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Malingering in Forensic Disability-Related Assessments: Prevalence 15 ± 15 %

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Abstract

Psychological injuries concern conditions produced by negligent actions, such as in motor vehicle accidents, and that result in claims for damages, such as in tort. In the psychological injury context, malingering refers to fabrications or gross exaggerations of psychological conditions for purposes of monetary gain. As much as the diagnoses that might result in such cases (e.g., posttraumatic stress disorder, PTSD), chronic pain, persistent postconcussive syndrome (PPCS) after a mild traumatic brain injury (mTBI) are considered contentious, so is the attribution of malingering and related negative response biases. This paper reviews the literature since the publication of the book by Young (2014) on the topic of malingering in the context of psychological injury cases. In particular, it examines the recent literature on the definition of malingering, and its prevalence or base rate, in the forensic disability and related context. The paper reviews not only recent articles, but also the 2015 Institute of Medicine book on the topic of use of validity tests in social security disability examinations. It examines the seminal work of Larrabee, Millis, and Meyers (2009) on the prevalence of malingering and indicates its consistencies. The paper concludes that (a) the definition of malingering can be improved and (b) the prevalence of malingering according to the recent research, as well as in Young’s 2014 book on the topic, is less than Larrabee’s catchy phrase that is prominent in some circles in the literature of 40 ± 10 %. More likely, it gravitates around 10 to 20 % so that, instead of 40 ± 10 %, the most appropriate percentage of malingering and related negative response biases in the disability and forensic context, as well as the clinical context, might be 15 ± 15 %, in general, with the percentage possibly being more than that for cases such as mTBI involving PPCS. These findings are pertinent to practice and for court.

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Acknowledgment

The author does mostly rehabilitation and some plaintiff work, with isolated insurer cases. This paper was prepared for Continuing Education Workshops on the author’s 2014 malingering book (Young, 2014) and on its update. The workshops involved the American Psychological Association in August, 2015 (Young, 2015a) and the Ontario Psychological Association in February, 2015 (Young, 2015b).

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The author declares that he has no competing interests.

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  1. Department of Psychology, Glendon College, York University, 2275 Bayview Ave., Toronto, ON, M4N 3M6, Canada

    Gerald Young

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Young, G. Malingering in Forensic Disability-Related Assessments: Prevalence 15 ± 15 %. Psychol. Inj. and Law 8, 188–199 (2015). https://doi.org/10.1007/s12207-015-9232-4

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