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Malingering Research Update -- Part 2

Kenneth S. Pope, Ph.D., ABPP

Minnesota Multiphasic Personality Inventory - 2 (MMPI-2)

"Accuracy of Megargee's Criminal Offender Infrequency (FC) Scale in detecting malingering among forensic examinees" by M. D. Gassen, C. A. Pietz,B. J. Spray, & R. L. Denney. Criminal Justice & Behavior, April 2007, vol. 34, #4, pages 493-504.

Summary: "E. I. Megargee (2004) developed a Minnesota Multiphasic Personality Inventory (MMPI-2) Infrequency scale for use in criminal settings called the Criminal Offender Infrequency (Fc) scale. This study compared Fc with 7 other MMPI-2 validity scales in detecting malingering by obtaining archival data from evaluations of male inmates that used the MMPI-2 and the Structured Interview of Reported Symptoms (SIRS). Participants were placed into groups based on the SIRS results: feigning, honest, or indeterminate. Prediction accuracy analyses were conducted for the MMPI-2 scales in differentiating honest from feigning participants. A cutoff of Fc > 14 produced the highest hit rate of any cutoff on all of the scales examined. Results from this study suggest Fc may be a useful addition to the MMPI-2 for detecting malingering in criminal settings."

"Association between the MMPI-2 restructured form (MMPI-2-RF) and malingered neurocognitive dysfunction among non-head injury disability claimants." Tarescavage, A. M., et al. (2013). Clin Neuropsychol 27(2): 313-335.

Summary: "The MMPI-2-RF's Validity Scales classification accuracy of Malingered Neurocognitive Dysfunction improved when multiple scales were interpreted. Additionally, higher scores on MMPI-2-RF substantive scales measuring distress, internalizing dysfunction, thought dysfunction, and social avoidance were associated with probable and definite Malingered Neurocognitive Dysfunction."

"Association of the MMPI-2 restructured form (MMPI-2-RF) validity scales with structured malingering criteria" by Wygant, D. B., J. L. Anderson, et al. Psychological Injury and Law, 2011, 4(1), pages 13-23.

Summary: “The current study examined the validity scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath and Tellegen 2008) in relation to the structured malingering criteria developed to assess malingered neurocognitive dysfunction and pain-related disability. These criteria examined a sample of 251 individuals undergoing compensation-seeking evaluations, who completed a battery of response bias measures. The MMPI-2-RF over-reporting scales yielded large effect sizes in contrasting those in the probable/definite malingering groups from the incentive only groups. The largest effects were found for the Infrequent Responses and Gervais et al.....Response Bias Scale, an experimental scale that can be scored on the MMPI-2-RF. Classification analyses were also utilized to examine various cut scores for the individual validity scales, as well as their use in combination. These results suggest that the MMPI-2-RF validity scales can be used to screen for malingering, as they exhibited good sensitivity at lower cutoffs.”

"Comparing the Sensitivity of the MMPI-2 Clinical Scales and the MMPI-RC Scales to Clients Rated as Psychotic, Borderline or Neurotic on the Psychodiagnostic Chart" by Robert M. Gordon, Ronald W. Stoffey, & Bethany L. Perkins. Psychology, 2013, vol. 4, #9, pages 12-16.

Summary: "The results over-all showed support that most of the MMPI-2 scales have more clinical sensitivity than the RC scales at all levels of psychopathology and particularly at the less pathological levels. K correction does not account for the elevation differences. Most of the RC scales add little to no incremental validity to the MMPI-2 Clinical scales except for RC 1, RC 2, and RC 9 and these may be used as supplemental scales."

"A comparison of selected MMPI-2 and MMPI-2-RF validity scales in assessing effort on cognitive tests in a military sample" by Jones, A. and M. V. Ingram. The Clinical Neuropsychologist, 2011, 25(7), pages1207-1227.

Summary: “Using a relatively new statistical paradigm, Optimal Data Analysis (ODA; Yarnold & Soltysik, 2005), this research demonstrated that newly developed scales for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and MMPI-2 Restructured Form (MMPI-2-RF) specifically designed to assess over-reporting of cognitive and/or somatic symptoms were more effective than the MMPI-2 F-family of scales in predicting effort status on tests of cognitive functioning in a sample of 288 military members.”

"Comparison of MMPI-2 validity scale scores of personal injury litigants and disability claimants" by Tsushima, W. T., O. Geling, et al. The Clinical Neuropsychologist, 2011, 25(8), pages 1403-1414.

Summary: “Five validity scales derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Infrequency Scale (F), Infrequency-Psychopathology Scale (F[p]), Symptom Validity Scale (FBS), Henry-Heilbronner Index (HHI), and Response Bias Scale (RBS) were evaluated in 118 litigation patients (LPs) and 163 clinical patients (CPs). Varied statistical methods, including hierarchical logistic regression analyses, Receiver Operating Characteristic (ROC) curve, Area Under the Curve (AUC) values, and sensitivity/specificity analyses, showed that RBS performed better than the other four scales in identifying LPs. The regression analyses found RBS to be the most significant predictor of LP and CP group membership.... The effectiveness of RBS in identifying LPs, all of whom reported neuropsychological symptoms, was attributed to its development based on cognitive effort test scores.”

"Comparison of the PAI and MMPI-2 as predictors of faking bad" by Dorothy Blanchard, Robert McGrath, D. Pogge, & A. Khadivi. Journal of Personality Assessment, 2003, pages 197-205.

Summary: Using archival MMPI-2 and PAI records of psychiatric inpatients as a reference sample, this study asked 2 groups of college students to complete the MMPI-2 and PAI by feigning serious mental illness so that they would either (group 1) convince a jury that they should be judged "not guilty by reason of insanity" or (group 2) convince a mental health professional that they should be hospitalized. A linear combination of the MMPI-2 indicators slightly more effective than the PAI in identifying those faking their responses.

"A comparative analysis of MMPI-2 malingering detection models among inmates" by Steffan, J. S., R. D. Morgan, et al. Assessment, 2010, 17(2), pages 185-196.

Summary: “There are several strategies, or models, for combining the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity indicators to detect malingered psychiatric symptoms. Some scholars have recommended that an elevated F (Infrequency) score should be followed by the inspection of Fp (Infrequency–Psychopathology), whereas a recent meta-analysis indicated that Fp and Ds (Gough’s Dissimulation Scale) should be examined. For correctional settings, one model of malingering suggests that F, Fp, and F - K (Gough’s Dissimulation Index) should be inspected for one or more elevated scores.... Results from classification and logistic regression analyses supported the sequential use of F and Fp in malingering detection.”

"Construct validity of the Lees-Haley Fake Bad Scale:Does this scale measure somatic malingering and feigned emotional distress?" by James N. Butcher, Paul A. Arbisib, Mera M. Atlisa, and John L. McNultyc. Archives of Clinical Neuropsychology, July, 2003, pages 473-485.

Summary: Study of "Personal Injury Litigants" who were being assessed with the Fake Bad Scale (FBS) and other measures during actual ongoing forensic evaluations. In addition to the "personal injury litigants," there were 5 comparison groups used to gather additional psychometric date: Correctional Facility (N=2897), Chronic Pain Program (N=4,408), Psychiatric Inpatient (N=6,731), General Medical (N=5,080), and Veteran's Administration Hospital Inpatient (N=901). Study concludes: " The results indicate that the FBS is more likely to measure general maladjustment and somatic complaints rather than malingering. The rate of false positives produced by the scale is unacceptably high, especially in psychiatric settings. The scale is likely to classify an unacceptably large number of individuals who are experiencing genuine psychological distress as malingerers. It is recommended that the FBS not be used in clinical settings nor should it be used during disability evaluations to determine malingering." Study notes: "This scale also shows a bias toward classifying women as malingerers. . . . The use of the term bias in the context of MMPI-2 based prediction indicates that the predictor scale systematically under- or over-predicts criterion in a particular group and/or the association between the predictor scale and criterion variable significantly differs between two groups. . . . With respect to the FBS, there are substantially more women then men designated as malingerers at a particular cutoff score for all of the clinical groups examined. . . . Simply increasing the cutoff scores for women does not alter the differential predictive validity of the scale or the strength of association between the scale and malingering. Consequently, the issue of gender bias associated with the FBS warrants further study and, until the issue is resolved, use of the FBS with women should be avoided."

"Detection of malingered ADHD using the MMPI-2-RF" by Harp, J. P., L. J. Jasinski, et al. Psychological Injury and Law, 2011, 4(1), pages 32-43.

Summary: “This study examined the utility of the Minnesota Multiphasic Personality Inventory—2 Restructured Form (MMPI-2-RF) validity scales for detecting feigning and exaggeration of attention-deficit/hyperactive disorder (ADHD) among college students. Under a simulation study design, participants with and without ADHD were assigned to perform honestly or to feign or exaggerate deficits related to ADHD while completing self-report symptom inventories. Participants instructed to feign produced symptom profiles similar to honest clinical profiles and more severe than honest nonclinical profiles. Participants with ADHD instructed to exaggerate produced less severe profiles than those instructed to feign and more severe profiles than clinical controls. MMPI-2-RF scale Fp-r showed potential for use in malingered ADHD detection at a revised cut score, which was significantly lower than the cut score suggested in the test manual; use of the revised cut score will require further validation. Scales F-r, Fs, and FBS-r did not classify well, but should be assessed in future studies of malingered ADHD. Detection of exaggeration was consistently poorer than detection of feigning.”

"Detection of overreported psychopathology with the MMPI-2 RF form validity scales" by Sellbom, M. and R. M. Bagby. Psychological Assessment, 2010, 22(4), pages 757-767.

Summary: “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).”

"Detecting Incomplete Effort on the MMPI-2: An Examination of the Fake-Bad Scale in Mild Head Injury" by S.R. Ross, S.R. Millis, R.A. Krukowski, S.H. Putnam, and K.M. Adams. Journal of Clinical & Experimental Neuropsychology, 2004, vol. 26, #1.

Summary: "The current study is an investigation of the MMPI-2 Fake Bad Scale (FBS) in the detection of incomplete effort in mild head injury (MHI). Using ROC curve analysis, we found that a cutoff score of 21 had a sensitivity of 90% and specificity of 90%, providing an overall correct classificatory rate of 90%. . . . we found that a cutoff score only slightly higher than that originally reported by Lees-Haley et al. (1991) resulted in maximum sensitivity and specificity for this scale."

"Detection of feigned head injury symptoms on the MMPI-2 in head injured patients and community controls" by Chantel Dearth, David Berry, Chad Vickery, Victoria Vagnini, Raymond Baser, Stephen Orey, & Dona Cragar. Archives of Clinical Neuropsychology, January, 2005, vol. 20, #1, pages 95-110.

Summary: In this study, " MMPI-2 results from 39 moderately to severely head injured (HI) and 44 community volunteer (CV) participants given instructions to feign symptoms or answer honestly during an analog forensic neuropsychological examination were compared. No significant effects for HI or the interaction between the HI and instruction set (IS) factors were noted on either clinical or selected validity scales (F, Fb, F(p), Ds2, FBS). However, the main effect of IS was significant for both clinical and validity scales (median Cohen's d = 1.34 and 1.39, respectively). Most validity scales were characterized by perfect specificity rates but low to modest sensitivity, whereas FBS had both moderate sensitivity and specificity. Logistic regressions showed that the F and Ds2 scales made a significant contribution independent of motivational tests to the identification of feigning during neuropsychological examination."

"Detection of feigned mental disorders: A meta-analysis of the MMPI-2 & malingering" by Richard Rogers, Kenneth Sewell, Mary Martin, & Michael Vitacco. Assessment, June, 2003, pages 160-177.

Summary: The authors conducted a meta-analysis of 65 feigning studies and 11 diagnostic studies using the MMPI-2. "For the rare-symptoms strategy, Fp (Cohen's d = 2.02) appears especially effective across diagnostic groups; its cut scores evidence greater consistency than most validity indicators. The data supported the F as an effective scale but questioned the routine use of Fb. Among the specialized scales, Ds appeared especially useful because of its sophisticated strategy, consistent cut score, and minimal false-positives." The authors provide guidelines for using MMPI-2 validity scales with various diagnostic groups.

"Detection of feigned uncoached and coached posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims" by Alison Bury & Michael Bagby. Psychological Assessment, December, 2002, pages 472-484.

Summary: Participants first took the MMPI-2 under standard conditions and then took it a second time, trying to fake posttraumatic stress disorder (PTSD). They were divided into one of 4 groups for the malingering condition: (1) without any coaching, (2) coached with info about PTSD symptoms, (3) coached with information about the MMPI-2 validity scales, and (4) coached with information about PTSD symptoms and the MMPI-2 validity scales. The participant's protocols were compared with protocols from claimants suffering from PTSD following a workplace accident. "Participants given information about the validity scales were the most successful in avoiding detection as faking. The family of F scales (i.e., F, F-sub(B), F-sub(p)), particularly F-sub(p), produced consistently high rates of positive and negative predictive power."

"Detection of Malingering Using Atypical Performance Patterns on Standard Neuropsychological Tests" by Glenn Larrabee. Clinical Neuropsychologist, August, 2003, vol. 17, #3, pages 410-425.

Summary: "Cut-off scores defining clinically atypical patterns of performance were identified for five standard neuropsychological and psychological tests: Benton Visual Form Discrimination (VFD), Fingertapping (FT), WAIS-R Reliable Digit Span (RDS), Wisconsin Card Sorting Failure-to-Maintain Set (FMS), and the Lees-Haley Fake Bad Scale (FBS) from the MMPI-2. . . . Combining the derivation and cross-validation samples yielded a sensitivity of 87.8%, specificity of 94.4%, and combined hit rate of 91.6%." In closing the discussion section, the author emphasizes that "assessment of effort in medicolegal settings must be multivariate. . . . As shown in the present investigation, requiring multiple indicators of poor effort lowers the chances of false positive identification errors in the assessment of malingering."

"Detection of Symptom Exaggeration with the MMPI-2 in Litigants with Malingered Neurocognitive Dysfunction" by Glenn Larrabee. Clinical Neuropsychologist, February, 2003, vol. 17, #1, pages 54-68.

Summary: "MMPI-2 scores of 26 persons identified as meeting criteria for definite malingered neurocognitive deficit (MND), were contrasted with the MMPI-2 scores of 29 persons who had suffered moderate or severe closed head injury. The Lees-Haley Fake Bad Scale (FBS) was the most sensitive MMPI-2 scale in discriminating the malingerers from the head-injured persons, with additional significant differences obtained on standard MMPI-2 clinical scales including Scales 1(Hs), 2(D), 3(Hy), 7(Pt), and 8(Sc)."

"Developing sensitivity to distortion: Utility of psychological tests in differentiating malingering and psychopathology in criminal defendants" by Michael Heinze. Journal of Forensic Psychiatry & Psychology, April, 2003, vol. 14, #1, pages 151-177.

Summary: Examined findings from 66 men hospitalized as incompetent to stand trial. Tests included the Minnesota Multiphasic Personality Inventory (MMPI-2), Structured interview of Reported Symptoms (SIRS), M Test, the Atypical Presentation Scale (AP), and the Rey 15-Item Memory Test (RMT). "Overall, results support the use of psychological testing in the detection of malingering of psychotic symptoms."

"Development and Validation of the Malingering Discriminant Function Index for the MMPI–2" by Jason R. Bacchiochi and Michael Bagby. Journal of Personality Assessment, 2006, Vol. 87, No. 1, pages 51-61.

Summary: This article reports the authors' work "to develop a MMPI–2 fake bad validity index that would be less vulnerable to validity-scale knowledge. Applying discriminant function procedures, we derived a set of weighted Clinical and Content scales that reliably distinguished large samples of validity-scale coached undergraduate research participants instructed to feign mental illness (n = 534) from psychiatric patient samples (n = 590). We subsequently validated this Malingering Discriminant Function Index (M–DFI) in independent samples of research participants (n = 230) and patients (n = 300) and showed relatively less attenuation in predictive capacity compared with F, FB, and FP across uncoached and validity scale coached feigning conditions."

"Diagnostic accuracy of the MMPI-2 Malingering Discriminant Function Index in the detection of malingering among inmates" by Jarrod Steffan & Robert Morgan. Journal of Personality Assessment, July-August, 2008, vol. 90, #4, pages 392-398.

Summary: "The MMPI-2 Malingering Discriminant Function Index (M-DFI) was designed to detect malingerers educated about MMPI-2 validity indicators. However, given current attorney practices, the clinical utility of the M-DFI lies in its ability to detect examinees who are cautioned about the indicators. In this study, we compared 45 inmate simulators cautioned to avoid detection on the MMPI-2 with 46 psychiatric inmates who completed the MMPI-2 under standard instructions. Logistic regression analyses indicated that although the M-DFI performed better than several individual indicators, results were mixed for combinations of indicators, and the M-DFI did not outperform different sets of existing indicators. These findings support existing strategies to detect malingering on the MMPI-2."

"Differences in MMPI-2 FBS and RBS scores in brain injury, probable malingering, and conversion disorder groups: a preliminary study." Peck, C. P., et al. (2013) Clin Neuropsychol 27(4): 693-707.

Summary: "Findings from this preliminary study suggest that the conjunctive use of the Symptom Validity Scale and the RBS from the Minnesota Multiphasic Personality Inventory-2 may be useful in differentiating probable malingering from individuals with brain injuries and conversion disorders."

"Differentiation of mentally ill criminal defendants from malingerers on the MMPI-2 and PAI" by
L. T. Kucharski & D. S.Thomas. American Journal of Forensic Psychology, 2007, vol. 25, #3, pages 21-42.

Summary: "he results demonstrated that the MMPI-2 F, Fp and the newly developed Fc and the PAI NIM scales reasonably accurately differentiated the groups with acceptable sensitivity and specificity. Practical cutoff scores were identified for all but Fc."

"Discriminating malingered from genuine civilian posttraumatic stress disorder: A validation of three MMPI-2 infrequency scales (F, Fp, and Fptsd)" by Jon Elhai, James Naifeh, Irene Zucker, Steven Gold, Sarah Deitsch, & Christopher Frueh. Assessment, June, 2004, vol. 11, #2, page 139-144.

Summary: This study "evaluated the MMPI-2's F, Infrequency-Psychopathology scale (Fp), and Fptsd scales in discriminating genuine civilian PTSD among 41 adult victims of child sexual abuse from a group of 39 students instructed to simulate PTSD. Analyses demonstrated Fptsd's incremental validity over F but not over Fp."

"Does the disorder matter? Investigating a moderating effect on coached noncredible overreporting using the MMPI-2 and PAI." Veltri, C. O. C. and J. E. Williams (2013). Assessment; 20(2):199-209

Summary: "The results of this study indicated that the specific psychiatric disorder being feigned did moderate the impact coaching had on the detection of overreported psychopathology using several scales on the MMPI-2 and PAI."

"Effectiveness of the MMPI-2-RF validity scales for feigned mental disorders and cognitive impairment: A known-groups study" by Rogers, R., N. D. Gillard, et al. Journal of Psychopathology and Behavioral Assessment, 2011, 33(3), pages 355-367.

Summary: “The MMPI and MMPI-2 validity scales have long been accepted as standard tools in the assessment of feigned mental disorders (FMD) based on their extensive empirical validation. Studies are now examining MMPI-2-RF with modified validity scales plus the new Infrequent Somatic Responses Scale.... As predicted by its detection strategies, most MMPI-2-RF validity scales have limited effectiveness with the FCI group. However, FBS-r and RBS may be useful in conjunction with other clinical data for ruling out FCI for genuine neuropsychological consults. An entirely separate concern is whether certain diagnostic groups, such as major depression, will have marked elevations on MMPI-2-RF scales thereby increasing the likelihood of false-positives.”

"Examining the Use of the M-FAST With Criminal Defendants Incompetent to Stand Trial" by Holly Miller. International Journal of Offender Therapy & Comparative Criminology, June, 2004, vol. 48, #3, pages 268-280.

Summary: In this study of 50 criminal defendants found incompetent to stand trial because of a mental illness, "the M-FAST total score and items were compared with the Structured Interview of Reported Symptoms (SIRS) and the fake-bad indicators of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results indicated good evidence of construct and criterion validity, demonstrated by t tests, receiver operating characteristics analysis, and high correlations between the M-FAST, SIRS, and the fake-bad indices on the MMPI-2. Tentative cut scores for the M-FAST total score and scales were examined and demonstrated high utility with the sample of criminal defendants incompetent to stand trial."

"Exaggerated MMPI-2 symptom report in personal injury litigants with malingered neurocognitive deficit" by Glenn Larrabee. Archives of Clinical Neuropsychology, August, 2003, vol. 18, #6, pages 673-686.

Summary: Examined the effectiveness of the traditional MMPI-2 validity scales, the Fake Bad Scale (FBS), and the Infrequency Psychopathology Scale (F(p)) with 33 personal injury litigants. "The FBS was more sensitive to symptom exaggeration than F, Fb, and F(p). The definite and probable MND litigants also produced mean elevations on MMPI-2 scales 1, 3 and 7 that were significantly higher than those produced by various clinical groups including non-litigating severe closed head injury, multiple sclerosis, spinal cord injury, chronic pain, and depression. These data suggest that MMPI-2 profiles characteristic of malingered injury differ from those associated with malingered psychopathology."

"An examination of the association between psychopathy and dissimulation using the MMPI-2-RF validity scales" Marion, B. E., et al.. Law Hum Behav. (2013). 37(4):219-30.

Summary: "Combined results indicated that psychopathy did not affect the utility of the MMPI-2-RF validity scales in detecting overreporting. The underreporting analyses indicated that psychopathy did not affect the utility of L-r; however, callous-aggressive (or "meanness") psychopathy traits moderated the utility of K-r in detecting those feigning psychological adjustment, such that K-r was better able to detect individuals high on, rather than low on, psychopathy when underreporting. These results are promising in terms of evidence that individuals high on psychopathic traits are not any better than individuals low on these traits in feigning during psychological evaluations."

"Examination of the new MMPI-2 Response Bias Scale (Gervais): Relationship with MMPI-2 validity scales" by Nathaniel Nelson, Jerry Sweet, & Robert Heilbronner. Journal of Clinical and Experimental Neuropsychology, January, 2007, Vol 29(1), pages 67-72.

Summary: This research "examined relationships of the RBS with numerous MMPI-2 validity scales in a sample of 211 participants with secondary gain (SG) or no secondary gain (NSG). Of the validity scales observed, RBS yielded the largest effect size difference between groups (d = .65), followed closely by FBS (d = .60) and the L-scale (d = .51). Overall, RBS correlated most significantly (r = .74, p < .001) with FBS, but also showed significant correlations with most other validity scales for both groups. RBS further demonstrated significant correlations (p < .001) with all clinical scales except for Mf."

"Examination of the MMPI-2 Restructured Form (MMPI-2-RF) Validity Scales in Civil Forensic Settings: Findings from Simulation and Known Group Samples" by Dustin B. Wygant, Yossef S. Ben-Porath, Paul A. Arbisi, David T.R. Berry, David B. Freeman, & Robert L. Heilbronner. Archives of Clinical Neuropsychology, 2009, 27, pages 671-680.

Summary: The Discussion section notes that "using simulation and known-groups samples, results from the current study suggest that the MMPI-2-RF validity scales are
useful in detecting symptom exaggeration associated with medico-legal settings."

"Fake Bad Scale and MMPI-2 F-Family in Detection of Implausible Psychological Trauma Claims" by Frank Greiffenstein, John Baker, Bradley Axelrod, Edward Peck, and Roger Gervais. Clinical Neuropsychologist, November, 2004, vol. 18, #4, pages 573-590.

Summary: This study concludes that the "superiority of the FBS in applied forensic settings could derive from its development in actual litigants and content reflective of nonpsychotic exaggerations. The FBS appears acceptable for use in applied forensic settings where persons seek compensation for nonpsychotic syndromes." The authors emphasize that "use of the FBS in courtroom settings should be guided by a number of considerations. High FBS scores should never be used as the sole basis for diagnosing feigned somatic and/or nonpsychotic emotional complaints. Lanyon and Almer (2001) recommend multimodal assessment of misrepresentation in addition to the MMPI-2. The clinician needs to combine FBS scores with other atypical indicators (e.g., from clinical history) to determine whether exaggeration is present."

"Fake Bad Scale in a typical and severe closed head injury litigants" by Frank Greiffenstein, John Baker, Thomas Gola, Jacobus Donders, & Lori Miller. Journal of Clinical Psychology, December, 2002, pages 1591-1600.

Summary: Conducted study examining the Fake Bad Scale (FBS) in "litigating atypical minor, litigating moderate-severe, and non-litigating moderate-severe head injury samples." Findings included: "FBS showed significant associations with various neuropsychological symptom validity measures. FBS appears to capture a hybrid of infrequent symptom reporting styles with an emphasis on unauthentic physical complaints. However, FBS also correlated with documented abnormal neurological signs within a litigating moderate-severe brain-injury group. Its use as a symptom infrequency measure may have to be modified in more severe injury litigants, as some FBS items may reflect true long-term outcome in severe cerebral dysfunction."

"Faking PTSD from a motor vehicle accident on the MMPI-2" by Diane Moyer, Barbara Burkhardt, & Robert Gordon. American Journal of Forensic Psychology, 2002, pages 81-89.

Summary: Gave information about PTSD diagnostic criteria to one group but not to the other prior to administering the MMPI-2. Both groups were asked to feign PTSD. "Results indicated that knowledge about the specific symptoms of PTSD did not create a more accurate profile, but rather was likely to produce more invalid (F>T89) profiles, detecting them as malingerers."

"Inaccuracies About the MMPI-2 Fake Bad Scale in the Reply by Ben-Porath, Greve, Bianchini, and
Kaufman (2009)" by Carolyn L. Williams & James N. Butcher, Carlton S. Gass & Edward Cumella & Zina Kally. Psychological Injury & Law, June, 2009, vol. 2, #2, pp. 182-197.

Summary: "Almost half of the 43 items on the FBS, when scored in the deviant direction, produce a differential responding between men and women of 5% or higher, with women more likely to respond in the deviant direction than men. Only one FBS item produces a similar difference in endorsement frequencies in which men are more likely to respond in the scored direction. Not surprisingly then, women produce higher scores than men on the FBS. As Ben-Porath et al. (2009, p. 76) admit, this gender effect was recognized early in the scale's history and 'led to adjustments in the recommended raw score cutoffs for FBS (24 men; 26 women; Lees-Haley 1992).' Yet, Ben- Porath and Tellegen (2007a, b) have more recently recommended the same raw score cutoffs for men and women on the FBS (i.e., above 22 and above 28). As we pointed out in our article, the practical outcome of this recommendation is that the interpretive statement that an individual's FBS score raises "very significant concerns about the validity of self- reported symptoms" (Ben-Porath and Tellegen 2007a, b) occurs at a T score equivalent of 87 for women, but 95 for men, almost a full standard deviation lower for women, thus lowering the threshold for women to be identified as potentially malingering. Ben-Porath et al. (2009) ignored this substantive concern."

"Incremental validity of the MMPI-2-RF over-reporting scales and RBS in assessing the veracity of memory complaints" by Gervais, R. O., Y. S. Ben-Porath, et al. Archives of Clinical Neuropsychology, 2010, 25(4), pages 274-284.

Summary: “Regression analyses demonstrated the incremental validity of the MMPI-2-RF Infrequent Responses, Infrequent Psychopathology Responses, Infrequent Somatic Responses, and FBS-r scales relative to MMPI-2 F, Fp, and FBS in predicting memory complaints.”

Summary: The Discussionm section notes that "the present study is an extension of Gervais and colleagues’ (2008) research, which examined the incremental validity of the RBS and MMPI-2 over-reporting validity scales in assessing memory complaints. In this study, we examined the incremental validity of the MMPI-2-RF over-reporting validity scales relative to their MMPI-2 counterparts and the RBS in assessing memory complaints. Although the RBS was more strongly associated with the mean MCI score and all subscales of the MCI (with the exception of AAB) than the MMPI-2-RF over-reporting validity scales, these MMPI-2-RF validity scales generally exceeded their MMPI-2 counterparts in their sensitivity to memory complaints."

"Independent validation of the MMPI-2-RF somatic/cognitive and validity scales in TBI litigants tested for effort" by Youngjohn, J. R., R. Wershba, et al. The Clinical Neuropsychologist, 2011, 25(3), pages 463-476.

Summary: “Our study examines MMPI-2-RF Validity scales and the newly created Somatic/Cognitive scales in a recently reported sample of 82 traumatic brain injury (TBI) litigants who either passed or failed effort tests (Thomas & Youngjohn, 2009). The restructured Validity scales FBS-r (restructured symptom validity), F-r (restructured infrequent responses), and the newly created Fs (infrequent somatic responses) were not significant predictors of TBI severity. FBS-r was significantly related to passing or failing effort tests, and Fs and F-r showed non-significant trends in the same direction. Elevations on the Somatic/Cognitive scales profile (MLS-malaise, GIC-gastrointestinal complaints, HPC-head pain complaints, NUC-neurological complaints, and COG-cognitive complaints) were significant predictors of effort test failure. Additionally, HPC had the anticipated paradoxical inverse relationship with head injury severity. The Somatic/Cognitive scales as a group were better predictors of effort test failure than the RF Validity scales, which was an unexpected finding. MLS arose as the single best predictor of effort test failure of all RF Validity and Somatic/Cognitive scales. Item overlap analysis revealed that all MLS items are included in the original MMPI-2 Hy scale, making MLS essentially a subscale of Hy.”

"Infrequency-Posttraumatic Stress Disorder Scale (Fptsd) for the MMPI-2: Development and Initial Validation With Veterans Presenting With Combat-Related PTSD" by Jon Elhai, Kenneth Ruggiero, Christopher Frueh, Jean Beckham, Paul Gold, & Michelle Feldman. Journal of Personality Assessment, 2002, vol. 79, #3, pages 531-549.

Summary: Assembled a new scale -- the Infrequency-Posttraumatic Stress Disorder scale (Fptsd) -- consisting of items that were infrequently endorsed by "940 male combat veterans presenting for treatment at the posttraumatic stress disorder (PTSD) clinics of 2 Veterans Affairs Medical Centers." The authors conclude that "that, relative to previously established validity and oveneporting scales (F, Fb, and Fp), Fptsd was significantly less related to psychopathology and distress and better at discriminating simulated from genuinely reported PTSD."

"A known-groups evaluation of the Response Bias Scale in a neuropsychological setting." Sullivan, K. A., et al. (2013). Appl Neuropsychol Adult. 2013;20(1):20-32.

Summary: "When MNCD group membership was predicted using logistic regression, the RBS failed to add incrementally to F. In a separate regression to predict group membership, K added significantly to the RBS. Receiver-operating curve analysis revealed a nonsignificant area under the curve statistic, and at the ideal cutoff in this sample of >12, specificity was moderate (.79), sensitivity was low (.47), and positive and negative predictive power values at a 13% base rate were .25 and .91, respectively. Although the results of this study require replication because of a number of limitations, this study has made an important first attempt to report RBS classification accuracy statistics for predicting poor effort at a range of base rates."

"Malingering as a categorical or dimensional construct: The latent structure of feigned psychopathology as measured by the SIRS and MMPI-2 by Walters, Glenn D.; Rogers, Richard; Berry, David T. R.; Miller, Holly A.; Duncan, Scott A.; McCusker, Paul J.; Payne, Joshua W.; Granacher Jr., Robert P. Psychological Assessment, September, 2008, vol. 20, #3, pages 238-247.

Summary: "The 6 nonoverlapping primary scales of the Structured Interview of Reported Symptoms (SIRS) were subjected to taxometric analysis in a group of 1,211 criminal and civil examinees in order to investigate the latent structure of feigned psychopathology. Both taxometric procedures used in this study, mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV), produced dimensional results. A subgroup of participants (n = 711) with valid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols were included in a second round of analyses in which the 6 nonoverlapping primary scales of the SIRS and the Infrequency (F), InfrequencyPsychopathology (Fp), and Dissimulation (Ds) scales of the MMPI-2 served as indicators. Again, the results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingeringhonest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one."

"Malingering in forensic neuropsychology: Daubert and the MMPI-2" by Paul Lees-Haley, Grant Iverson, Rael Lange, David Fox, & Lyle Allen. Journal of Forensic Neuropsychology, 2002, 3, pages 167-203.

Summary: Discusses the research addressing various MMPI-2 validity scales that are used to help evaluate malingering, such as VRIN, TRIN, L, F, K, F--K, F-sub(B), F(p), FBS (Fake Bad Scale), Total Obvious-Subtle, Ds, Dsr, and Ego Strength.

"Meta-Analysis of the MMPI-2 Fake Bad Scale: Utility in Forensic Practice" by Nathaniel Nelson, Jerry Sweet, & GeorgeDemakis. Clinical Neuropsychologist, 2006, vol. 20, #1, pages 39-58.

Summary: This meta-analysis examined "weighted effect size differences among the FBS and other commonly used validity scales (L, F, K, Fh, 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 0-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...."

"MMPI-2 fake-bad scales: An attempted cross-validation of proposed cutting scores for outpatients" by David Berry, Cynthia Cimino, Nicole Chong, Susan LaVelle, Ivy Ho, Tamme Morse, Sonja Thacker. Journal of Personality Assessment, April, 2001, pages 296-314.

Summary: The authors report on a study of 118 psychiatric outpatients "Minnesota Multiphasic Personality Inventory-2 (MMPI-2) results were compared in 118 psychiatric outpatients who were "given standard instructions, instructions to exaggerate their problems, instructions to feign a disorder they did not have, or instructions to feign global psychological disturbance. The groups were comparable on demographic, occupational and diagnostic characteristics as well as intake MMPI-2 results. Experimental MMPI-2 results showed that clinical scales were generally elevated in the feigning groups, with only modest differences across dissimulating instruction sets. The feigning groups had reliably higher scores than controls on all overreporting indexes examined, although no significant differences between feigning groups were present for overreporting indexes. Classification rates using previously proposed cutting scores for outpatients on individual feigning indexes showed near perfect specificity, but low to at best moderate sensitivity."

"MMPI-2 Fake Bad Scale: Concordance And Specificity Of True And Estimated Scores" by Nathaniel W. Nelson, Thomas D. Parsons, Christopher L. Grote, Clifford A. Smith, & James R. Sisung. Journal of Clinical and Experimental Neuropsychology, 2006, vol. 28, #1, pages 1-12.

Summary: "The purpose of this study was to demonstrate concordance between T-FBS and E-FBS scores, and to further demonstrate their specificities in the current clinically referred epilepsy sample. As predicted, E-FBS scores correlated very highly (.78) with T-FBS scores, with T-FBS/E-FBS correspondence being especially high for women (.85) compared to men (.62)."

"MMPI-2 F scale elevations in adult victims of child sexual abuse" by Jill Flitter, Jon Elhai, & Steven N. Gold. Journal of Traumatic Stress, June, 2003, vol. 16, #3, pages 269-274.

Examined MMPI-2 F score patterns for 87 women seeking outpatient therapy for the effects of child sex abuse. "Self-report measures of dissociation, posttraumatic stress, depression, and family environment individually correlated significantly with F, and collectively accounted for 40% of its variance. Dissociation was the strongest predictor. Findings suggest that high F elevations may reflect genuine problem areas often found among CSA victims, rather than symptom overreporting."

"MMPI-2 scale to detect malingered depression (Md Scale)" by Jarrod Steffan, James Clopton, & Robert Morgan. Assessment, December, 2003, vol. 10, #4, pages 382-392.

Summary: Initial data about a 32-item scale "that discriminated college students who feigned depression from those who were genuinely depressed."

"The MMPI-2 Symptom Validity Scale (FBS) not influenced by medical impairment: A large sleep center investigation" by M. F. Greiffenstein. Assessment, 2010, 17(2), pages 269-277.

Summary: 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.”

"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)" by Yossef S. Ben-Porath, Kevin W. Greve, Kevin J. Bianchini, & Paul M. Kaufmann. Psychological Injury & Law, March, 2009, vol. 1, #5.

Summary: "In closing, we have shown that there is a solid empirical foundation for the clinical and forensic use of the FBS. Despite Butcher et al.'s (2003, 2008) arguments, there is no true scientific controversy. Indeed, the views and arguments presented by Butcher et al. (2008) are inconsistent with current research findings and practice recommendations as well as the conclusions of authorities in the field who have no direct involvement with this research. For example, after reviewing the literature on FBS (including Butcher et al.'s. 2003 arguments) for the third edition of their Compendium, Strauss et al. (2006) concluded: 'Although the value of the FBS to detect suboptimal effort has been questioned (Butcher et al. 2003), the available evidence suggests that it provides unique information over and above traditional MMPI-2 validity indices in personal injury cases, including exaggerated pain, post- traumatic anxiety, and neurological problems' (p. 1123). Butcher et al.'s (2003) criticisms stimulated some of the subsequent research aimed at better characterizing the validity of FBS. However, that research has repeatedly failed to support their conclusions and recommendation against using the scale. Rather, thoughtfully designed and well-conducted studies have consistently demonstrated the valuable role of FBS in forensic psychological and neuropsychological assessment."

"MMPI-2 validity scale characteristics in a correctional sample" by John McNulty, Johnathan Forbey, John Graham, Yossef Ben-Porath, Maureen Black, Stephen Anderson, & Kathleen Burlew. Assessment, September, 2003, vol. 10, #3, pages 288-298.

Summary: Examined forms of faking on the MMPI-2 among 51,486 inmates at the Ohio Department of Rehabilitation & Correction system. "Overall, approximately 79% of the study participants produced valid profiles. Of the entire study sample, 11.3% produced content-nonresponsive profiles, and 9.4% produced content-responsive faking profiles. African Americans produced a higher proportion of content-nonresponsive profiles than Caucasians, and women were slightly more likely than men to nonresponsive produce content-responsive faking profiles."

"Posttraumatic stress disorder in veterans: The utility of the MMPI–2–RF validity scales in detecting overreported symptoms." Goodwin, B. E., et al. (2013). Psychological Assessment, 25(3):671-8.

Summary: "Group differences on validity scale scores indicated that these scales were associated with large effect sizes for differentiating veterans who overreported from those with PTSD and for differentiating between mental health professionals and veterans with PTSD."

"Potential for Bias in MMPI-2 Assessments Using the Fake Bad Scale (FBS)" by James N. Butcher & Carlton S. Gass, Edward Cumella, Zina Kally & Carolyn L. Williams. Psychological Injury & Law, February, 2009, vol. 1, #3.

Summary: "Based on a review and a careful analysis of a large amount of published FBS research, the FBS does not appear to be a sufficiently reliable or valid test for measuring 'faking bad,' nor should it be used to impute the motivation to malinger in those reaching its variable and imprecise cutting scores. We agree with the conclusions of the three judges in Florida that the FBS does not meet the Frye standards of being scientifically sound and generally accepted in the field, and that expert testimony based on the scale should be excluded from consideration in court. potential for bias against women, those with disabilities and physical illness, psychiatric inpatients, individuals exposed to highly traumatic situations, and those motivated to present themselves in a favorable light. The samples used to develop the FBS are not broadly representative of the populations evaluated by the MMPI-2, nor are its criteria used to define malingering objective and replicable. There is insufficient evidence of its psychometric reliability or validity, and there is no consensus about appropriate cut-off scores or use of norms."

"Predicting test of memory malingering and medical symptom validity test failure within a Veterans Affairs Medical Center: use of the Response Bias Scale [of the MMPI-2] and the Henry-Heilbronner Index." Arch Whitney, K. A. (2013). Clin Neuropsychol 28(3): 222-235.

Summary: "The ability of the Response Bias Scale (RBS) and the Henry-Heilbronner Index (HHI), along with several other MMPI-2 validity scales, to predict performance on two separate stand-alone symptom validity tests, the Test of Memory Malingering (TOMM) and the Medical Symptom Validity Test (MSVT), was examined. Findings from this retrospective data analysis of outpatients seen within a Veterans Affairs medical center (N = 194) showed that group differences between those passing and failing the TOMM were largest for the RBS (d = 0.79), HHI (d = 0.75), and Infrequency (F; d = 0.72). The largest group differences for those passing versus failing the MSVT were greatest on the HHI (d = 0.83), RBS (d = 0.80), and F (d = 0.78). Regression analyses showed that the RBS accounted for the most variance in TOMM scores (20%), whereas the HHI accounted for the most variance in MSVT scores (26%). Nonetheless, due to unacceptably low positive and negative predictive values, caution is warranted in using either one of these indices in isolation to predict performance invalidity."

"Predictive capacity of the MMPI-2 and PAI validity scales and indexes to detect coached and uncoached feigning" by Michael Bagby, Robert Nicholson, Jason Bacchiochi, Andrew Ryder, & Allison, Bury. Journal of Personality Assessment, February, 2002, pages 69-86.

Summary: Studied the effectiveness of the validity scales and malingering indices of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI). "Coaching had no effect on the ability of the research participants to feign more successfully than those participants who received no coaching. For the MMPI-2, the Psychopathology F scale, or F-sub((p)), proved to be the best at distinguishing psychiatric patients from research participants instructed to malinger. For the PAI, the Rogers Discriminant Function index (RDF) was clearly superior to the other PAI fake-bad validity indicators; neither the Negative Impression Management scale nor Malingering Index were effective at detecting malingered profiles in this study."

"Psychometric Perspectives on Detection of Malingering of Pain: Use of the Minnesota Multiphasic Personality lnventory-2" by Paul Arbisi and James Butcher. Clinical Journal of Pain, November, 2004, vol. 20, #6, pages 383-391.

Summary: This article presents "a rationale for the use of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in the comprehensive assessment of chronic pain with an emphasis on the advantage the MMPI-2 provides in the detection of response bias or malingering. A critical review of available MMPI-2 validity scales is presented, and recommendations for use of these scales in the evaluation of patients with chronic pain are made."

"Screening for feigned psychiatric symptoms in a forensic sample by using the MMPI-2 and the Structured Inventory of Malingered Symptomatology" by Jason Lewis, Andrew Simcox, & David Berry. Psychological Assessment, June, 2002, pages 170-176.

Summary: Reports results of administering the Structured Interview of Reported Symptoms (SIRS), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Structured Inventory of Malingered Symptomatology (SIMS) to 55 men in the midst of pretrial forensic assessments for criminal responsibility or competence to stand trial. "On the basis of results from the SIRS, 31 were classified as honest responders and 24 as feigning. Significant differences between the 2 groups were found on all SIMS scales as well as on all tested MMPI-2 fake bad validity scales. The SIMS total score and the MMPI-2 Backpage Infrequency (Fb) scale had relatively high negative predictive power (100% and 92%, respectively)."

"Sensitivity and Specificity of the MMPI-2 Validity Scales and Indicatorsto Malingered Neurocognitive Dysfunction in Traumatic Brain Injury" by Kevin Greve, Jeffrey Bianchini, Adrianne Brennan, and Matthew Heinly. Clinical Neuropsychologist, in press.

Summary: This study "used a known-groups design to determine the classification accuracy of 10 MMPI-2 validity scales and indicators in the detection of cognitive malingering in traumatic brain injury. Participants were 259 traumatic brain injury and 133 general clinical patients seen for neuropsychological evaluation. The TBI patients were subdivided into groups based on a comprehensive examination of effort following the Slick et al. (1999) criteria. More extreme scores demonstrated excellent specificity; often impressive sensitivity was seen even while maintaining a low false positive error rate. Specificity was good even in stroke, memory disorder, and psychiatric patients without incentive."

"Updated Meta-Analysis of the MMPI-2 Symptom Validity Scale (Fbs): Verified Utility in Forensic Practice" by Nathaniel W. Nelson, James B. Hoelzle, Jerry J. Sweet,
Paul A. Arbisi, & George J. Demakis. Clinical Neuropsychologist, 2010, vol. 24, pages 201-724,

Summary: "The present study was conducted to summarize the MMPI-2 FBS literature from 1991 to the present, with substantial growth of more than a 50% increase in FBS studies identified since the Nelson et al. (2006b) meta-analysis. The current FBS composite effect size is large (d¼0.95) and stable relative to previous findings in 2006 (d¼0.96). The cumulative FBS literature suggests that the scale continues to differentiate groups as well as, and under certain conditions superior to, other MMPI-2 validity scales (including all of the F-family scales). In particular, two factors that are particularly relevant to practicing neuropsychologists, effort status and TBI, substantially moderated FBS magnitudes. Although scales within the F family at times also showed moderate to large effect size differences related to effort and TBI, these were invariably lower than that of FBS."

"Use of the MMPI-2 Restructured Clinical (RC) scales in detecting criminal malingering" by Peter Weiss, Katherine Bell, & William Weiss. Journal of Police and Criminal Psychology, April, 2010, vol 25, #1, pages 49-55.

Summary: "Sixty undergraduate students were given the MMPI-2 twice. One administration was conducted according to the MMPI-2 manual, and the other was given with a special set of malingering instructions specific to a prison setting. The two MMPI-2 profiles for each participant were scored for both the Basic and RC scales. Eight participants were eliminated from the data analysis due to validity (VRIN or TRIN) concerns. Data from the remaining 52 participants were analyzed using a 2 × 2 repeated measures ANOVA. Results showed that, as expected, the participants achieved higher MMPI-2 scores in the malingering condition. Also, participants achieved higher scores overall on the Basic scales and a significant interaction showed that participants achieved higher scores on the Basic Scales in the malingering condition than on the RC scales in that condition. These results supported prior research, indicating that malingerers produce elevated RC profiles. However, the present results also suggest that the Basic scales may be more effective in actually detecting malingerers, mainly due to the much lower ceiling on the RC scaled scores. Further implications of these findings for research and clinical work are also discussed."

"Utility of the MMPI-2 infrequency psychopathology F(p) and the revised infrequency psychopathology scales in the detection of malingering" by Thomas Kucharski, Diane Johnsen, & Stephanie Procell. American Journal of Forensic Psychology, 2004, vol 22, #1, pages 33-40.

Summary: In this study, "167 federal defendants referred for evaluation by the court were administered the MMPI-2. The referrals were divided into two groups, those suspected of malingering and those believed to be actually mentally ill. Subjects were defined as Suspected Malingerers if there was an absence of a history of psychiatric treatment, their first known report of symptoms occurred after their arrest on the instance offense and the diagnosis reported to the court was not a major Axis I mental illness. Those with a documented history of psychiatric hospitalization preceding the instant offense, with a diagnosis of an Axis I major mental illness were defined as a Mentally Ill group. Step-wise logistical regression analyses with group as the criterion and the MMPI-2 validity scales as predictors revealed that neither the F(p) scale, nor the revised F(p) scale added to the F scale in predicting group membership. The F scale alone correctly classified 80.8% of cases with no incremental accuracy added by either F(p) or the revised F(p)."

"Utility of the MMPI-2-rf in detecting non-credible somatic complaints" by Sellbom, M., D. Wygant, et al. Psychiatry Research, 2012.

Summary: “The Fs and Fp-r scales were associated with the best differentiation between the three groups; the Fs scale was the most sensitive to somatic malingering, whereas the Fp-r scale was the most specific. Both scales were associated with high likelihood ratios in differentiating the somatic malingering group from the somatoform and medical illness groups. Although the FBS-r scale was overall the most sensitive in differentiating non-credible somatic complaints from genuine medical illness, it could not differentiate well between the somatic malingering and somatoform patient conditions. The MMPI-2-RF appears to have considerable promise in detecting individuals who feign physical health problems.”

"Utility of the MMPI–2-RF (Restructured Form) validity scales in detecting malingering in a criminal forensic setting: A known?-?groups design" by Sellbom, Toomey, Wygant, Kucharski, & Duncan. Psychological Assessment, March, 2010, vol. 22, #11), pages 22-31.

Summary: "The goal of this investigation was to determine the utility of the MMPI–2-RF validity scales in detecting malingering in a known-groups design. We found that, as expected, F-r and FP-r were the best scales in differentiating malingering and nonmalingering groups as determined by the SIRS."

"Validation of MMPI-2-RF Validity Scales in criterion group neuropsychological samples" by Schroeder, R. W., L. E. Baade, et al. The Clinical Neuropsychologist, 2012, 26(1), pages 129-146.

Summary: “This study utilized multiple criterion group neuropsychological samples to evaluate the ‘over-reporting’ and ‘under-reporting’ MMPI-2-RF validity scales. The five criterion groups included in this study were (1) litigating traumatic brain injury patients who failed Slick et al. criteria for probable malingering, (2) litigating traumatic brain injury patients who passed Slick et al. criteria, (3) mixed neuropsychological outpatients who passed SVTs and were diagnosed with primary neurological conditions, (4) mixed neuropsychological outpatients who passed SVTs and were diagnosed with primary psychiatric conditions, and (5) epileptic seizure disorder inpatients who were diagnosed via video-EEG. Using the data from these groups, cumulative percentages for all possible T-scores and sensitivity and specificity rates for optimal cutoff scores were determined. When specificity rates were set at 90% across all non-malingering neurological condition groups, sensitivity rates ranged from 48% (FBS-r) to 10% (K-r).”

"Validity index for the MMPI-2" by John Meyers, Scott Millis, & Kurt Volkert. Archives of Clinical Neuropsychology, February, 2002, pages 157-169.

Summary: Assessed a method of pooling 7 MMPI-2 validity scales into a single weighted measure for identifying malingering in chronic pain patients. "The weighted method was able to correctly classify 100% of nonlitigants, using a cutoff score of >=5. The findings of this study suggest that chronic pain patients in litigation produce a different profile on the MMPI-2 validity scales than do nonlitigants. In a group of knowledgeable actors (malingerers), 86% was correctly classified. The overall finding showed 100% specificity and 86% sensitivity."

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Summary: Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

Modified Somatic Perception Questionnaire (MSPQ)

"Exaggerated Pain Report in Litigants with Malingered Neurocognitive Dysfunction" by Glenn Larrabee. Clinical Neuropsychologist, August, 2003, vol. 17, #3, pages 395-401.

Summary: This study of 29 litigants found that the Modified Somatic Perception Questionnaire (MSPQ) was better than the McGill Pain Questionnaire (MPQ) or the Pain Disability Index (PDI) for detecting exaggerated pain symptoms but cautioned that "significant elevations on the MPQ, PDI, and MSPQ are supportive, but not independently diagnostic of the symptom exaggeration characteristic of malingering."

Morel Emotional Numbing Test-Revised (MENT-R)

"Detecting malingered posttraumatic stress disorder using the Morel Emotional Numbing Test-Revised (MENT-R) and the Miller Forensic Assessment of Symptoms Test (M-FAST)" by J. M. Messer & W. J. Fremouw. Journal of Forensic Psychology Practice, 2007, vol 7, #3, pages 33-57.

Summary: "Total scores on the MENT-R distinguished among the four groups of participants. The three groups responding honestly averaged fewer than 3.5 errors, while malingerers missed over 5 times that number. Scores on the M-FAST were also higher for the group of participants malingering. Although the MENT-R and M-FAST correctly identified 63 and 78% of coached malingerers, respectively, the combined use of both measures resulted in the correct classification of over 90% of the participants instructed to malinger PTSD."

"Detection of feigned crime-related amnesia: A multi-method approach" by Giger, P., T. Merten, et al. Journal of Forensic Psychology Practice, 2010, 10(5), pages 440-463.

Summary: “Sixty participants were assigned to three conditions: responding honestly; feigning crime-related amnesia; feigning amnesia with a warning not to exaggerate. High sensitivity and specificity were obtained for the Structured Inventory of Malingered Symptomatology, the Amsterdam Short-Term Memory Test, and the Morel Emotional Numbing Test. Only three warned malingerers went undetected. The results demonstrate that validated instruments exist to support forensic decision making about crime-related amnesia. Yet, warning may undermine their effectiveness, even when using a multi-method approach.”

"Development of a validity scale for combat-related posttraumatic stress disorder: Evidence from simulated malingerers and actual disability claimants" by Kenneth R. Morel. Journal of Forensic Psychiatry & Psychology, 2008, vol. 19, #1, pages 52-63.

Summary: "Individuals being evaluated for posttraumatic stress disorder (PTSD) in disability compensation cases or forensic settings are at increased risk of response bias, making the legitimacy of face-valid self-report measures assessing PTSD in these settings questionable. The following two studies evaluate the Quick Test for PTSD (Q-PTSD) as a time-efficient method of detecting response bias in individuals being assessed for combat-related PTSD. In the first study, 78 participants were randomly assigned to either an experimental group (simulated malingerers) or a control group (genuine reporting) and were administered the Q-PTSD along with a standard measure of combat-related PTSD. The Q-PTSD demonstrated suitable internal consistency and construct validity. Post-hoc analyses revealed that the best cutoff score for the Q-PTSD resulted in values =.91 for sensitivity, specificity, positive predictive value, and negative predictive value in this sample. Utilizing the established cutoff, the second study evaluated the criterion-related validity of the Q-PTSD by assessing its correlation with the Morel Emotional Numbing Test for PTSD (MENT) in 67 military veterans applying for disability pensions and claiming combat-related PTSD."

Multidimensional Investigation of Neuropsychological Dissimulation (MIND)

"Multidimensional approach towards malingering detection" by Lori Holmquist & Richard Wanlass. Archives of Clinical Neuropsychology, February, 2002, pages 143-156.

Summary: Conducted a validation study, with 62 participants, of a new instrument, the Multidimensional Investigation of Neuropsychological Dissimulation (MIND), developed to identify exaggerated responding in regard to brain-injury symptoms. "Discriminant function analysis was used to classify 3 groups of Ss: 24 normals responding in a sincere manner; 21 normals who were educated about mild to moderate head injuries and given substantial incentives to malinger without obvious detection; and 17 clinically diagnosed, brain-injured patients with mild to moderate impairments. A univariate F test indicates significant group differences on 6 of the 8 original predictor variables. Using these 6 variables, there was an overall classification rate of 68%, reflecting only a 10% false negative rate in the dissimulating group. For a 2-group classification (i.e., dissimulating and mildly to moderately brain-injured Ss), an 82% overall accuracy rate was achieved."

Mississippi Scale for Combat-Related Posttraumatic Stress Disorder

"Development of a validity scale for combat-related posttraumatic stress disorder: Evidence from simulated malingerers and actual disability claimants" by Kenneth R. Morel. Journal of Forensic Psychiatry & Psychology, 2008, vol. 19, #1, pages 52-63.

Summary: "Individuals being evaluated for posttraumatic stress disorder (PTSD) in disability compensation cases or forensic settings are at increased risk of response bias, making the legitimacy of face-valid self-report measures assessing PTSD in these settings questionable. The following two studies evaluate the Quick Test for PTSD (Q-PTSD) as a time-efficient method of detecting response bias in individuals being assessed for combat-related PTSD. In the first study, 78 participants were randomly assigned to either an experimental group (simulated malingerers) or a control group (genuine reporting) and were administered the Q-PTSD along with a standard measure of combat-related PTSD. The Q-PTSD demonstrated suitable internal consistency and construct validity. Post-hoc analyses revealed that the best cutoff score for the Q-PTSD resulted in values =.91 for sensitivity, specificity, positive predictive value, and negative predictive value in this sample. Utilizing the established cutoff, the second study evaluated the criterion-related validity of the Q-PTSD by assessing its correlation with the Morel Emotional Numbing Test for PTSD (MENT) in 67 military veterans applying for disability pensions and claiming combat-related PTSD."

Neuropsychological Symptom Inventory (NSI)

"The efficacy of neuropsychological symptom inventory in the differential diagnosis of medical, psychiatric, and malingering patients" by Barbara Gelder, Jeffrey Titus, & Raymond Dean. International Journal of Neuroscience, November, 2002, pages 1377-1394.

Summary: Conducted study showing that the Neuropsychological Symptom Inventory (NSI) "was able to significantly discriminate malingered responses from medical and psychiatric patient responses. However, applying a lie scale derived from previous research with the NSI did not allow discrimination between the malingered group and the psychiatric patients. Using the factors of the NSI derived from earlier research offered both greater detection of malingerers and enhanced evaluation of symptom profiles of medical and psychiatric patients."

Nonverbal Symptom Validity Test

"Sensitivity of the Test of Memory Malingering and the Nonverbal Medical Symptom Validity Test: A replication study" by Armistead-Jehle, P. and R. Gervais. Applied Neuropsychology, 2011,18(4), pages 284-290.

Summary: “Nearly twice as many examinees failed the NV-MSVT than the TOMM. Profile analyses of the NV-MSVT demonstrated patterns suggestive of inconsistent effort in those who failed the NV-MSVT but passed the TOMM. A classification analysis employing the Word Memory Test and Medical Symptom Validity Test as external criteria for poor effort showed that the NV-MSVT is substantially more sensitive to poor effort than the TOMM and maintains an acceptable false-positive rate.”

Pain Disability Index (PDI)

"Exaggerated Pain Report in Litigants with Malingered Neurocognitive Dysfunction" by Glenn Larrabee. Clinical Neuropsychologist, August, 2003, vol. 17, #3, pages 395-401.

Summary: This study of 29 litigants found that the Modified Somatic Perception Questionnaire (MSPQ) was better than the McGill Pain Questionnaire (MPQ) or the Pain Disability Index (PDI) for detecting exaggerated pain symptoms but cautioned that "significant elevations on the MPQ, PDI, and MSPQ are supportive, but not independently diagnostic of the symptom exaggeration characteristic of malingering."

Patient Pain Profile (P3)

"Patient Pain Profile and the assessment of malingered pain" by Brian McGuire & Arthur Shores. Journal of Clinical Psychology. March, 2001, pages 401-409.

Summary: The authors report that "40 patients (aged 22-59 yrs) with a pain condition completed the P3 under normal instructions, while 20 students (aged 17-31 yrs) responded under instructions to feign a pain disorder but to attempt to avoid detection. The simulators did not differ on the P3 Validity Scale compared with the pain group, but scored significantly higher than the pain group on the P3 clinical scales (Depression, Anxiety, Somatization). The simulators were more likely to obtain an abnormal score on all of the clinical scales. The Depression scale had highest positive and negative predictive power and correctly classified 80% of the participants."

Paulhus Deception Scales (PDS)

"Deception in prison assessment of substance abuse" by Henry Richards & Shilpa Pai. Journal of Substance Abuse Treatment, March, 2003, vol. 24, #2, pages 121-128.

Summary: Compared findings for the Paulhus Deception Scales to the Texas Christian University Drug Screen I for 35 female and 277 male prison inmates. "Almost 37% of participants produced protocols of questionable validity, with 22% faking-good and 14.7% faking-bad . However, over 90% of participants obtained scores that were not covered by the manual's profile typology. These findings underline the importance of deception to correctional assessment and the need for more information on the psychometrics and operating characteristics of the PDS in correctional settings."

Personality Assessment Inventory (PAI)

"Comparison of the PAI and MMPI-2 as predictors of faking bad" by Dorothy Blanchard, Robert McGrath, D. Pogge, & A. Khadivi. Journal of Personality Assessment, 2003, pages 197-205.

Summary: Using archival MMPI-2 and PAI records of psychiatric inpatients as a reference sample, this study asked 2 groups of college students to complete the MMPI-2 and PAI by feigning serious mental illness so that they would either (group 1) convince a jury that they should be judged "not guilty by reason of insanity" or (group 2) convince a mental health professional that they should be hospitalized. A linear combination of the MMPI-2 indicators slightly more effective than the PAI in identifying those faking their responses.

"Cross-validation of the PAI Negative Distortion Scale for feigned mental disorders: A research report." Rogers, R., et al. (2013). Assessment 20(1): 36-42.

Summary: "Simulators were asked to feign total disability in an effort to secure unwarranted compensation from their insurance company. Even in an inpatient sample with severe Axis I disorders and concomitant impairment, the NDS proved effective as a rare-symptom strategy with low levels of item endorsement that remained mostly stable across genders. For construct validity, the NDS was moderately correlated with the Structured Interview of Reported Symptoms–Second Edition and other PAI feigning scales."

"The detection of feigned disabilities: The effectiveness of the Personality Assessment Inventory in a traumatized inpatient sample" by Rogers, R., N. D. Gillard, et al. Assessment, 2012, 19(1): 77-88.

Summary: “Research on feigned mental disorders indicates that severe psychopathology coupled with significant trauma histories often complicate feigning determinations, resulting in inaccuracies on otherwise effective measures. As part of malingering assessments, the Personality Assessment Inventory (PAI) is often used because of its excellent validation and the availability of three feigning indicators (Negative Impression, Malingering Index, and Rogers Discriminant Function), which have evidenced large effect sizes and clinically useful cut scores. The current study examined the effectiveness of the PAI in a traumatized inpatient sample using a between-subjects simulation design. Although Negative Impression appeared affected by trauma—especially in conjunction with dissociative symptoms—very positive results were found for Malingering Index and Rogers Discriminant Function. They remained relatively unelevated under honest conditions, despite posttraumatic stress disorder and extensive comorbidity. Using single-point cut scores provided moderately good classification of feigned and genuine PAI profiles. For purposes of classification, the authors operationally defined small indeterminate groups that were considered too close to classify (i.e., ±5T of the cut scores). With indeterminate cases removed, the overall classification rates improved modestly. However, the more important finding involved the error rates for the indeterminate group, which exceeded 50%.”

"Detection of feigning using multiple PAI Scale elevations: A new index." Gaines, M. V., et al. (2013). Assessment 20(4): 437-447.

Summary: "Regression analyses revealed that MFI was a stronger predictor of SIRS outcome than NIM, MAL, and RDF. In addition, NIM, MAL, and RDF did not add substantial incremental validity to MFI in predicting SIRS outcome. Receiver operating characteristic analyses revealed sensitivity of 68.89% and specificity of 94.34% at an MFI cutoff of more than 76, which compared favorably with the utility of NIM, MAL, and RDF."

"Detection of malingering of psychiatric disorder with the Personality Assessment Inventory: An investigation of criminal defendants" by L. T. Kucharski, J. P. Toomey, K. Fila, & S. Duncan. Journal of Personality Assessment, February, 2007, vol 88. #1, pages 25-32.

Summary: A regressional analysis using malingering vs. non-malingering as criterion found that "the PAI Negative Impression Management (NIM) scale but not the Rogers Discriminant Function (RDF; Rogers, Sewell, Morey & Ustad, 1996) nor the Malingering index (MAL; Morey, 1996) significantly differentiated the malingering from the not malingering group."

"The detection of malingered pain-related disability with the Personality Assessment Inventory" by Hopwood, C. J., M. J. Orlando, et al. Rehabilitation Psychology, 2010, 55(3), pages 307-310.

Summary: “Although existing PAI validity indicators demonstrated strong effects in discriminating actual pain and MPRD cases, these indicators were not sufficiently sensitive to feigned pain to recommend for clinical practice. A discriminant function was developed and cross-validated, which improved upon the sensitivity of the other indicators and yielded an overall hit rate of 88% for detecting individuals instructed to malinger pain-related disability.”

"Detection of malingering in psychiatric unit and general population prison inmates: A comparison of the PAI, SIMS, and SIRS" by J. F. Edens, N. G. Poythress, M. M. Watkins-Clay. Journal of Personality Assessment, February, 2007, vol. 88, #1, pages 33-42.

Summary: This study "compared the utility of three instruments, the Personality Assessment Inventory (PAI; Morey, 1991), the Structured Inventory of Malingered Symptomatology (Smith & Burger, 1997), and the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) to detect malingering among prisoners. We examined 4 inmate samples: (a) prisoners instructed to malinger, (b) "suspected malingerers" identified by psychiatric staff, (c) general population control inmates, and (d) psychiatric patients. Intercorrelations among the measures for the total sample (N = 115) were quite high, and receiver operating characteristic analyses suggested similar rates of overall predictive accuracy across the measures. Despite this, commonly recommended cut scores for these measures resulted in widely differing rates of sensitivity and specificity across the subsamples. Moreover, although all instruments performed well in the nonpsychiatric samples (i.e., simulators and controls), classification accuracy was noticeably poorer when attempting to differentiate between psychiatric patients and suspected malingerers, with only 2 PAI indicators significantly discriminating between them."

"Differentiation of mentally ill criminal defendants from malingerers on the MMPI-2 and PAI" by
L. T. Kucharski & D. S.Thomas. American Journal of Forensic Psychology, 2007, vol. 25, #3, pages 21-42.

Summary: "he results demonstrated that the MMPI-2 F, Fp and the newly developed Fc and the PAI NIM scales reasonably accurately differentiated the groups with acceptable sensitivity and specificity. Practical cutoff scores were identified for all but Fc."

"Does the disorder matter? Investigating a moderating effect on coached noncredible overreporting using the MMPI-2 and PAI." Veltri, C. O. C. and J. E. Williams (2013). Assessment; 20(2):199-209

Summary: "The results of this study indicated that the specific psychiatric disorder being feigned did moderate the impact coaching had on the detection of overreported psychopathology using several scales on the MMPI-2 and PAI."

"Malingering on the Personality Assessment Inventory: Identification of specific feigned disorders" by C. J. Hopwood, L. C. Morey, R. Rogers, & K. Sewell. Journal of Personality Assessment, February, 2007, vol. 88, #1, pages 43-48.

Summary: This study "tested a method designed to delineate the specific Clinical scales relevant for interpretation of deliberately feigned disorders. We used associations between the Negative Impression Management (NIM) scale and Clinical scales in the normative standardization sample to derive NIM predicted scale scores in a regression framework. We contrasted these predicted scores with observed scores on Clinical scales to yield NIM predicted discrepancies hypothesized to identify those Clinical scales most salient for the interpretation of negative distortion. We found this method to be effective in identifying particular distortion on the relevant scales for individuals attempting to feign 3 specific diagnoses (major depressive disorder, generalized anxiety disorder, and schizophrenia)."

"Predictive capacity of the MMPI-2 and PAI validity scales and indexes to detect coached and uncoached feigning" by Michael Bagby, Robert Nicholson, Jason Bacchiochi, Andrew Ryder, & Allison, Bury. Journal of Personality Assessment, February, 2002, pages 69-86.

Summary: Studied the effectiveness of the validity scales and malingering indices of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI). "Coaching had no effect on the ability of the research participants to feign more successfully than those participants who received no coaching. For the MMPI-2, the Psychopathology F scale, or F-sub((p)), proved to be the best at distinguishing psychiatric patients from research participants instructed to malinger. For the PAI, the Rogers Discriminant Function index (RDF) was clearly superior to the other PAI fake-bad validity indicators; neither the Negative Impression Management scale nor Malingering Index were effective at detecting malingered profiles in this study."

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

Portland Digit Recognition Test (PDRT)

"Detecting malingering in traumatic brain injury and chronic pain: A comparison of three forced-choice symptom validity tests" by Greve, Kevin W.; Ord, Jonathan; Curtis, Kelly L.; Bianchini, Kevin J.; & Brennan, Adrianne. Clinical Neuropsychologist, August, 2008, vol. 22, #5, pages 896-918.

Summary: "Individual and joint malingering detection accuracy of the Portland Digit Recognition Test (PDRT), Test of Memory Malingering (TOMM), and Word Memory Test (WMT) was examined in traumatic brain injury (TBI; 43 non-malingering, 27 malingering) and chronic pain (CP; 42 non-malingering, 58 malingering) using a known-groups design. At published cutoffs, the PDRT and TOMM were very specific but failed to detect about 50% of malingerers; the WMT was sensitive but prone to false positive errors. ROC analyses demonstrated comparable accuracy across all three tests. Joint classification accuracy was superior to that of the individual tests."

"Portland Digit Recognition Test: A review of validation data and clinical use" by Laurence Binder. Journal of Forensic Neuropsychology, 2002, 2, pages 27-41.

Summary: Reviews the studies that have helped establish the PDRT's (Portland Digit Recognition Test) sensitivity and specificity. Notes that a survey found "that 27% of forensic neuropsychologists reported using the PDRT consistently."


Psychological Inventory of Criminal Thinking Styles (PICTS)

"Screening for malingering/exaggeration of psychiatric symptomatology in prison inmates using the PICTS Confusion and Infrequency scales" by G. D. Walters. Journal of Forensic Sciences, 2011, 56(2), pages 444-449.

Summary: “A sample of 76 federal prison inmates with a history or current complaints of significant psychiatric symptomatology at intake were followed for a period of 4–39 months by a psychologist who rated the inmate as malingering..., substantially exaggerating..., minimally exaggerating..., or honestly reporting signs and symptoms of schizophrenia, bipolar disorder, major depression, or severe anxiety disorder. The Confusion-revised (Cf-r) and Infrequency (INF) scales of the Psychological Inventory of Criminal Thinking Styles, which had been administered routinely at intake, revealed that only the INF successfully predicted malingering and exaggeration of psychiatric symptomatology even after pre-existing group differences in age, race, and overall criminal thinking were controlled. These results suggest that the INF scale can potentially serve as an effective initial screening measure for malingering ⁄ exaggeration in inmates presenting with mental health complaints.”

 

Quick Test for Posttraumatic Stress Disorder

"Development of a validity scale for combat-related posttraumatic stress disorder: Evidence from simulated malingerers and actual disability claimants" by Kenneth R. Morel. Journal of Forensic Psychiatry & Psychology, 2008, vol. 19, #1, pages 52-63.

Summary: "Individuals being evaluated for posttraumatic stress disorder (PTSD) in disability compensation cases or forensic settings are at increased risk of response bias, making the legitimacy of face-valid self-report measures assessing PTSD in these settings questionable. The following two studies evaluate the Quick Test for PTSD (Q-PTSD) as a time-efficient method of detecting response bias in individuals being assessed for combat-related PTSD. In the first study, 78 participants were randomly assigned to either an experimental group (simulated malingerers) or a control group (genuine reporting) and were administered the Q-PTSD along with a standard measure of combat-related PTSD. The Q-PTSD demonstrated suitable internal consistency and construct validity. Post-hoc analyses revealed that the best cutoff score for the Q-PTSD resulted in values =.91 for sensitivity, specificity, positive predictive value, and negative predictive value in this sample. Utilizing the established cutoff, the second study evaluated the criterion-related validity of the Q-PTSD by assessing its correlation with the Morel Emotional Numbing Test for PTSD (MENT) in 67 military veterans applying for disability pensions and claiming combat-related PTSD."

Raven's Standard Progressive Matrices (RSPM)

"Comparison of RSPM performances between the head injured patients with and without malingering" by Shu-ming Ding, Bei-ling Gao, & Ren-gang Liu. Chinese Journal of Clinical Psychology, May, 2002, pages 97-99.

Summary: Examining the performance of malingering and non-malingering head injury patients on the Raven's Standard Progressive Matrices (RSPM), this study found: "There were significant differences in the performances of the two groups of patients in subtests A, B, C and D of the RSPM. There were no significant differences on subtest E."

"Detection of children's malingering on Raven's Standard Progressive Matrices" by Kim McKinzey, Joerg Prieler, & John Raven. British Journal of Clinical Psychology, March, 2003, pages 95-99.

Summary: "A formula for detecting faked Raven's SPM profiles was cross-validated on 44 children and adolescents (ages 7-17 yrs). It yielded a false negative rate of 64%. However, a rule using three very easy items (i.e., any of A3, A4 or B1 missed) yielded a hit rate of 95%, with 5% false positive and negative rates."

Recognition Memory Test

"Warrington's Recognition Memory Test in the detection of response bias" by Scott Millis. Journal of Forensic Neuropsychology, 2002, 2, pages 147-166.

Summary: Discusses the psychometric properties of the Recognition Memory Test (RMT), a technique for using the RMT to identify response bias, and benchmarks based on a sample of 90 people with acute traumatic brain injury.

Reliable Digit Span

"Detecting malingered neurocognitive dysfunction using the Reliable Digit Span in traumatic brain injury" by Charles Mathias, Kevin Grevem Kevin Bianchini, Rebecca Houston, & John Crouch. Assessment, September, 2002, pages 301-308.

Summary: Examined the sensitivity, specificity, and predictive power of the Reliable Digit Span in regard to malingering neurocognitive dysfunction on 54 traumatic brain injury patients and a control group of 30 patients. Concluded that "classification accuracy for the RDS was excellent."

"Detection of Malingering Using Atypical Performance Patterns on Standard Neuropsychological Tests" by Glenn Larrabee. Clinical Neuropsychologist, August, 2003, vol. 17, #3, pages 410-425.

Summary: "Cut-off scores defining clinically atypical patterns of performance were identified for five standard neuropsychological and psychological tests: Benton Visual Form Discrimination (VFD), Finger tapping (FT), WAIS-R Reliable Digit Span (RDS), Wisconsin Card Sorting Failure-to-Maintain Set (FMS), and the Lees-Haley Fake Bad Scale (FBS) from the MMPI-2. . . . Combining the derivation and cross-validation samples yielded a sensitivity of 87.8%, specificity of 94.4%, and combined hit rate of 91.6%." In closing the discussion section, the author emphasizes that "assessment of effort in medicolegal settings must be multivariate. . . . As shown in the present investigation, requiring multiple indicators of poor effort lowers the chances of false positive identification errors in the assessment of malingering."

"Intraindividual variability as an indicator of malingering in head injury" by Esther, Strauss, Daniel Slick, Judi Levy-Bencheton, Michael Hunter, Stuart MacDonald, & David Hultsch. Archives of Clinical Neuropsychology, July, 2002, pages 423-444.

Summary: Analog study of malingering using the Reliable Digit Span (RDS) task, the Victoria Symptom Validity Test (VSVT), and the Computerized Dot Counting Test (CDCT). Half the participants were asked to fake an injury convincingly and the other half were asked to take the tests honestly. Findings suggest that "regardless of an individual's experience, consideration of both level of performance (particularly on forced-choice symptom validity tasks) and intraindividual variability holds considerable promise for the detection of malingering."

"Malingering in Toxic Exposure: Classification Accuracy of Reliable Digit Span and WAIS-III Digit Span Scaled Scores" by Kevin Greve,, Steven Springer, Kevin Bianchini,William Black,, Matthew Heinly,, Jeffrey Love,, Douglas Swift,, & Megan Ciota. Assessment,, March, Vol 14(1), pages 12-21..

Summary: This research "examined the sensitivity and false-positive error rate of reliable digit span (RDS) and the WAIS-III Digit Span (DS) scaled score in persons alleging toxic exposure and determined whether error rates differed from published rates in traumatic brain injury (TBI) and chronic pain (CP). Data were obtained from the files of 123 persons referred for neuropsychological evaluation related to alleged exposure to environmental and industrial substances. Malingering status was determined using the criteria of Slick, Sherman, and Iverson (1999). The sensitivity and specificity of RDS and DS in toxic exposure are consistent with those observed in TBI and CP. These findings support the use of these malingering indicators in cases of alleged toxic exposure"

"Reliable Digit Span is Unaffected by Laboratory-Induced Pain Implications for Clinical Use" By Joseph Etherton, Kevin Bianchini, Megan Ciota, & Kevin Greve. Assessment, March, 2005, vol. 12, #1, pages 101-106.

Summary: 60 "undergraduate volunteers randomly assigned to one of three conditions (control, simulator, pain) completed the Digit Span subtext from the Wechsler Adult Intelligence Scale-III from which the RDS is derived. No differences in RDS scores were found between the control and pain groups, and neither group scored below 8. Sixty-five percent of the simulator group scored 7 or below."

"Sensitivity and Specificity of Reliable Digit Span in Malingered Pain-Related Disability" by Joseph Etherton, Kevin Bianchini, Kevin Greve, &Matthew Heinly. Assessment, June, 2005, vol. 12, #2, pages 130-136.

Summary: According to this article, " The reliable digit span (RDS) performance of chronic pain patients with unambiguous spinal injuries and no evidence of exaggeration or response bias (n = 53) was compared to that of chronic pain patients meeting criteria for definite malingered neurocognitive dysfunction (n = 35), and a group of nonmalingering moderate-severe traumatic brain injury (TBI) patients (n = 69). The results demonstrated that scores of 7 or lower were associated with high specificity (> .90) and sensitivity (up to .60) even when moderate to severe TBI are included. Multiple studies have demonstrated that RDS scores of 7 or lower rarely occur in TBI and pain patients who are not intentionally performing poorly on cognitive testing. This study supports the use of the RDS in detecting response bias in neuropsychological patients complaining of pain as well as in the assessment of pain-related cognitive impairment in patients whose primary complaint is pain."

"Use of reliable digits to detect malingering in a criminal forensic pretrial population" by Scott Duncan & Denella Ausborn. Assessment, March, 2002, 56-61.

Summary: A cross-validation study extending previous research "on the reliable digits method of detecting suspected malingering on the Wechsler Adult Intelligence Scale - Revised (WAIS-R). The results support the use of the reliable digits method on a criminal forensic pretrial population . . . . Sensitivities, specificities, and incremental hit rates for 2 cut levels of the reliable digits method, MMPI-2 Infrequency and the Personality Assessment Inventory Negative Impression Scales, as well as multiple combined cut scores, were comparable to those observed in previous studies that used neuropsychologically evaluated participants."

Rey Malingering Tests

"Classification accuracy of multiple visual spatial measures in the detection of suspect effort" by Whiteside, D., D. Wald, et al. The Clinical Neuropsychologist, 2011, 25(2), pages 287-301.

Summary: “The purpose of this study was to evaluate the classification accuracy of several commonly used visual spatial measures, including the Judgment of Line Orientation Test, the Benton Facial Recognition Test, the Hooper Visual Organization Test, and the Rey Complex Figure Test-Copy and Recognition trials. Participants included 491 consecutive referrals who participated in a comprehensive neuropsychological assessment and met study criteria.... The groups differed significantly on all measures. Additionally, receiver operating characteristic (ROC) analysis indicated all of the measures had acceptable classification accuracy, but a measure combining scores from all of the measures had excellent classification accuracy. Results indicated that various cut-off scores on the measures could be used depending on the context of the evaluation. Suggested cut-off scores for the measures had sensitivity levels of approximately 32-46%, when specificity was at least 87%. When combined, the measures suggested cut-off scores had sensitivity increase to 57% while maintaining the same level of specificity (87%).”

"Developing sensitivity to distortion: Utility of psychological tests in differentiating malingering and psychopathology in criminal defendants" by Michaela Heinze. Journal of Forensic Psychiatry & Psychology, April, 2003, vol. 14, #1, pages 151-177.

Examined findings from 66 men hospitalized as incompetent to stand trial. Tests included the Minnesota Multiphasic Personality Inventory (MMPI-2), Structured interview of Reported Symptoms (SIRS), M Test, the Atypical Presentation Scale (AP), and the Rey 15-Item Memory Test (RMT). "Overall, results support the use of psychological testing in the detection of malingering of psychotic symptoms."

"Effects of incentive and preparation time on performance and classification accuracy of standard and malingering-specific memory tests" by David Shum, John O'Gorman, & Arlene Alpar. Archives of Clinical Neuropsychology, September, 2004, vol 19, #6, pages 817-823.

Summary: This simulation study used a "2 (no incentive vs. a $20 incentive) * 2 (immediate vs. delayed preparation) factorial design. Eighty undergraduate students and 15 individuals with traumatic brain injury were administered standard (viz., Digit Span and Visual Memory Span from the WMS-R) and malingering-specific (viz., the Rey 15-Item Memory Test and the Multi-Digit Memory Test) memory tests. Preparation time was found to have a significant effect on performance and classification accuracy on a number of these tests, but incentive was found to have a significant effect on the performance but not the classification accuracy of one test (viz., the Multi-Digit Memory Test). These findings suggest that extra-test variables such as incentive and preparation time should be taken into consideration in evaluating the utility of standard and malingering-specific memory tests in detecting malingering."

"Effects of motivation, coaching, and knowledge of neuropsychology on the simulated malingering of head injury" by Kristi Erdal. Archives of Clinical Neuropsychology, January, 2004, vol. 19, #1, pages 73-88.

Summary: Investigated whether students could successfully take head injury on the Rey 15-Item Test (FIT) and the Dot Counting Test (DCT) by randomly assigning them to one of 3 motivation groups -- no motivation, compensation, & avoidance of blame for motor vehicle accident -- and one of 3 coaching conditions -- no coaching, coaching post-concussive symptoms, & coaching symptoms in addition to warning about malingering detection. The author concluded that "coaching interaction on the accuracy variables indicated that those in the compensation condition performed the most poorly, and that coaching plus warning only tempers malingering on memory tasks, not timed tasks."

"Evaluation of malingering cut-off scores for the Rey 15-Item Test: A brain injury case study series" by Laura Taylor, Jeffrey Kreutzer, & Deborah West. Brain Injury, April, 2003, pages 295-308.

Summary: The authors present 5 case studies in which the Rey Fifteen-Item Test (FIT) and standardized neurobehavioral and neuropsychological measures were administered to people who were outpatients with severe brain injury." Using the standardized scoring protocol, all 5 patients obtained perfect (15/15 correct) scores on the FIT. All patients exhibited significant impairment on other neuropsychological indices, included measures of memory and attention. Results lend support to the use of higher cut-off scores to identify malingering."

"Malingering on the RAVLT: Part II. Detection strategies" by Karen Sullivan, Cassandra Deffenti, & Beth Keane. Archives of Clinical Neuropsychology, April, 2002, pages 223-233.

Summary: Undergraduates were assigned to one of 4 conditions (malingerers, malingers-with-warning, warning only, and control) to assess 2 potential malingering indices derived on the "Results indicate that both indices failed to reliably differentiate between malingerers and nonmalingerers, and warnings failed to modify Ss' behaviour."

"Review of Rey's strategies for detecting malingered neuropsychological impairment" by Richard Frederick. Journal of Forensic Neuropsychology, 2002, 2, pages 1-25.

Summary: Examines the research into the efficacy of the Rey 15-Item Memory Test (RMT), the Rey Word Recognition Test (WRT), and the Rey Dot Counting Test (DCT).

"Rey AVLT Serial Position Effect: A Useful Indicator of Symptom Exaggeration?" byMatthew Powell, Jeffrey Gfeller, Michael Oliveri, Shannon Stanton, and Bryan Hendricks, Bryan. Clinical Neuropsychologist, July, 2004, vol. 18, #3, pages 465-476.

Summary: "The SPE on the RAVLT was examined in four groups: normal controls (NC), symptom-coached simulators (SC), test-coached simulators (TC), and a group of moderate to severe subacute traumatic brain injury (TBI) patients. Normal control participants and TBI patients demonstrated the expected SPE. Only the SC simulators clearly suppressed the primacy effect. The SPE appears neither sensitive nor specific enough to be used independently of more sensitive symptom validity tests in the detection of suboptimal effort. It may be especially problematic when used with clients presenting with sophisticated styles of exaggeration and in settings with lower base rates of compromised effort."

"Test of Malingered Incompetence (TOMI): A forced-choice instrument for assessing cognitive malingering in competence to stand trial evaluations" by Colwell, Kevin; Colwell, Lori H.; Perry, Ashlie T.; Wasieleski, David; & Billings, Tod. American Journal of Forensic Psychology, 2008, vol. 26, #3, pages 17-42.

Summary: "The TOMI consists of two 25-item, two-alternative, forced-choice scales--General Knowledge (TOMI-G) and Legal Knowledge (TOMI-L)-- designed to detect malingered cognitive impairment in CST evaluations. The TOMI was derived and validated with a university sample (N = 242), with a cut score of < 21 providing maximum classification accuracy of honest and dishonest respondents. Subsequently, the TOMI was administered to forensic inpatient residents (N = 30) and was compared to existing, well-established tests of malingering (the Rey-FIT and the TOMM). Results indicated strong correlations and predictive agreement for both scales, and distinction between honest and probable dishonest respondents for the TOMI-L. A third study provided additional validation for the TOMI in distinguishing honest from dishonest student respondents (N = 120) and examined the effects of motivation on response style. For dishonest responders, those in the high motivation group scored significantly lower than those in the low motivation group, further betraying their dishonesty."

"Using the TOMM for evaluating children's effort to perform optimally on neuropsychological measures" by Marios Constantinou & Robert McCaffrey. Child Neuropsychology, June, 2003, pages 81-90.

Summary: The study involved administering the Test of Memory Malingering (TOMM) and the Rey-15-item test to 128 children ranging from 5 to 12 years old. "The results indicated that the TOMM has the potential to be used as a measure for identifying children who do not put forth maximal effort during neuropsychological evaluations. In contrast, the Rey-15-item test does not appear to be a promising measure of effort for use with children, especially younger children."

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

Rivermead Questionnaire

"Using the Wechsler Memory Scale-III to detect malingering in mild traumatic brain injury" by Ord, Jonathan S.; Greve, Kevin W.; & Bianchini, Kevin J. Clinical Neuropsychologist, July, 2008, vol. 22, #4, pages 689-704.

Summary: "This study examined the classification accuracy of the WMS-III primary indices in the detection of Malingered Neurocognitive Dysfunction (MND) in Traumatic Brain Injury (TBI) using a known-groups design. Sensitivity, specificity, and positive predictive power are presented for a range of index scores comparing mild TBI non-malingering (n = 34) and mild TBI malingering (n = 31) groups. A moderate/severe TBI non-malingering (n = 28) and general clinical group (n = 93) are presented to examine specificity in these samples. In mild TBI, sensitivities for the primary indices ranged from 26% to 68% at 97% specificity. Three systems used to combine all eight index scores were also examined and all achieved at least 58% sensitivity at 97% specificity in mild TBI. Specificity was generally lower in the moderate/severe TBI and clinical comparison groups. This study indicates that the WMS-III primary indices can accurately identify malingered neurocognitive dysfunction in mild TBI when used as part of a comprehensive classification system."

"Use of specific malingering measures in a Spanish sample" by Vilar-López, Raquel; Gómez-Río, Manuel; Caracuel-Romero, Alfonso; Llamas-Elvira, Jose; & Pérez-García, Miguel. Journal of Clinical and Experimental Neuropsychology, August, 2008, vol. 30, #6, pages 710-722.

Summary: "There are an increasing number of tests available for detecting malingering. However, these tests have not been validated for using in Spanish speakers. The purpose of this study is to explore the value of three specific malingering tests in the Spanish population. This study used a known-groups design, together with a group of analog students. The results show that both the Victoria Symptom Validity Test and the b Test can be used to detect malingering in Spanish population. However, some restrictions must be applied when the Rey 15-Item Test is administered and interpreted."

Rogers Discriminant Function

"Detection of malingering of psychiatric disorder with the Personality Assessment Inventory: An investigation of criminal defendants" by L. T. Kucharski, J. P. Toomey, K. Fila, & S. Duncan.
Journal of Personality Assessment, February, 2007, vol 88. #1, pages 25-32.

Summary: A regressional analysis using malingering vs. non-malingering as criterion found that "the PAI Negative Impression Management (NIM) scale but not the Rogers Discriminant Function (RDF; Rogers, Sewell, Morey & Ustad, 1996) nor the Malingering index (MAL; Morey, 1996) significantly differentiated the malingering from the not malingering group."

Rorschach

"Can sex offenders who minimize on the MMPI conceal psychopathology on the Rorschach?" by Linda Grossman, Orest Wasyliw, Andrea Benn, & Kevin Gyoerkoe. Journal of Personality Assessment, June, 2002, vol. 78, #3, pages 484-501.

Summary: This study "divided 74 alleged sex offenders (aged 20-78 yrs) according to whether they minimized on the MMPI ... or MMPI-2 ... and compared their Rorschachs on indexes of distress, faulty judgment, interpersonal dysfunction, and cognitive distortions.... As predicted, sex offenders showed more Rorschach psychopathology than normative samples. Sex offenders' protocols that contained sexual content also showed perceptual distortions. These findings indicate that the Rorschach is resilient to attempts at faking good and may therefore provide valuable information in forensic settings where intentional distortion is common."

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Summary: Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

Sixteen PF (16 PF)

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

Slick Criteria for Malingered Neurocognitive Dysfunction

"Malingered Neurocognitive Dysfunction in Neurotoxic Exposure: An Application of the Slick Criteria" by Kevin Bianchini, Rebecca Houston, Kevin Greve, Rick Irvin, William Black, Douglas Swift, and Joseph Tamimie. Journal of Occupational & Environmental Medicine, in press.

Summary: In a group of 4 patients whom one of the authors originally evaluated as a defense expert, the authors explore Slick criteria for malingered neurocognitive dysfunction.

Stanford-Binet-Revised

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

Stroop

"Differentiating malingering from genuine cognitive dysfunction using the Trail Making Test-ration and stroop interference scores" by J. Egeland & T. Langfjæran. Applied Neuropsychology, 2007, vol. 14, #2, pages 113-119.

Summary: "In this study possible malingerers (n = 41), impaired (30) or cognitively normal (17) litigants were compared on the Trail Making Test B:A ratio score and Stroop Interference. The majority of possible malingerers had a low TMT-ratio (<2.5) and an inverted Stroop effect, whereas the majority of impaired subjects had a high TMT-ratio and specific Stroop interference. Sensitivity to malingering was 61 and 68 percent, and specificity was 57 and 59 percent. This is too low for valid classification of individuals. However, the combination of both measures increases predictability. The clinician is advised to look for other evidence of malingering in cases of simultaneous low TMT-ratio and inverted Stroop. Patients with high TMT-ratio and Stroop interference, should be thoroughly examined for indications of brain disease. "

"Is the emotional Stroop paradigm sensitive to malingering? A between-groups study with professional actors and actual trauma survivors" by Todd Buckley, Tara Galovski, Edward Blanchard, & Edward Hickling. Journal of Traumatic Stress, February, 2003, pages 59-66.

Summary: Conducted an experiment in which 6 "professional actors, trained by psychologists and acting coaches to feign PTSD, were covertly enrolled into a treatment outcome study for PTSD with the aim of investigating malingering. During pretreatment assessment, individuals completed an emotional Stroop task. Vocal response latencies to different classes of stimuli were examined for sensitivity to malingering. . . . The actor/dissimulation group was able to feign an overall slowing of response latency across stimulus types, similar to the PTSD group. However, they were unable to modulate response latency as a function of stimulus content, a pattern that characterized the PTSD group."

Structured Interview of Reported Symptoms (SIRS)

"Assessment of malingering with repeat forensic evaluations: Patient variability and possible misclassification on the SIRS and other feigning measures" by Richard Rogers, Michael Vitacco, & Samantha Kurus. Journal of the American Academy of Psychiatry and the Law, vol. 38, #1, March, 2010, pages 109-114.

Summary: Patients with Axis I disorders often fluctuate markedly in their clinical presentations in forensic and other professional settings. Although such fluctuations could suggest ineffectual efforts at malingering, more likely explanations include confusion or poor insight into psychopathology, imprecision in the assessment methods, or actual changes in symptomatology. An important concern is whether such fluctuations, common in repeat forensic evaluations, might lead to false-positive results—specifically, the misclassifications of patients as malingerers. We used the Structured Interview of Reported Symptoms (SIRS) to examine the effects of repeat administration of the interview on 52 likely genuine forensic inpatients. As expected, test-retest correlations for individual SIRS scales were highly variable. Despite this variability, the magnitude of differences remained small. The SIRS produced no errors in the classification of likely genuine forensic inpatients at the first or the repeat administrations."

"Detection of feigning using multiple PAI Scale elevations: A new index." Gaines, M. V., et al. (2013). Assessment 20(4): 437-447.

Summary: "Regression analyses revealed that MFI was a stronger predictor of SIRS outcome than NIM, MAL, and RDF. In addition, NIM, MAL, and RDF did not add substantial incremental validity to MFI in predicting SIRS outcome. Receiver operating characteristic analyses revealed sensitivity of 68.89% and specificity of 94.34% at an MFI cutoff of more than 76, which compared favorably with the utility of NIM, MAL, and RDF."

"Detection of malingering in psychiatric unit and general population prison inmates: A comparison of the PAI, SIMS, and SIRS" by J. F. Edens, N. G. Poythress, M. M. Watkins-Clay. Journal of Personality Assessment, February, 2007, vol. 88, #1, pages 33-42.

Summary: This study "compared the utility of three instruments, the Personality Assessment Inventory (PAI; Morey, 1991), the Structured Inventory of Malingered Symptomatology (Smith & Burger, 1997), and the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) to detect malingering among prisoners. We examined 4 inmate samples: (a) prisoners instructed to malinger, (b) "suspected malingerers" identified by psychiatric staff, (c) general population control inmates, and (d) psychiatric patients. Intercorrelations among the measures for the total sample (N = 115) were quite high, and receiver operating characteristic analyses suggested similar rates of overall predictive accuracy across the measures. Despite this, commonly recommended cut scores for these measures resulted in widely differing rates of sensitivity and specificity across the subsamples. Moreover, although all instruments performed well in the nonpsychiatric samples (i.e., simulators and controls), classification accuracy was noticeably poorer when attempting to differentiate between psychiatric patients and suspected malingerers, with only 2 PAI indicators significantly discriminating between them."

"Developing sensitivity to distortion: Utility of psychological tests in differentiating malingering and psychopathology in criminal defendants" by Michaela Heinze. Journal of Forensic Psychiatry & Psychology, April, 2003, vol. 14, #1, pages 151-177.

Examined findings from 66 men hospitalized as incompetent to stand trial. Tests included the Minnesota Multiphasic Personality Inventory (MMPI-2), Structured interview of Reported Symptoms (SIRS), M Test, the Atypical Presentation Scale (AP), and the Rey 15-Item Memory Test (RMT). "Overall, results support the use of psychological testing in the detection of malingering of psychotic symptoms."

"Examining the Use of the M-FAST With Criminal Defendants Incompetent to Stand Trial" by Holly Miller, Holly. International Journal of Offender Therapy & Comparative Criminology, June, 2004, vol. 48, #3, pages 268-280.

Summary: In this study of 50 criminal defendants found incompetent to stand trial because of a mental illness, "the M-FAST total score and items were compared with the Structured Interview of Reported Symptoms (SIRS) and the fake-bad indicators of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results indicated good evidence of construct and criterion validity, demonstrated by t tests, receiver operating characteristics analysis, and high correlations between the M-FAST, SIRS, and the fake-bad indices on the MMPI-2. Tentative cut scores for the M-FAST total score and scales were examined and demonstrated high utility with the sample of criminal defendants incompetent to stand trial."

"Investigating the relationship between antisocial personality disorder and malingering" by Pierson, A. M., B. Rosenfeld, et al. Criminal Justice and Behavior, 2011, 38(2), pages 146-156.

Summary: “Forensic patients with antisocial personality disorder (APD) were compared to forensic patients without APD on a validated measure of malingering (Structured Interview of Reported Symptoms [SIRS]). Results indicated that patients with APD were not significantly more likely to exceed accepted cutoff scores on the SIRS (i.e., 17.9% vs. 11.6%, respectively), nor were they more likely to be suspected of malingering by clinicians (17.9% vs. 18.6%). Although there was a high level of disagreement between clinicians' determination of malingering and classification by the SIRS, this relationship was not significant.”

"Malingering as a categorical or dimensional construct: The latent structure of feigned psychopathology as measured by the SIRS and MMPI-2 by Walters, Glenn D.; Rogers, Richard; Berry, David T. R.; Miller, Holly A.; Duncan, Scott A.; McCusker, Paul J.; Payne, Joshua W.; Granacher Jr., Robert P. Psychological Assessment, September, 2008, vol. 20, #3, pages 238-247.

Summary: "The 6 nonoverlapping primary scales of the Structured Interview of Reported Symptoms (SIRS) were subjected to taxometric analysis in a group of 1,211 criminal and civil examinees in order to investigate the latent structure of feigned psychopathology. Both taxometric procedures used in this study, mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV), produced dimensional results. A subgroup of participants (n = 711) with valid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols were included in a second round of analyses in which the 6 nonoverlapping primary scales of the SIRS and the Infrequency (F), InfrequencyPsychopathology (Fp), and Dissimulation (Ds) scales of the MMPI-2 served as indicators. Again, the results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingeringhonest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one."

"New and improved? A comparison of the original and revised versions of the Structured Interview of Reported Symptoms." Green D, Rosenfeld B, Belfi B. (2013) Assessment 20: 210-218.

Summary: "The SIRS-2 yielded an impressive specificity rate (94.3%) that exceeded that obtained using the original SIRS scoring method (92.0%) and approached that observed in the SIRS-2 normative data (97.5%). However, changes in scoring resulted in markedly lower sensitivity rates of the SIRS-2 (36.8% among forensic patients and 66.7% among simulators) compared with the SIRS (47.4% and 75.0%, respectively). The removal of the Total Score from the SIRS-2 further hindered identification of feigning. Analyses also evaluated the additive value of the new RS-Total and MT Index scales in the SIRS-2."

"Screening for feigned psychiatric symptoms in a forensic sample by using the MMPI-2 and the Structured Inventory of Malingered Symptomatology" by Jason Lewis, Andrew Simcox, & David Berry. Psychological Assessment, June, 2002, pages 170-176.

Summary: Reports results of administering the Structured Interview of Reported Symptoms (SIRS), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Structured Inventory of Malingered Symptomatology (SIMS) to 55 men in the midst of pretrial forensic assessments for criminal responsibility or competence to stand trial. "On the basis of results from the SIRS, 31 were classified as honest responders and 24 as feigning. Significant differences between the 2 groups were found on all SIMS scales as well as on all tested MMPI-2 fake bad validity scales. The SIMS total score and the MMPI-2 Backpage Infrequency (Fb) scale had relatively high negative predictive power (100% and 92%, respectively)."

"Use of the SIRS in compensation cases: An examination of its validity and generalizability" by Richard Rogers, Joshua Payne, David Berry, & Robert Granacher Jr. Law and Human Behavior. Vol 33(3), Jun 2009, pp. 213-224.

Summary: "The present study examined SIRS data from 569 individuals undergoing forensic neuropsychiatric examinations for the purposes of workers' compensation, personal injury, or disability proceedings. Using bootstrapping comparisons, three primary groups were identified: FMD, feigned cognitive impairment (FCI), genuine-both (GEN-Both) that encompasses both genuine disorders (GEN-D) and genuine-cognitive presentation (GEN-C). Consistent with the SIRS main objective, very large effect size (M Cohen's d=1.94) were observed between FMD and GEN-Both groups. Although not intended for this purpose, moderate to large effect sizes (M d=1.13) were found between FCI and GEN-Both groups. An important consideration is whether SIRS results are unduly affected by common diagnoses or clinical conditions. Systematic comparisons were performed based on common disorders (major depressive disorder, PTSD, and other anxiety disorders), presence of a cognitive disorder (dementia, amnestic disorder, or cognitive disorder NOS), or intellectual deficits (FSIQ<80). Generally, the magnitude of differences on the SIRS primary scales was small and nonsignificant, providing evidence of the SIRS generalizability across these disgnostic categories. Finally, the usefulness of the SIRS improbable failure-revised (IF-R) scale was tested as a FCI screen. Although it has potential in ruling out genuine cases, the IF-R should not be used as a feigning screen."

"Validation of the Spanish SIRS with monolingual Hispanic outpatients" by Correa, A. A., R. Rogers, et al. Journal of Personality Assessment, 2010, 92(5), pages 458-464.

Summary: “Using a between-subjects simulation design, the Spanish SIRS was found to produce reliable results with small standard errors of measurement.”

"What Tests Are Acceptable for Use in Forensic Evaluations? A Survey of Experts" by Stephen Lally. Professional Psychology: Research & Practice, October, 2003, vol. 34, #5, pages 491-498.

Summary: Surveyed diplomates in forensic psychology "regarding both the frequency with which they use and their opinions about the acceptability of a variety of psychological tests in 6 areas of forensic practice. The 6 areas were mental state at the offense, risk for violence, risk for sexual violence, competency to stand trial, competency to waive Miranda rights, and malingering." In regard to the forensic assessment of malingering, "the majority of the respondents rated as acceptable the Structured Interview of Reported Symptoms (SIRS), Test of Memory Malingering, Validity Indicator Profile, Rey Fifteen Item Visual Memory Test, MMPI-2, PAI, WAIS-III, and Halstead-Reitan. The SIRS and the MMPI-2 were recommended by the majority. The psychologists were divided between acceptable and unacceptable about using either version of the MCMI (II or III). They were also divided, although between acceptable and no opinion, for the WASI, KBIT, Luria-Nebraska, and Stanford-Binet-Revised. The diplomates viewed as unacceptable for evaluating malingering the Rorschach, 16PF, projective drawings, sentence completion, and TAT. The majority gave no opinion on the acceptability of the Malingering Probability Scale, M-Test, Victoria Symptom Validity Test, and Portland Digit Recognition Test."

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