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Shura RD, Ingram PB, Miskey HM, Martindale SL, Rowland JA, Armistead-Jehle P. Validation of the personality assessment inventory (PAI) cognitive bias (CBS) and cognitive bias scale of scales (CB-SOS) in a post-deployment veteran sample. Clin Neuropsychol 2023; 37:1548-1565. [PMID: 36271822 DOI: 10.1080/13854046.2022.2131630] [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: 06/08/2022] [Accepted: 09/27/2022] [Indexed: 11/03/2022]
Abstract
Objective: The present study evaluated the function of four cognitive, symptom validity scales on the Personality Assessment Inventory (PAI), the Cognitive Bias Scale (CBS) and the Cognitive Bias Scale of Scales (CB-SOS) 1, 2, and 3 in a sample of Veterans who volunteered for a study of neurocognitive functioning. Method: 371 Veterans (88.1% male, 66.1% White) completed a battery including the Miller Forensic Assessment of Symptoms Test (M-FAST), the Word Memory Test (WMT), and the PAI. Independent samples t-tests compared mean differences on cognitive bias scales between valid and invalid groups on the M-FAST and WMT. Area under the curve (AUC), sensitivity, specificity, and hit rate across various scale point-estimates were used to evaluate classification accuracy of the CBS and CB-SOS scales. Results: Group differences were significant with moderate effect sizes for all cognitive bias scales between the WMT-classified groups (d = .52-.55), and large effect sizes between the M-FAST-classified groups (d = 1.27-1.45). AUC effect sizes were moderate across the WMT-classified groups (.650-.676) and large across M-FAST-classified groups (.816-.854). When specificity was set to .90, sensitivity was higher for M-FAST and the CBS performed the best (sensitivity = .42). Conclusion: The CBS and CB-SOS scales seem to better detect symptom invalidity than performance invalidity in Veterans using cutoff scores similar to those found in prior studies with non-Veterans.
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Affiliation(s)
- Robert D Shura
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- VA Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Paul B Ingram
- Texas Tech University, Lubbock, TX, USA
- Dwight D. Eisenhower Veteran Affairs Medical Center, Eastern Kansas Veteran Healthcare System, Leavenworth, KS, USA
| | - Holly M Miskey
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- VA Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarah L Martindale
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- VA Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jared A Rowland
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- VA Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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Monaro M, Bertomeu CB, Zecchinato F, Fietta V, Sartori G, De Rosario Martínez H. The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies. Int J Legal Med 2021; 135:2017-2032. [PMID: 33829284 PMCID: PMC8354940 DOI: 10.1007/s00414-021-02589-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs. METHODS We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020. RESULTS Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed. CONCLUSIONS Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.
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Affiliation(s)
- Merylin Monaro
- Department of General Psychology, Università degli Studi di Padova, via Venezia 8, 35131, Padova, Italy.
| | - Chema Baydal Bertomeu
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Ed. 9C. Camino de Vera s/n, 46022, Valencia, Spain
| | - Francesca Zecchinato
- Department of General Psychology, Università degli Studi di Padova, via Venezia 8, 35131, Padova, Italy
| | - Valentina Fietta
- Department of General Psychology, Università degli Studi di Padova, via Venezia 8, 35131, Padova, Italy
| | - Giuseppe Sartori
- Department of General Psychology, Università degli Studi di Padova, via Venezia 8, 35131, Padova, Italy
| | - Helios De Rosario Martínez
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Ed. 9C. Camino de Vera s/n, 46022, Valencia, Spain
- CIBER de Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Zaragoza, Spain
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Sherman EMS, Slick DJ, Iverson GL. Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria. Arch Clin Neuropsychol 2020; 35:735-764. [PMID: 32377667 PMCID: PMC7452950 DOI: 10.1093/arclin/acaa019] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/12/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Empirically informed neuropsychological opinion is critical for determining whether cognitive deficits and symptoms are legitimate, particularly in settings where there are significant external incentives for successful malingering. The Slick, Sherman, and Iversion (1999) criteria for malingered neurocognitive dysfunction (MND) are considered a major milestone in the field's operationalization of neurocognitive malingering and have strongly influenced the development of malingering detection methods, including serving as the criterion of malingering in the validation of several performance validity tests (PVTs) and symptom validity tests (SVTs) (Slick, D.J., Sherman, E.M.S., & Iverson, G. L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13(4), 545-561). However, the MND criteria are long overdue for revision to address advances in malingering research and to address limitations identified by experts in the field. METHOD The MND criteria were critically reviewed, updated with reference to research on malingering, and expanded to address other forms of malingering pertinent to neuropsychological evaluation such as exaggeration of self-reported somatic and psychiatric symptoms. RESULTS The new proposed criteria simplify diagnostic categories, expand and clarify external incentives, more clearly define the role of compelling inconsistencies, address issues concerning PVTs and SVTs (i.e., number administered, false positives, and redundancy), better define the role of SVTs and of marked discrepancies indicative of malingering, and most importantly, clearly define exclusionary criteria based on the last two decades of research on malingering in neuropsychology. Lastly, the new criteria provide specifiers to better describe clinical presentations for use in neuropsychological assessment. CONCLUSIONS The proposed multidimensional malingering criteria that define cognitive, somatic, and psychiatric malingering for use in neuropsychological assessment are presented.
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Affiliation(s)
| | | | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Spaulding Rehabilitation Hospital and Spaulding Research Institute, Charlestown, MA, USA
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
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Gaasedelen OJ, Whiteside DM, Altmaier E, Welch C, Basso MR. The construction and the initial validation of the Cognitive Bias Scale for the Personality Assessment Inventory. Clin Neuropsychol 2019; 33:1467-1484. [DOI: 10.1080/13854046.2019.1612947] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Owen J. Gaasedelen
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, USA
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - Douglas M. Whiteside
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Elizabeth Altmaier
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, USA
| | - Catherine Welch
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, USA
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Young G. PTSD in Court III: Malingering, assessment, and the law. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 52:81-102. [PMID: 28366496 DOI: 10.1016/j.ijlp.2017.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/02/2017] [Indexed: 06/07/2023]
Abstract
This journal's third article on PTSD in Court focuses especially on the topic's "court" component. It first considers the topic of malingering, including in terms of its definition, certainties, and uncertainties. As with other areas of the study of psychological injury and law, generally, and PTSD (posttraumatic stress disorder), specifically, malingering is a contentious area not only definitionally but also empirically, in terms of establishing its base rate in the index populations assessed in the field. Both current research and re-analysis of past research indicates that the malingering prevalence rate at issue is more like 15±15% as opposed to 40±10%. As for psychological tests used to assess PTSD, some of the better ones include the TSI-2 (Trauma Symptom Inventory, Second Edition; Briere, 2011), the MMPI-2-RF (Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form; Ben-Porath & Tellegen, 2008/2011), and the CAPS-5 (The Clinician-Administered PTSD Scale for DSM-5; Weathers, Blake, Schnurr, Kaloupek, Marx, & Keane, 2013b). Assessors need to know their own possible biases, the applicable laws (e.g., the Daubert trilogy), and how to write court-admissible reports. Overall conclusions reflect a moderate approach that navigates the territory between the extreme plaintiff or defense allegiances one frequently encounters in this area of forensic practice.
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Young G. Towards Balanced VA and SSA Policies in Psychological Injury Disability Assessment. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9230-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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