Malingering

An untested assumption of malingering research is that persons who feign mental illness will not attempt to fake a particular disorder, but will be content to fabricate non-specific and possibly global psychiatric impairment. We tested the effectiveness of the Structured Interview of Reported Symptoms (SIRS) to detect feigning of three diagnostic groupings: schizophrenia, mood disorders, and PTSD on 45 psychologically knowledgeable correctional residents. We found that the SIRS maintained its powers of discrimination with respect to clinical samples. Similar research on faking specific disorders is needed on the MMPI-2 and other psychological measures.

A simulation design was used to test the validity of the SIRS as a structured interview for the assessment of malingering. A correctional sample (25 simulators and 26 controls) was compared to previous validation research (Rogers et al., 1989) which had employed clinical and community samples. Results indicated that six of the 13 SIRS scales, as well as overall item endorsement, differed consistently between honest and simulating malingering conditions across correctional, clinical, and community settings. In addition, the suggestion that sociopaths may be more effective malingerers was not supported by the SIRS data.

The aims of the current study were to: (a) examine the predictive validity and efficacy of the Advanced Clinical Solutions Word Choice Test (WCT) as a measure of effort relative to the Test of Memory Malingering (TOMM); (b) investigate whether performing a dual (distraction) task would undermine performance on either test; (c) assess the effect of coaching on the diagnostic accuracy of both the WCT and the TOMM; and (d) establish an optimal cut score for the WCT. The current study used a simulation design based on an analogue design in which normal participants were instructed to either apply full effort or simulate a brain injury on the tasks without being detected. Participants included 93 undergraduate university students who were randomly assigned to 1 of 4 conditions: (a) distraction, (b) uncoached traumatic brain injury (TBI) simulators, (c) coached TBI simulators, or (d) full effort. The results demonstrated that the WCT and the TOMM were effective in detecting simulated cognitive impairment. Both tests were resistant to the effects of distraction and were equally effective in detecting coached and uncoached simulators. A cut score of 42 on the WCT was found to provide optimal specificity and sensitivity on the test.

It has recently been found that during recognition memory tests participants’ pupils dilate more when they view old items compared to novel items. This thesis sought to replicate this novel ‘‘Pupil Old/New Effect’’ (PONE) and to determine its relationship to implicit and explicit mnemonic processes, the veracity of participants’ responses, and the analogous Event-Related Potential (ERP) old/new effect. Across 9 experiments, pupil-size was measured with a video-based eye-tracker during a variety of recognition tasks, and, in the case of Experiment 8, with concurrent Electroencephalography (EEG).

The main findings of this thesis are that:
- the PONE occurs in a standard explicit test of recognition memory but not in “implicit” tests of either perceptual fluency or artificial grammar learning;
- the PONE is present even when participants are asked to give false behavioural answers in a malingering task, or are asked not to respond at all;
- the PONE is present when attention is divided both at learning and during recognition;
- the PONE is accompanied by a posterior ERP old/new effect;
- the PONE does not occur when participants are asked to read previously encountered words without making a recognition decision;
- the PONE does not occur if participants preload an “old/new” response;
- the PONE is not enhanced by repetition during learning.

These findings are discussed in the context of current models of recognition memory and other psychophysiological indices of mnemonic processes. It is argued that together these findings suggest that the increase in pupil-size which occurs when participants encounter previously studied items is not under conscious control and may reflect primarily recollective processes associated with recognition memory.

In 1889, The British Medical Journal published a piece titled, “Detective Medicine,” which describes feats of medical detection performed by physicians attending malingering prisoners. Though simulating illness had a long history, the medicalization of malingering at the fin de siècle led to a proliferation of such case histories and cheerful records of pathological feigners thwarted.

The Structured Interview of Reported Symptoms (SIRS) was constructed to assess specific strategies identified in the clinical literature for the evaluation of malingering. Two studies were conducted to evaluate the discriminant and concurrent validity of the SIRS. Study 1, with a simulation design, compared 40 simulators with 34 outpatient and 41 community controls using the SIRS, Minnesota Multiphasic Personality Inventory (MMPI), and M test. Test results established (a) a high level of discriminability between simulators and controls, and (b) general support for hypothesized relationships of SIRS with MMPI validity indicators and M Test scales. Study 2, with a known-groups comparison design, compared 25 suspected malingerers with 26 psychiatric inpa-tients from the same assessment unit. Nine of the 13 SIRS scales effectively discriminated between the two groups in the expected direction with excellent interrater reliability. In general, suspected malingerers in Study 2 endorsed similar response patterns as simulators in Study 1.

The MMPI and more recently the MMPI.2 have been held to be the clinical standard for assessing both fake-good and fake-bad response styles. In a contrasted.groups design. we compared simulators under fake-good (n. 67) and fake-bad (n-58) instructions to controls (n = 00) and psychiatric patients (n = 95) under standard instructions. For fake-good profiles, we found that F-K <-12 had a hit rate of 80.6% and was partly supported by earlier research (Austin, 1992). For fake-bad profiles, F> 89 and F-K > 7 were the optimum cutting scores with hit rates of 86.2% and 87.0%. respectively. Unfortunately, previous research fails to confirm these cutting scores and leading proponents of the MMPI-2 substantially disagree on what methods to employ. Therefore, we recommend in cases of suspected malingering that the MMPI-2 be used only for screening purposes.

A personal account of the experiences of a clinical psychologist who worked in the psychology and psychiatry departments at 1 Military Hospital, Voortrekkerhoogte in 1986 and 1987. He describes the structure of the service and some of the characters who were staff. There are also descriptions of some of the patients who were assessed and treated but from an anecdotal rather than clinical perspective. Complications of a medical service working within a military environment are described, as well as after-hours socialising in the SAMS Officers club, of young medical personnel, many of whom were national servicemen.

This is part of a series of books of personal accounts of South African Servicemen from 1966 – 1998.  The more established books in the series are `Pro Patria’ originally published in 1995, and `Grensvegter?: South African Army Psychologist’ published in 1996 – both republished via Amazon Kindle Direct Publishing in 2021.  The originals of `Pro Patria’ and `Grensvegter?’ have been cited in several articles by Gary Baines, Professor of History at Rhodes University, Grahamstown, South Africa.

Compared with other psychiatric disorders, diagnosis of factitious disorders is rare, with identification largely dependent on the systematic collection of relevant information, including a detailed chronology and scrutiny of the patient&#39;s medical record. Management of such disorders ideally requires a team-based approach and close involvement of the primary care doctor. As deception is a key defining component of factitious disorders, diagnosis has important implications for young children, particularly when identified in women and health-care workers. Malingering is considered to be rare in clinical practice, whereas simulation of symptoms, motivated by financial rewards, is regarded as more common in medicolegal settings. Although psychometric investigations (eg, symptom validity testing) can inform the detection of illness deception, such tests need support from converging evidence sources, including detailed interview assessments, medical notes, and relevant non-medical inv...

The objective of this study was to examine the relative effectiveness of the Minnesota Multiphasic Personality Inventory–2 (MMPI–2) and the Personality Assessment Inventory (PAI) validity scales and indexes to detect malingering. Research participants were either informed (coached) or not informed (uncoached) about the presence and operating characteristics of the validity scales and instructed to fake bad on both

This study was conducted to determine neuropsychological performance across different types of forensic cases. Participants (n = 160) ages 18-71 were collected from an archived database and are represented by four forensic domains: personal injury (n = 36), Social Security disability (n = 43), worker’s compensation (n = 37), and death penalty (n = 44). Ethnicities represented were Caucasian (n = 91), African American (n = 15), and Hispanic (n = 54). Analyses involved a between-subjects design where ANOVAS and MANOVAS of neuropsychological assessments and domains included data from 12 analyses. Differences for death penalty were seen on measures of intelligence, verbal ability, memory, executive functioning, and motor skills, (p < .017) and for Hispanics on measures of academic ability, verbal fluency, and attention (p < .05). Personal injury performed significantly better on measures of intelligence, verbal ability, verbal learning, memory, and executive function. The present findings support and extend prior literature.

We examined the utility of the validity scales on the recently released Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI-2 RF; Ben-Porath & Tellegen, 2008) to detect overreported psychopathology. This set of validity scales includes a newly developed scale and revised versions of the original MMPI-2 validity scales. We used an analogue, experimental simulation in which MMPI-2 RF responses (derived from archived MMPI-2 protocols) of undergraduate students instructed to overreport psychopathology (in either a coached or noncoached condition) were compared with those of psychiatric inpatients who completed the MMPI-2 under standardized instructions. The MMPI-2 RF validity scale Infrequent Psychopathology Responses best differentiated the simulation groups from the sample of patients, regardless of experimental condition. No other validity scale added consistent incremental predictive utility to Infrequent Psychopathology Responses in distinguishing the simulation groups from the sample of patients. Classification accuracy statistics confirmed the recommended cut scores in the MMPI-2 RF manual (Ben-Porath & Tellegen, 2008).