Skip to main content
Log in

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

  • Assessment
  • Published:
Psychological Injury and Law Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. It is estimated that about 85% of all treated TBIs are mild and that fewer than 1% of mild TBI cases eventuate in a post-concussion syndrome (McCrae 2008), although there are higher estimates, as well.

  2. Cited as Greiffenstein et al. (2007) in reference list.

  3. On the Pearson Assessments’ website (i.e., Ben-Porath and Tellegen 2007b) this cut score is 22. However, a verbatim statement appears on the University Press website (i.e., Ben-Porath and Tellegen 2007a) with the noteworthy exception that the recommended lower level cut score is 23, another example of the variable yardstick for cut score interpretive guidelines.

  4. These documents are available as a PDF by emailing the first author at butch001@umn.edu.

References

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • 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.

    Chapter  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Chapter  Google Scholar 

  • Ben-Porath, Y. S., & Tellegen, A. (2007a). MMPI-2 Fake Bad Scale (FBS). Retrieved December 4, 2007, from http://www.upress.umn.edu/tests/mmpi2_fbs.html.

  • Ben-Porath, Y. S., & Tellegen, A. (2007b). MMPI-2 FBS (Symptom Validity Scale). Retrieved December 4, 2007, from http://www.pearsonassessments.com/resources/fbs.html.

  • 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).

  • 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.

    Article  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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 

  • 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 

  • Butcher, J. N., & Williams, C. L. (2000). Essentials of MMPI-2 and MMPI-A Interpretation (2nd Ed.). Minneapolis: University of Minnesota Press.

    Google Scholar 

  • 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 

  • Dahlstrom, W. G., Welsh, G. S., & Dahlstrom, L. E. (1973). An MMPI handbook: Volume I: Clinical interpretation. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Davidson v. Strawberry Petroleum et al. (2007). Case #05–4320 Hillsborough County, Florida.

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Fox, D. D. (2005). Distributional characteristics and factor analysis of MMPI-2 F family and Fake Bad Scale. Unpublished data.

  • 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.

    Article  PubMed  Google Scholar 

  • Frye v. United States (1923). 293 F. 1013 (D.C. Cir.).

  • Gass, C. (1991). MMPI-2 interpretations in closed head trauma: A correction factor. Psychological Assessment, 3, 27–31.

    Article  Google Scholar 

  • Gass, C. S. (1996). MMPI-2 variables in attention and memory test performance. Psychological Assessment, 8, 135–138.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • Graham, J. R. (2006). MMPI-2: Assessing personality and psychopathology (4th Ed.). New York: Oxford University Press.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Greene, R. L. (2000). The MMPI-2: An interpretive manual (2nd Ed.). Boston: Allyn and Bacon.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Heyward, V. H., & Stolarczyk, L. M. (1996). Applied body composition assessment. Champaign, IL: Human Kinetics.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • Hunt, H. F. (1948). The effects of deliberate deception on MMPI performance. Journal of Consulting and Clinical Psychology, 12, 396–402.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Larrabee, G. J. (1998). Somatic malingering on the MMPI and MMPI-2 in personal injury litigants. The Clinical Neuropsychologist, 12, 179–188.

    Google Scholar 

  • 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 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Martens, M., Donders, J., & Millis, S. R. (2001). Evaluation of invalid response sets after traumatic head injury. Journal of Forensic Neuropsychology, 2, 1–18.

    Article  Google Scholar 

  • McCrae, M. A. (2008). Mild traumatic brain injury and post concussion syndrome. New York: Oxford University Press.

    Google Scholar 

  • Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157–169.

    Article  PubMed  Google Scholar 

  • Miller, L. J., & Donders, J. (2001). Subjective symptomatology after traumatic head injury. Brain Injury, 15, 297–304.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Chapter  Google Scholar 

  • Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory (3rd Ed). New York: McGraw Hill.

    Google Scholar 

  • Pearson Assessments (2007). FBS (Symptom Validity Scale) Added to MMPI-2 Standard Scoring Materials. Retrieved December 4, 2007, from http://pearsonassessments.com/news/pr011107.html.

  • 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 

  • Post, R. D., & Gasparikova-Krasnec, M. (1979). MMPI validity scales and behavioral disturbance in psychiatric inpatients. Journal of Personality Assessment, 43, 155–159.

    Article  PubMed  Google Scholar 

  • Price, D. D. (1999). Psychological mechanisms of pain and analgesia. Seattle, WA: IASP Press.

    Google Scholar 

  • Price, D. D., & Bushnell, M. C. (2004). Psychological methods of pain control: Basic science and clinical perspectives. Seattle, WA: IASP Press.

    Google Scholar 

  • 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 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Vandergracht v. Progressive Express et al. (2005). Case no. #02-04552, Hillsborough County, Florida.

  • Viglione, V., Muratori, F., Maestro, S., Brunori, E., & Picchi, L. (2006). Denial of symptoms and psychopathology in adolescent anorexia nervosa. Psychopathology, 39, 255–260.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Williams v. CSX Transportation, Inc. (2007). Case #04-CA-008892. Hillsborough County, Florida.

  • Wood, R. L. (2004). Understanding the ‘miserable minority’: A diathesis-stress paradigm for post-concussive syndrome. Brain Injury, 18, 1135–1153.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James N. Butcher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Butcher, J.N., Gass, C.S., Cumella, E. et al. Potential for Bias in MMPI-2 Assessments Using the Fake Bad Scale (FBS). Psychol. Inj. and Law 1, 191–209 (2008). https://doi.org/10.1007/s12207-007-9002-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12207-007-9002-z

Keywords

Navigation