Assessment of validity and response bias in neuropsychiatric evaluations (original) (raw)
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MALINGERING IN FORENSIC NEUROPSYCHOLOGY
uninet.edu
The focus of this session will on the importance of considering the issue of malingering as part of every forensic neuropsychological evaluation (ie, neuropsychological evaluations that will be presented in a courtroom). The DSM-IV definition of malingering will serve as the basis ...
Clinical and conceptual problems in the attribution of malingering in forensic evaluations
The journal of the American Academy of Psychiatry and the Law, 2009
The authors review clinical and conceptual errors that contribute to false attributions of malingering in forensic evaluations. Unlike the mental disorders, malingering is not defined by a set of (relatively) enduring symptoms or traits; rather, it is an intentional, externally motivated, and context-specific form of behavior. Despite this general knowledge, attributions of malingering are often made by using assessment tools that may detect feigning but cannot be relied upon to determine incentive and volition or consciousness (defining characteristics of malingering). In addition, forensic evaluators may overlook the possibility that feigning is a function of true pathology, as in Ganser syndrome or the factitious disorders, or that a seemingly malingered presentation is due to symptoms of an underlying disorder, such as dissociative identity disorder (DID). Other factors that set the stage for false positives, such as pressure on forensic specialists to identify malingering at al...
Egyptian Journal of Forensic Sciences, 2011
Background: Recently, there is a growing research and clinical interest in the field of forensic neuropsychology. Within this discipline, identification of feigned symptoms presented during forensic assessment has become a particularly important topic. Studies have demonstrated how difficult it can be to detect feigned presentations. Clinicians and researchers have failed to rule out malingering especially in cases of mild or moderate brain damage. Objectives: The study aims to compare between infrequency (F), fake bad scale (FBS) and infrequency psychopathology (F(p)) scales in diagnosis of malingering to determine the best neuropsychological scale that can be used for diagnosis of malingering; aiming to help forensic psychiatrists in their practice. Patients and methods: A cross-sectional descriptive study included 150 participants with recent head trauma was subjected using a questionnaire (includes demographic data, cause and degree of traumatic brain injury) completed by the participants. Three valid scales (infrequency (F), fake bad scale (FBS) and infrequency psychopathology F(p)) were administered to patients diagnosed as mild and moderate traumatic brain injury and attending the neurosurgery department at Suez Canal University Hospital seeking for a medical report about their recent trauma. The diagnostic outcomes of these scales were compared with the expert diagnosis based on the convenient clinical diagnostic tool (diagnostic and statistical manual of mental disorders IV (DSM-IV)).
Malingering neurocognitive dysfunction
Malingering neurocognitive dysfunction Psychologists examining patients involved in injury litigation, must consider the possibility of malingered neurocognitive dysfunction. This review article discusses the definition, diagnosis and baserate of malingering, as well as methods to detect exaggeration and malingering. Results from an earlier study by Egeland & Langfjæran (2007) are presented, as well as two historic cases that illustrate the complexities in this field. Distrust between patient and psychologist must be added to the list of contexts in risk of eliciting malingered test performance. The ethics of using symptom validity tests and unveiling the invalidity of a test protocol to the patient and in written reports, are discussed. http://www.psykologtidsskriftet.no/index.php?seks\_id=58711&a=2
Clinical Neuropsychologist, 2021
Objective: Citation and download data pertaining to the 2009 AACN consensus statement on validity assessment indicated that the topic maintained high interest in subsequent years, during which key terminology evolved and relevant empirical research proliferated. With a general goal of providing current guidance to the clinical neuropsychology community regarding this important topic, the specific update goals were to: identify current key definitions of terms relevant to validity assessment; learn what experts believe should be reaffirmed from the original consensus paper, as well as new consensus points; and incorporate the latest recommendations regarding the use of validity testing, as well as current application of the term 'malingering.' Methods: In the spring of 2019, four of the original 2009 work group chairs and additional experts for each work group were impaneled. A total of 20 individuals shared ideas and writing drafts until reaching consensus on January 21, 2021. Results: Consensus was reached regarding affirmation of prior salient points that continue to garner clinical and scientific support, as well as creation of new points. The resulting consensus statement addresses definitions and differential diagnosis, performance and symptom validity assessment, and research design and statistical issues. Conclusions/Importance: In order to provide bases for diagnoses and interpretations, the current consensus is that all clinical and forensic evaluations must proactively address the degree to which results of neuropsychological and psychological testing are valid.
A Validation of the Test of Memory Malingering in a Forensic Psychiatric Setting
Journal of Clinical and Experimental Neuropsychology (Neuropsychology, Development and Cognition: Section A), 2003
The Test of Memory Malingering (TOMM) has not been adequately validated in a forensic psychiatric setting. Dissimulation of cognitive impairment, as assessed by the TOMM, was evaluated in a group of 25 forensic inpatients admitted for evaluation of Competency to Stand Trial (CST/MSO group), and hypothesized to be at higher risk for feigning cognitive impairment. A comparison group of 36 patients, who were either civilly committed or adjudicated Not Guilty by Reason of Insanity (CIVIL/NGRI group), were hypothesized to be less likely to feign cognitive impairment. Groups were comparable in age, education, premorbid intelligence, and psychiatric symptom severity. Significantly more CST/MSO patients (36%) scored below a recommended TOMM cutoff score relative to CIVIL/NGRI patients (6%). Findings indicate excellent specificity and modest sensitivity, and generally support the validity of the TOMM in a forensic psychiatric population. The utility of different cutoff scores and need for multiple indicators of effort are discussed.
Differential Diagnosis of Malingering
This chapter covers the differential diagnosis of malingering and related clinical presentations in the context of independent neuropsychological assessment of compensation seeking individuals (e.g., those with a history of mild traumatic brain injury [MTBI])—a far from trivial issue in light of survey data suggesting that 20%–40% of persons in this population are thought to present with exaggerated or fabricated neuropsychological problems and deficits (Mittenberg, Patton, Cany-ock, & Condit, 2002; Sharland & Gfeller, 2007; Slick, Tan, Strauss, & Hultsch, 2004). The focus is on conceptual issues rather than specific psychometric tests and assessment methods (which are covered in other chapters in this book); and in that regard, there are no special considerations unique to cases of alleged MTBI. Nevertheless, the information in this chapter is directly applicable to symptom validity assessment in alleged or actual MTBI cases, and some of the example case scenarios involve patients ...
The Determination of Malingering: A Comprehensive Clinical-Forensic Approach
The Journal of Psychiatry & Law, 1987
A clinical model for the determination of malingering in forensic-psychiatric contexts is described. The model establishes three criteria that are useful in distinguishing malingerers from uncooperative patients and those suffering from a factitious disorder. The criteria involve: (1) ascertaining the presence of the classic signs and symptoms of feigned mental illness, (2) establishing a malingering motive, and (3) ruling out the presence of genuine psychopathology which would cause an individual to produce what appears to be voluntary symptomatology. The clinical application of the model is described and illustrated with case examples.