHD group compared to the control (p<0.01). The neurosis scale results, including anxiety, depression and somatization symptoms, were markedly increased in the CHD group compared to the control (p<0.01). The severity level of personality disorder was also increased in the CHD group (p<0.001). Differences in KMPI scale scores were not related to open cardiac surgery history. CONCLUSION In this study, young males with CHD tended to report more abnormal results on the multiphasic personal inventory test in comparison to normal subjects, suggesting that CHD may be related to psychopathology in young males in Korea. Therefore, clinicians are recommended to evaluate the psychopathological traits of patients with CHD.
Collapse
Affiliation(s)
- Chang Hyun Oh
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
- Seoul Regional Military Manpower Administration, Seoul, Korea
| | - Hyun Kyoung Lim
- Department of Anesthesiology & Pain Medicine, College of Medicine, Inha University, Incheon, Korea
| | - Joonho Chung
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Seung Hwan Yoon
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Hyeong-Chun Park
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Chong Oon Park
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| |
Collapse
|
9
|
Tearnan BH, Ross SA. The development and classification accuracy of the life assessment questionnaire in the detection of pain-related malingering. BEHAVIORAL SCIENCES & THE LAW 2012; 30:516-536. [PMID: 22821624 DOI: 10.1002/bsl.2028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper describes three phases of the development and validation of the Life Assessment Questionnaire (LAQ), a multi-scale inventory for assessing potential malingering in adults reporting chronic pain. Study 1 involved scale construction and item analysis. Discriminant validity was investigated in Study 2 by comparing scores for the clinical reference group with participants instructed to simulate chronic pain. Study 3 examined the convergent validity of the LAQ with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Behavioral Assessment of Pain (BAP). Results revealed that the simulation groups scored significantly higher than the clinical reference group across all scales. Receiver operating characteristic analysis revealed sensitivity and specificity scores ranging from 0.44 to 0.57 and 0.88 to 0.93, respectively. Positive predictive power values ranged between 0.79 and 0.88. Strong convergent validity was found for the LAQ. These studies demonstrated the effectiveness of the LAQ in classifying individuals who feign pain complaints, supporting the utility of the LAQ for reaching conclusions about the presence of malingering.
Collapse
Affiliation(s)
- Blake H Tearnan
- Department of Psychology, University of Nevada, Reno, NV 89502, USA.
| | | |
Collapse
|
10
|
Stoyanov D, Machamer PK, Schaffner KF, Rivera-Hernández R. The meta-language of psychiatry as cross-disciplinary effort: in response to Zachar (2012). J Eval Clin Pract 2012; 18:710-20. [PMID: 22515373 DOI: 10.1111/j.1365-2753.2012.01846.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Henry GK, Heilbronner RL, Mittenberg W, Enders C, Stevens A, Dux M. Noncredible Performance in Individuals with External Incentives: Empirical Derivation and Cross-Validation of the Psychosocial Distress Scale (PDS). ACTA ACUST UNITED AC 2011; 18:47-53. [DOI: 10.1080/09084282.2010.523385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
12
|
Demakis GJ, Elhai JD. Neuropsychological and Psychological Aspects of Malingered Posttraumatic Stress Disorder. PSYCHOLOGICAL INJURY & LAW 2011. [DOI: 10.1007/s12207-011-9099-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Heilbronner RL, Sweet JJ, Morgan JE, Larrabee GJ, Millis SR, Conference Participants1. American Academy of Clinical Neuropsychology Consensus Conference Statement on the Neuropsychological Assessment of Effort, Response Bias, and Malingering. Clin Neuropsychol 2010; 23:1093-129. [DOI: 10.1080/13854040903155063] [Citation(s) in RCA: 552] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
14
|
Greiffenstein MF. The MMPI-2 Symptom Validity Scale (FBS) Not Influenced by Medical Impairment: A Large Sleep Center Investigation. Assessment 2010; 17:269-77. [DOI: 10.1177/1073191109358823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Symptom Validity Scale (Minnesota Multiphasic Personality Inventory—2—FBS [MMPI-2-FBS]) is a standard MMPI-2 validity scale measuring overstatement of somatic distress and subjective disability. Some critics assert the MMPI-2-FBS misclassifies too many medically impaired persons as malingering symptoms. This study tests the assertion of malingering misclassification with a large sample of 345 medical inpatients undergoing sleep studies that standardly included MMPI-2 testing. The variables included standard MMPI-2 validity scales (Lie Scale [L], Infrequency Scale [F], K-Correction [K]; FBS), objective medical data (e.g., body mass index, pulse oximetry), and polysomnographic scores (e.g., apnea/hypopnea index). The results showed the FBS had no substantial or unique association with medical/sleep variables, produced false positive rates <20% (median = 9, range = 4-11), and male inpatients showed marginally higher failure rates than females. The MMPI-2-FBS appears to have acceptable specificity, because it did not misclassify as biased responders those medical patients with sleep problems, male or female, with primary gain only (reducing sickness). Medical impairment does not appear to be a major influence on deviant MMPI-2-FBS scores.
Collapse
|
15
|
Symptom Validity Testing in Claimants with Alleged Posttraumatic Stress Disorder: Comparing the Morel Emotional Numbing Test, the Structured Inventory of Malingered Symptomatology, and the Word Memory Test. PSYCHOLOGICAL INJURY & LAW 2009. [DOI: 10.1007/s12207-009-9057-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Johnson AL, Storzbach D, Binder LM, Barkhuizen A, Kent Anger W, Salinsky MC, Tun SM, Rohlman DS. MMPI-2 profiles: fibromyalgia patients compared to epileptic and non-epileptic seizure patients. Clin Neuropsychol 2009; 24:220-34. [PMID: 19859855 DOI: 10.1080/13854040903266902] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We compared MMPI-2 profiles of Gulf War veterans with fibromyalgia (FM) to epileptic seizure (ES) patients, psychogenic non-epileptic seizure (PNES) patients, and Gulf War veteran healthy controls. Both PNES and FM are medically unexplained conditions. In previous MMPI-2 research PNES patients were shown to have significantly higher Hs and Hy clinical scales than ES patients. In the present research the FM group had significantly higher Hs and Hy scale scores than both the ES group and the healthy control group. There was no significant difference between the FM and PNES Hs scale scores; however, the FM Hy scale score was significantly lower than the PNES Hy scale score. Present findings indicate a high level of psychological distress in the FM group.
Collapse
Affiliation(s)
- Amy L Johnson
- Portland VA Medical Center, Portland, OR 97239, USA.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Rubenzer S. Posttraumatic Stress Disorder: Assessing Response Style and Malingering. PSYCHOLOGICAL INJURY & LAW 2009. [DOI: 10.1007/s12207-009-9045-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
The MMPI-2 Symptom Validity Scale (FBS) Is an Empirically Validated Measure of Overreporting in Personal Injury Litigants and Claimants: Reply to Butcher et al. (2008). PSYCHOLOGICAL INJURY & LAW 2009. [DOI: 10.1007/s12207-009-9037-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
19
|
Henry GK, Heilbronner RL, Mittenberg W, Enders C, Domboski K. Comparison of the MMPI-2 Restructured Demoralization Scale, Depression Scale, and Malingered Mood Disorder Scale in Identifying Non-credible Symptom Reporting in Personal Injury Litigants and Disability Claimants. Clin Neuropsychol 2009; 23:153-66. [DOI: 10.1080/13854040801969524] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
20
|
Demakis GJ, Gervais RO, Rohling ML. The effect of failure on cognitive and psychological symptom validity tests in litigants with symptoms of post-traumatic stress disorder. Clin Neuropsychol 2008; 22:879-95. [PMID: 18756390 DOI: 10.1080/13854040701564482] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined the influence of performance on cognitive and psychological symptom validity tests on neuropsychological and psychological test performance in claimants evaluated in a medico-legal context (N = 301) with symptoms of PTSD. A second purpose of this study was to examine the influence of the severity of PTSD symptoms on cognitive test performance after excluding patients who failed to put forth adequate best effort and who exaggerated psychiatric symptoms. Patients were administered a battery of neuropsychological measures that were aggregated into a composite measure, the Cognitive-Test Battery Mean (C-TBM). Patients were also administered a battery of psychological tests that were aggregated into another composite measure, the Psychological-Test Battery Mean (P-TBM). We found that failure on cognitive symptom validity tests was associated with significantly poorer neuropsychological functioning, but there was not a significant effect on psychological symptoms. Conversely, failure on psychological symptom validity tests was associated with higher levels of psychopathology, but there was not a significant effect on cognitive ability. Finally, once patients were screened for adequate effort and genuine symptom reporting, the severity of PTSD symptoms did not appear to influence cognitive ability. This is the first study that assessed both types of symptom validity testing in PTSD claimants, which is important given that previous literature has demonstrated cognitive impairment in PTSD and that individuals with PTSD tend to claim cognitive impairment. Implications of these findings are discussed with regard to the existing literature and the relationship between these two types of symptom validity tests.
Collapse
Affiliation(s)
- George J Demakis
- Department of Psychology, University of North Carolina at Charlotte, NC 29223-0001, USA.
| | | | | |
Collapse
|
21
|
Henry GK, Heilbronner RL, Mittenberg W, Enders C, Stanczak SR. Comparison of the Lees-Haley Fake Bad Scale, Henry-Heilbronner Index, and Restructured Clinical Scale 1 in Identifying Noncredible Symptom Reporting. Clin Neuropsychol 2008; 22:919-29. [DOI: 10.1080/13854040701625853] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
22
|
Downing SK, Denney RL, Spray BJ, Houston CM, Halfaker DA. Examining the Relationship Between the Reconstructed Scales and the Fake Bad Scale of the MMPI-2. Clin Neuropsychol 2008; 22:680-8. [DOI: 10.1080/13854040701562825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Greiffenstein MF, Baker WJ. Validity Testing in Dually Diagnosed Post-Traumatic Stress Disorder and Mild Closed Head Injury. Clin Neuropsychol 2008; 22:565-82. [PMID: 17853127 DOI: 10.1080/13854040701377810] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Prospects for the coexistence of post-traumatic stress syndrome (PTSS) and mild traumatic brain injury (mTBI) rely exclusively on subjective evidence, increasing the risk of response bias in a compensatable social context. Using a priori specificities derived from genuine brain disorder groups, we examined validity failure rates in three domains (symptom, cognitive, motor) in 799 persons reporting persistent subjective disability long after mild neurological injury. Validity tests included the Test of Memory Malingering, MMPI-2 Fake Bad Scale, and Infrequency (F) scales, reliable digit span, and Halstead-Reitan finger tapping. Analyses showed invalidity signs in large excess of actuarial expectations, with rising invalidity risk conditional on post-traumatic complexity; the highest failure rates were produced by the 95 persons reporting both neurogenic amnesia and re-experiencing symptoms. We propose an "over-endorsement continuum" hypothesis: The more complex the post-traumatic presentation after mild neurological injury, the stronger the association with response bias. Late-appearing dual diagnosis is a litigation phenomenon so intertwined with secondary gain as to be a byproduct of it.
Collapse
|
24
|
|
25
|
Henry GK, Heilbronner RL, Mittenberg W, Enders C, Roberts DM. Empirical Derivation of a New MMPI-2 Scale for Identifying Probable Malingering in Personal Injury Litigants and Disability Claimants: The 15-Item Malingered Mood Disorder Scale (MMDS). Clin Neuropsychol 2008; 22:158-68. [DOI: 10.1080/13825580601025916] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
26
|
Staudenmayer H, Phillips S. MMPI-2 validity, clinical and content scales, and the Fake Bad Scale for personal injury litigants claiming idiopathic environmental intolerance. J Psychosom Res 2007; 62:61-72. [PMID: 17188122 DOI: 10.1016/j.jpsychores.2006.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND Idiopathic environmental intolerance (IEI) is a descriptor for nonspecific complaints that are attributed to environmental exposure. METHODS The Minnesota Multiphasic Personality Inventory 2 (MMPI-2) was administered to 50 female and 20 male personal injury litigants alleging IEI. RESULTS The validity scales indicated no overreporting of psychopathology. Half of the cases had elevated scores on validity scales suggesting defensiveness, and a large number had elevations on Fake Bad Scale (FBS) suggesting overreporting of unauthenticated symptoms. The average T-score profile for females was defined by the two-point code type 3-1 (Hysteria-Hypochondriasis), and the average T-score profile for males was defined by the three-point code type 3-1-2 (Hysteria, Hypochondriasis-Depression). On the content scales, Health Concerns (HEA) scale was significantly elevated. CONCLUSION Idiopathic environmental intolerance litigants (a) are more defensive about expressing psychopathology, (b) express distress through somatization, (c) use a self-serving misrepresentation of exaggerated health concerns, and (d) may exaggerate unauthenticated symptoms suggesting malingering.
Collapse
|
27
|
Henry GK, Heilbronner RL, Mittenberg W, Enders C. The Henry-Heilbronner Index: A 15-Item Empirically Derived MMPI-2 Subscale for Identifying Probable Malingering in Personal Injury Litigants and Disability Claimants. Clin Neuropsychol 2006; 20:786-97. [PMID: 16980262 DOI: 10.1080/13854040500287749] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A new 15-item MMPI-2 subscale, the Henry-Heilbronner Index (HHI), representing a "pseudosomatic factor," was empirically derived from both the 43-item Lees-Haley Fake Bad Scale (FBS) and the 17-item Shaw and Matthews' Pseudoneurologic Scale (PNS). The HHI was superior to both the FBS and PNS in identification of symptom exaggeration in personal injury litigants and disability claimants compared to non-litigating head-injured controls. Logistic regression analyses revealed that a cutscore of > or = 8 on the HHI was associated with good specificity (89%) and sensitivity (80%). These results suggest that the HHI may be useful in identifying personal injury litigants and disability claimants who exaggerate, overreport, or malinger physical symptoms on the MMPI-2 related to their current health and/or litigation status.
Collapse
Affiliation(s)
- George K Henry
- Los Angeles Neuropsychology Group, Los Angeles, CA 90025, USA.
| | | | | | | |
Collapse
|
28
|
Nelson NW, Sweet JJ, Demakis GJ. Meta-Analysis of the MMPI-2 Fake Bad Scale: Utility in Forensic Practice. Clin Neuropsychol 2006; 20:39-58. [PMID: 16393920 DOI: 10.1080/13854040500459322] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Some clinical researchers disagree regarding the clinical utility of the MMPI-2 Fake Bad scale (FBS ) within forensic and clinical settings. The present meta-analysis summarizes weighted effect size differences among the FBS and other commonly used validity scales (L, F, K, Fb, Fp, F-K, O-S, Ds2, Dsr2 ) in symptom overreporting and comparison groups. Forty studies that included FBS were identified through exploration of online databases, perusal of published references, and communication with primary authors. Nineteen of the 40 studies met restrictive inclusion criteria, resulting in a pooled sample size of 3664 (1615 overreporting participants and 2049 comparison participants). The largest grand effect sizes were observed for FBS (.96), followed by O-S (.88), Dsr2 (.79), F-K (.69), and the F- scale (.63). Significant within-scale variability was observed for seven validity scales, including FBS (Q = 119.11, p < .001). Several subsequent FBS moderator analyses yielded moderate to large effect sizes and were statistically significant for level of cognitive effort, type of overreporting comparison group, and condition associated with overreporting (e.g., traumatic brain injury, posttraumatic stress, chronic pain). Findings suggest that the FBS performs as well as, if not superior to, other validity scales in discriminating overreporting and comparison groups; the preponderance of the present literature supports the scale's use within forensic settings.
Collapse
|
29
|
Rogers R, Payne JW. Damages and rewards: assessment of malingered disorders in compensation cases. BEHAVIORAL SCIENCES & THE LAW 2006; 24:645-58. [PMID: 17016811 DOI: 10.1002/bsl.687] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The assessment of malingering poses unique challenges to forensic practitioners in compensation cases and disability determinations. Beyond malingering itself, false claims can be presented regarding both the source of genuine symptoms and their injurious effects on work and social functioning. The article examines how contextually based psychological factors can affect clients' presentation in compensation cases. Important distinctions between different types of response style (e.g. malingering, feigning, and secondary gain) are presented. In addition, empirically validated detection strategies provide a clinical framework for the assessment of feigned disorders. With an emphasis on compensation cases and clinically relevant disorders, the effectiveness of these detection strategies is considered for specific psychological measures.
Collapse
Affiliation(s)
- Richard Rogers
- Department of Psychology, University of North Texas, P.O. Box 311280, Denton, TX 76203-1280, USA.
| | | |
Collapse
|
30
|
Etherton JL, Bianchini KJ, Ciota MA, Heinly MT, Greve KW. Pain, malingering and the WAIS-III Working Memory Index. Spine J 2006; 6:61-71. [PMID: 16413450 DOI: 10.1016/j.spinee.2005.05.382] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Revised: 05/05/2005] [Accepted: 05/25/2005] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Pain patients often report cognitive symptoms, and many will include them in their claims of disability. There is empirical evidence that patients with pain do experience problems on attention-demanding cognitive tasks, but the results are mixed and the potential impact of exaggeration in the context of pain-related litigation has not been addressed. PURPOSE 1) Examine the impact of pain and malingering on attention; 2) determine if the Working Memory Index (WMI) of the Wechsler Adult Intelligence Scale-3 (WAIS-III) can reliably detect malingering. STUDY DESIGN/SETTING Study 1: simulator design; Study 2: clinical known-groups design. PATIENT SAMPLE Study 1 used healthy college students; Study 2 used chronic pain patients and neurological patients. OUTCOME MEASURES The WMI and its constituent subtests. METHODS Study 1: College students were administered the WMI under three conditions: standard administration, with cold-pressor induced pain, or with instructions to simulate impairment due to pain. Study 2: Known-groups design in which the WMI was examined in non-malingering and definite malingering chronic pain patients, non-malingering moderate-severe traumatic brain injury, and memory disorder patients seen for routine psychological evaluation. Malingering was operationalized using published criteria. RESULTS There were no group differences in WMI or its subtests among non-malingering groups, but some individual clinical patients with pain did score at a level suggestive of attentional impairment. The lowest scores were found in the simulated malingering college students and definite malingering clinical pain groups, in which about half scored worse than 95% of the non-malingering clinical patients. CONCLUSIONS This study demonstrated that even when controlling for exaggeration some pain patients do exhibit problems with attentional function. However, significant impairment in WMI performance (eg, index score<or=70), particularly in the absence of brain dysfunction, cannot reasonably be attributed to the effects of either acute or chronic pain, even at moderate to severe levels, and likely reflects intentional exaggeration.
Collapse
Affiliation(s)
- Joseph L Etherton
- Department of Psychology, Loyola University, 6363 St. Charles Avenue, New Orleans, Louisiana 70118, USA
| | | | | | | | | |
Collapse
|