Psychological Injury and Law

, Volume 1, Issue 3, pp 191–209 | Cite as

Potential for Bias in MMPI-2 Assessments Using the Fake Bad Scale (FBS)

  • James N. Butcher
  • Carlton S. Gass
  • Edward Cumella
  • Zina Kally
  • Carolyn L. Williams


The Fake Bad Scale (FBS), developed to identify malingering of emotional distress among claimants seeking compensation for personal injuries, was recently added to the MMPI-2 scoring materials, resulting in its widespread dissemination across the various clinical settings that use the MMPI-2 in psychological evaluations. We examine: (1) questions of item bias in the FBS; (2) how malingering and nonmalingering groups are identified in FBS studies, including whether the research has been broadly inclusive and fully represents the populations assessed by the MMPI-2; (3) the reliability and validity of the FBS; (4) the highly variable recommendations for raw score cut-offs and how they relate to T scores; (5) two inpatient groups [men in a tertiary care Veterans Affairs Healthcare System (VA) unit and women in an eating disorders program] who may be inappropriately labeled as malingering by the FBS; (6) the publisher’s statement on use of the FBS; and (7) a Frye hearing in Florida where the FBS was excluded from expert testimony, one of three so far. We raise questions about its potential bias against people with disabilities and physical illnesses, women, individuals exposed to highly traumatic situations, and those motivated to present themselves in a favorable light. Psychologists using the FBS for making decisions about clients’ motivations need to be aware of the serious problems with the scale’s use and the cases of its inadmissibility in court.


Bias MMPI-2 Fake Bad Scale FBS Symptom Validity Malingering 


  1. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  2. Arbisi, P. A. (2006). Use of the MMPI-2 in personal injury and disability evaluations. In J. N. Butcher (Ed.), MMPI-2: The practitioner’s handbook (pp. 407–442). Washington, D.C.: American Psychological Association.CrossRefGoogle Scholar
  3. Arbisi, P. A., & Ben-Porath, Y. S. (1997). Characteristics of the MMPI-2 F(p) Scale as a function of diagnosis in an inpatient sample of veterans. Psychological Assessment, 9, 102–105.CrossRefGoogle Scholar
  4. Arbisi, P. A., Ben-Porath, Y. S., & McNulty, J. (2006). The ability of the MMPI-2 to detect feigned PTSD within the context of compensation seeking. Psychological Services, 3, 249–261.CrossRefGoogle Scholar
  5. Arbisi, P. A., & Butcher, J. N. (2004). Failure of the FBS to predict malingering of somatic symptoms: Response to critiques by Greve and Bianchini and Lees-Haley and Fox. Archives of Clinical Neuropsychology, 19, 341–345.CrossRefGoogle Scholar
  6. Bagby, R. M., Buis, T., & Nicholson, R. A. (1995). Relative effectiveness of the standard validity scales in detecting fake-bad and fake-good responding: Replication and extension. Psychological Assessment, 7, 84–92.CrossRefGoogle Scholar
  7. Bagby, R. M., Marshall, M. B., Bury, A., Bacchiocci, J. R., & Miller, L. (2006). Assessing underreporting and over reporting styles on the MMPI-2. In J. N. Butcher (Ed.), MMPI-2: The practitioner’s handbook (pp. 39–69). Washington, D.C.: American Psychological Association.CrossRefGoogle Scholar
  8. Ben-Porath, Y. S., & Tellegen, A. (2007a). MMPI-2 Fake Bad Scale (FBS). Retrieved December 4, 2007, from
  9. Ben-Porath, Y. S., & Tellegen, A. (2007b). MMPI-2 FBS (Symptom Validity Scale). Retrieved December 4, 2007, from
  10. Berry, D. T. R., & Schipper, L. J. (2007). Detection of feigned psychiatric symptoms during forensic neuropsychological examinations. In G. J. Larrabee (Ed.), Assessment of Malingered Neuropsychological Deficits (pp. 226–263).Google Scholar
  11. Berry, D. T. R., Wetter, M. W., Baer, R. A., Youngjohn, J., Gass, C. S., Lamb, D. G., et al. (1995). Over reporting of closed-head injury symptoms on the MMPI-2. Psychological Assessment, 7, 517–523.CrossRefGoogle Scholar
  12. Binder, L. M., & Rohling, M. L. (1996). Money matters: A meta-analytic review of the effects of financial incentives on recovery after closed-head injury. American Journal of Psychiatry, 153, 7–10.PubMedGoogle Scholar
  13. Burandt, C. A. (2006). Detecting incomplete effort on the MMPI-2: An examination of the Fake-Bad Scale in electrical injury. Dissertation Abstracts International: Section B: The Sciences and Engineering, 67(4-B), 2216.Google Scholar
  14. Bury, A. S., & Bagby, R. M. (2002). The detection of feigned uncoached and coached post-traumatic stress disorder with the MMPI-2 in a sample of workplace accident victims. Psychological Assessment, 14, 472–484.PubMedCrossRefGoogle Scholar
  15. Bush, S. S., Ruff, R. M., Troster, A. I., Barth, J. T., Koffler, S. P., Pliskin, N. H., et al. (2005). NAN position paper: Symptom validity assessment: Practice issues and medical necessity. Archives of Clinical Neuropsychology, 20, 419–426.PubMedCrossRefGoogle Scholar
  16. Butcher, J. N., Arbisi, P. A., Atlis, M. M., & McNulty, J. L. (2003). The construct validity of the Lees-Haley Fake Bad Scale: Does this scale measure somatic malingering and feigned emotional distress? Archives of Clinical Neuropsychology, 18, 473–485.PubMedCrossRefGoogle Scholar
  17. Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A., & Kaemmer, B. (1989). Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for Administration, Scoring, and Interpretation. Minneapolis, MN: University of Minnesota Press.Google Scholar
  18. Butcher, J. N., Graham, J. R., Ben-Porath, Y. S., Tellegen, A., Dahlstrom, W. G., & Kaemmer, B. (2001). Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for Administration, Scoring, and Interpretation (Rev. Ed.). Minneapolis, MN: University of Minnesota Press.Google Scholar
  19. Butcher, J. N., & Han, K. (1995). Development of an MMPI-2 scale to assess the presentation of self in a superlative manner: The S Scale. In J. N. Butcher & C. D. Spielberger (Eds.), Advances in personality assessment (Vol 10, pp. 25–50). Hillsdale, N. J.: Erlbaum.Google Scholar
  20. Butcher, J. N., & Williams, C. L. (2000). Essentials of MMPI-2 and MMPI-A Interpretation (2nd Ed.). Minneapolis: University of Minnesota Press.Google Scholar
  21. Charles, T. L., Jr. (2000). Usefulness of the Minnesota Multiphasic Personality Inventory-2 in detection of deception in a personal injury type forensic population. Dissertation Abstracts International: Section B: The Sciences & Engineering, 60(10-B), 5221 May.Google Scholar
  22. Dahlstrom, W. G., Welsh, G. S., & Dahlstrom, L. E. (1973). An MMPI handbook: Volume I: Clinical interpretation. Minneapolis: University of Minnesota Press.Google Scholar
  23. Davidson v. Strawberry Petroleum et al. (2007). Case #05–4320 Hillsborough County, Florida.Google Scholar
  24. Dearth, C. S., Berry, D. T. R., Vickery, C. D., Vagnini, V. L., Baer, R. E., Orey, S. A., et al. (2005). Detection of feigned head injury symptoms on the MMPI-2 in head injured patients and community controls. Archives of Clinical Neuropsychology, 20, 95–110.PubMedCrossRefGoogle Scholar
  25. Elhai, J. D., Gold, P. B., Frueh, B. C., & Gold, S. N. (2000). Cross-validation of the MMPI-2 in detecting malingered posttraumatic stress disorder. Journal of Personality Assessment, 75, 449–463.PubMedCrossRefGoogle Scholar
  26. Fox, D. D. (2005). Distributional characteristics and factor analysis of MMPI-2 F family and Fake Bad Scale. Unpublished data.Google Scholar
  27. Fox, D. D., Gerson, A., & Lees-Haley, P. R. (1995). Interrelationship of MMPI-2 validity scales in personal injury claims. Journal of Clinical Psychology, 51, 42–47.PubMedCrossRefGoogle Scholar
  28. Frye v. United States (1923). 293 F. 1013 (D.C. Cir.).Google Scholar
  29. Gass, C. (1991). MMPI-2 interpretations in closed head trauma: A correction factor. Psychological Assessment, 3, 27–31.CrossRefGoogle Scholar
  30. Gass, C. S. (1996). MMPI-2 variables in attention and memory test performance. Psychological Assessment, 8, 135–138.CrossRefGoogle Scholar
  31. Gass, C. S., & Wald, H. S. (1997). MMPI-2 interpretation and closed-head trauma: Cross-validation of a correction factor. Archives of Clinical Neuropsychology, 12, 199–205.PubMedCrossRefGoogle Scholar
  32. Geisinger, K. F. (2005). The testing industry, ethnic minorities, and individuals with disabilities. In R. P. Philps (Ed.), Defending standardized testing. Mahwah, N. J.: Erlbaum.Google Scholar
  33. Gervais, R. O., Ben-Porath, Y. S., Wygant, D. B., & Green, P. (2007). Development and validation of a Response Bias Scale (RBS) for the MMPI-2. Assessment, 14, 196–208.PubMedCrossRefGoogle Scholar
  34. Graham, J. R. (2006). MMPI-2: Assessing personality and psychopathology (4th Ed.). New York: Oxford University Press.Google Scholar
  35. Graham, J. R., Watts, D., & Timbrook, R. E. (1991). Detecting fake-good and fake-bad MMPI-2 profiles. Journal of Personality Assessment, 57, 264–277.PubMedCrossRefGoogle Scholar
  36. Greene, R. L. (2000). The MMPI-2: An interpretive manual (2nd Ed.). Boston: Allyn and Bacon.Google Scholar
  37. Greiffenstein, M. F., & Baker, W. J. (2001). Comparison of premorbid and postinjury MMPI-2 profiles in late post concussion claimants. The Clinical Neuropsychologist, 15, 162–170.PubMedGoogle Scholar
  38. Greiffenstein, M. F., Baker, W. J., Axelrod, B., Peck, T. A., & Gervais, R. (2004). The Fake Bad Scale and MMPI-2 F-Family in Detection of Implausible Psychological Trauma Claims. The Clinical Neuropsychologist, 18, 573–590.PubMedCrossRefGoogle Scholar
  39. Greiffenstein, M. F., Baker, W. J., Gola, T., Donders, J., & Miller, L. J. (2002). The FBS in atypical and severe closed head injury litigants. Journal of Clinical Psychology, 58, 1591–1600.PubMedCrossRefGoogle Scholar
  40. Greiffenstein, M. F., Fox, D., & Lees-Haley, P. R. (2007). The MMPI-2 Fake Bad Scale in Detection of Noncredible Brain Injury Claims. In K. Boone (Ed.), Detection of noncredible cognitive performance (pp. 210–235). New York: Guilford Press.Google Scholar
  41. Greve, K. W., & Bianchini, K. J. (2004). Response to Butcher et al. (2003). The construct validity of the Lees-Haley Fake-Bad Scale. Archives of Clinical Neuropsychology, 19, 337–339.PubMedCrossRefGoogle Scholar
  42. Greve, K. W., Bianchini, K. J., Love, J. M., Brenna, A., & Heinley, M. T. (2006). Sensitivity and specificity of the MMPI-2 validity indicators to malingered neurocognitive dysfunction in traumatic brain injury. The Clinical Neuropsychologist, 20, 491–512.PubMedCrossRefGoogle Scholar
  43. Grossman, L. S., & Wasyliw, O. E. (1988). A psychometric study of stereotypes: Assessment of malingering in a criminal forensic group. Journal of Personality Assessment, 52, 549–563.PubMedCrossRefGoogle Scholar
  44. Guéz, M., Brännström, R., Nyberg, L., Toolanen, G., & Hildingsson, C. (2005). Neuropsychological functioning and MMPI-2 profiles in chronic neck pain: A comparison of whiplash and non-traumatic groups. Journal of Clinical and Experimental Neuropsychology, 27, 151–163.PubMedCrossRefGoogle Scholar
  45. Gynther, M. D., & Petzel, T. P. (1967). Differential endorsement of MMPI F Scale items by psychotics and behavior disorders. Journal of Clinical Psychology, 23, 185–188.PubMedCrossRefGoogle Scholar
  46. Heyward, V. H., & Stolarczyk, L. M. (1996). Applied body composition assessment. Champaign, IL: Human Kinetics.Google Scholar
  47. Hoffman, R. G., Scott, J. G., Emick, M. A., & Adams, R. L. (1999). The MMPI-2 and closed-head injury: Effects of litigation and head injury severity. Journal of Forensic Neuropsychology, 1, 3–13.CrossRefGoogle Scholar
  48. Hunt, H. F. (1948). The effects of deliberate deception on MMPI performance. Journal of Consulting and Clinical Psychology, 12, 396–402.Google Scholar
  49. Iverson, G. L., Henrichs, T. F., Barton, E. A., & Allen, S. (2002). Specificity of the MMPI-2 Fake Bad Scale as a marker for personal injury malingering. Psychological Reports, 90, 131–136.PubMedCrossRefGoogle Scholar
  50. Kay, T., Newman, B., Cavallo, M., & Ezrachi, O. (1992). Toward a neuropsychological model of functional disability after mild traumatic brain injury. Neuropsychology, 6, 371–384.CrossRefGoogle Scholar
  51. Larrabee, G. J. (1998). Somatic malingering on the MMPI and MMPI-2 in personal injury litigants. The Clinical Neuropsychologist, 12, 179–188.Google Scholar
  52. Larrabee, G. J. (2007). Evaluation of exaggerated health and injury symptomatology. In G. J. Larrabee (Ed.), Assessment of malingered neuropsychological deficit (pp. 264–286). New York: Oxford University Press.Google Scholar
  53. Larrabee, G. J., Greiffenstein, M. F., Greve, K. W., & Bianchini, K. J. (2007). Refining diagnostic criteria for malingering. In G. J. Larrabee (Ed.), Assessment of malingered neuropsychological deficits (pp. 334–372). New York: Oxford University Press.Google Scholar
  54. Lees-Haley, P. R. (1992). Efficacy of MMPI-2 validity scales and MCMI-II modifier scales for detecting spurious PTSD claims: F, F-K, Fake Bad Scale, ego strength, subtle-obvious subscales, DIS, and DEB. Journal of Clinical Psychology, 48, 681–689.PubMedCrossRefGoogle Scholar
  55. Lees-Haley, P. R., English, L. T., & Glenn, W. J. (1991). A Fake Bad Scale on the MMPI-2 for personal injury claimants. Psychological Reports, 68, 203–210.PubMedCrossRefGoogle Scholar
  56. Lees-Haley, P. R., & Fox, D. D. (2004). Commentary on Butcher, Arbisi, Atlis, and McNulty (2003) on the Fake Bad Scale. Archives of Clinical Neuropsychology, 19, 333–336.PubMedCrossRefGoogle Scholar
  57. Leininger, B. E., Kreutzer, J. S., & Hill, M. R. (1991). Comparison of minor and severe head injury emotional sequelae using the MMPI. Brain Injury, 5, 199–205.PubMedCrossRefGoogle Scholar
  58. Martens, M., Donders, J., & Millis, S. R. (2001). Evaluation of invalid response sets after traumatic head injury. Journal of Forensic Neuropsychology, 2, 1–18.CrossRefGoogle Scholar
  59. McCrae, M. A. (2008). Mild traumatic brain injury and post concussion syndrome. New York: Oxford University Press.Google Scholar
  60. Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157–169.PubMedCrossRefGoogle Scholar
  61. Miller, L. J., & Donders, J. (2001). Subjective symptomatology after traumatic head injury. Brain Injury, 15, 297–304.PubMedCrossRefGoogle Scholar
  62. Moskowitz, J. L., Lewis, R. J., Ito, M. S., & Ehrmentraut, J. (1999). MMPI-2 profiles of NGRI and civil patients. Journal of Clinical Psychology, 55, 659–668.PubMedCrossRefGoogle Scholar
  63. Nelson, N. W., Sweet, J. J., & Demakis, G. J. (2006). Meta-Analysis of the MMPI-2 Fake Bad Scale: Utility in forensic practice. The Clinical Neuropsychologist, 20, 39–58.PubMedCrossRefGoogle Scholar
  64. Nelson, N. W., Sweet, J. J., & Heilbronner, R. L. (2007). Examination of the new MMPI-2 Response Bias Scale (Gervais): Relationship with MMPI-2 validity scales. Journal of Clinical and Experimental Neuropsychology, 29, 67–72.PubMedCrossRefGoogle Scholar
  65. Nicholson, K., & Martelli, M. F. (2007). The effect of compensation status. In G. Young, A. Kane, & K. Nicholson (Eds.), Causality in psychological injury: Presenting evidence in court (pp. 411–426). New York: Springer Science & Business Media.CrossRefGoogle Scholar
  66. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory (3rd Ed). New York: McGraw Hill.Google Scholar
  67. Pearson Assessments (2007). FBS (Symptom Validity Scale) Added to MMPI-2 Standard Scoring Materials. Retrieved December 4, 2007, from
  68. Pope, K. S., Butcher, J. N., & Seelen, J. (2006). The MMPI, MMPI-2, and MMPI-A in court: A practical guide for expert witnesses and attorneys (3rd Ed.). Washington, DC: American Psychological Association.Google Scholar
  69. Post, R. D., & Gasparikova-Krasnec, M. (1979). MMPI validity scales and behavioral disturbance in psychiatric inpatients. Journal of Personality Assessment, 43, 155–159.PubMedCrossRefGoogle Scholar
  70. Price, D. D. (1999). Psychological mechanisms of pain and analgesia. Seattle, WA: IASP Press.Google Scholar
  71. Price, D. D., & Bushnell, M. C. (2004). Psychological methods of pain control: Basic science and clinical perspectives. Seattle, WA: IASP Press.Google Scholar
  72. Putnam, S. H., & Millis, S. R. (1994). Psychosocial factors in the development and maintenance of chronic somatic and functional symptoms following mild traumatic brain injury. Advances in Medical Psychotherapy, 7, 1–22.Google Scholar
  73. Rissmiller, D. J., Wayslow, A., Madison, H., Hogate, P., Rissmiller, F. R., & Steer, R. A. (1998). Prevalence of malingering in inpatient suicide ideators and attempters. Crisis, 19, 62–66.PubMedGoogle Scholar
  74. Rogers, R., Sewell, K. W., Martin, M. A., & Vitacco, M. J. (2003). Detection of feigned mental disorders: A meta-analysis of the MMPI-2 and malingering. Assessment, 10, 160–177.PubMedCrossRefGoogle Scholar
  75. Ross, S. R., Putnam, S. H., Gass, C. S., Bailey, D. E., & Adams, K. M. (2002). MMPI-2 indices of psychological disturbance and attention and memory test performance in head injury. Archives of Clinical Neuropsychology, 18, 905–906.CrossRefGoogle Scholar
  76. Sharland, M. J., & Gfeller, J. D. (2007). A survey of neuropsychologists’ beliefs and practices with respect to the assessment of effort. Archives of Clinical Neuropsychology, 22, 213–223.PubMedCrossRefGoogle Scholar
  77. Tsushima, W. T., & Tsushima, V. G. (2001). Comparison of the Fake Bad Scale and other MMPI-2 validity scales with personal injury litigants. Assessment, 8, 205–212.PubMedCrossRefGoogle Scholar
  78. Vandergracht v. Progressive Express et al. (2005). Case no. #02-04552, Hillsborough County, Florida.Google Scholar
  79. Viglione, V., Muratori, F., Maestro, S., Brunori, E., & Picchi, L. (2006). Denial of symptoms and psychopathology in adolescent anorexia nervosa. Psychopathology, 39, 255–260.PubMedCrossRefGoogle Scholar
  80. Vitousek, K. M., & Stumpf, R. E. (2005). Difficulties in the assessment of personality traits and disorders in eating-disordered individuals. Eating Disorders: The Journal of Prevention, 13, 37–60.CrossRefGoogle Scholar
  81. Wasyliw, O. E., Grossman, L. S., Haywood, T. W., & Cavanaugh, J. L. (1988). The detection of malingering in criminal forensic groups: MMPI validity scales. Journal of Personality Assessment, 52, 321–333.PubMedCrossRefGoogle Scholar
  82. Williams v. CSX Transportation, Inc. (2007). Case #04-CA-008892. Hillsborough County, Florida.Google Scholar
  83. Wood, R. L. (2004). Understanding the ‘miserable minority’: A diathesis-stress paradigm for post-concussive syndrome. Brain Injury, 18, 1135–1153.PubMedCrossRefGoogle Scholar
  84. Wygant, D. B., Sellbom, M., Ben-Porath, Y. S., Stafford, K. P., Freeman, D. B., & Heilbronner, R. L. (2007). The relation between symptom validity testing and MMPI-2 scores as a function of forensic evaluation context. Archives of Clinical Neuropsychology, 22, 489–499.PubMedCrossRefGoogle Scholar
  85. Youngjohn, J. R., Davis, D., & Wolf, I. (1997). Head injury and the MMPI-2: Paradoxical severity effects and the influence of litigation. Psychological Assessment, 9, 177–184.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC. 2008

Authors and Affiliations

  • James N. Butcher
    • 1
  • Carlton S. Gass
    • 2
  • Edward Cumella
    • 3
  • Zina Kally
    • 3
  • Carolyn L. Williams
    • 1
  1. 1.University of MinnesotaMinneapolisUSA
  2. 2.Miami Veterans Affairs Healthcare SystemMiamiUSA
  3. 3.Remuda Programs for Eating DisordersWickenburgUSA

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