Abstract
Forensic practitioners face continuing challenges in differentiating factitious presentations from malingering, which may be particularly salient in civil forensic cases. In striking contrast to malingering, very little research has studied factitious psychological presentations (FPPs). To address this virtual void, the Inventory of Self and Interpersonal Problems (I-SIP) was developed with two primary scales to address motivations: Factitious (FACT) and Antisocial Characteristics (ANT-C). The I-SIP was tested on 80 inpatients under both genuine and feigning (factitious or malingering) conditions. As predicted, factitious feigners evidenced a dramatic spike on the FACT scale that clearly differentiated it from the other conditions with 90% or higher accuracy. In addition, a ratio between the two primary scales improved the specificity between factitious and malingered presentations. Professional implications are discussed, including the use of the I-SIP as a preliminary alert for factitious presentations.
Similar content being viewed by others
Notes
References
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). American Psychiatric Association Publishing.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Revised). American Psychiatric Association Publishing.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). American Psychiatric Association Publishing.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association Publishing. doi:https://doi.org/10.1176/appi.books.9780890425596
Brinkley, C. A., Schmitt, W. A., Smith, S. S., & Newman, J. P. (2001). Construct validation of a self-report psychopathy scale: does Levenson’s self-report psychopathy scale measure the same constructs as Hare’s psychopathy checklist-revised? Personality and Individual Differences, 31(7), 1021–1038. https://doi.org/10.1016/S0191-8869(00)00178-1
Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Telelgen, A., & Kaemmer, B. (1989). MMPI-2 manual. University of Minnesota Press.
Clark, L. A., & Watson, D. (1995). Constructing validity: basic issues in objective scale development. Psychological Assessment, 7(3), 309–319. https://doi.org/10.1037/1040-3590.7.7.309
Cunnien, A. J. (1997). Psychiatric and medical syndromes associated with deception. In R. Rogers (Ed.), Clinical assessment of malingering and deception (2nd ed., pp. 23–46). Guilford Press.
Falkenbach, D., Poythress, N., Falki, M., & Manchak, S. (2007). Reliability and validity of two self-report measures of psychopathy. Assessment, 14(4), 341–350. https://doi.org/10.1177/1073191107305612
Hamilton, J. C., Feldman, M. D., & Cunnien, A. J. (2008). Factitious disorder in medical and psychiatric practices. In R. Rogers (Ed.), Clinical assessment of malingering and deception (3rd ed., pp. 128–144). Guilford Press.
Henson, R. K. (2001). Understanding internal consistency reliability estimates: a conceptual primer on coefficient alpha. Measurement and Evaluation in Counseling and Development, 34(3), 177–189. https://doi.org/10.1080/07481756.2002.12069034
Hill, C. A. (1987). Affiliation motivation: people who need people… but in different ways. Journal of Personality and Social Psychology, 52(5), 1008–1018. https://doi.org/10.1037/0022-3514.52.5.1008
Himsl, K., Burchett, D., Tarescavage, A. M., & Glassmire, D. M. (2017). Assessing reading ability for psychological testing in forensic assessments: an investigation with the WRAT-4 and MMPI-2-RF. The International Journal of Forensic Mental Health, 16(3), 239–248. https://doi.org/10.1080/14999013.2017.1330293
Hyler, S. E., & Spitzer, R. L. (1978). Hysteria split asunder. The American Journal of Psychiatry, 135(12), 1500–1504. https://doi.org/10.1176/ajp.135.12.1500
Jonas, J. M., & Pope, H. G. (1985). The dissimulating disorders: a single diagnostic entity? Comprehensive Psychiatry, 26(1), 58–62. https://doi.org/10.1016/0010-440X(85)90049-5
Kanaan, R. A. A., & Wessely, S. C. (2010). The origins of factitious disorder. History of the Human Sciences, 23(2), 68–85. https://doi.org/10.1177/0952695109357128
Lawlor, A., & Kirakowski, J. (2014). When the lie is the truth: grounded theory analysis of an online support group for factitious disorder. Psychiatry Research, 218(1), 209–218. https://doi.org/10.1016/j.psychres.2014.03.034
Levenson, M. R., Kiehl, K. A., & Fitzpatrick, C. M. (1995). Assessing psychopathic attributes in a noninstitutionalized population. Journal of Personality and Social Psychology, 68(1), 151–158. https://doi.org/10.1037//0022-3514.68.1.151
Lilienfeld, S., & Andrews, B. (1996). Development and preliminary validation of a self-report measure of psychopathic personality traits in noncriminal populations. Journal of Personality Assessment, 66(3), 488–524. https://doi.org/10.1207/s15327752jpa6603_3
Lipsitt, D. R. (1996). Introduction. In M. D. Feldman & S. J. Eisendrath (Eds.), The spectrum of factitious disorders. (pp. xix-xxviii). American Psychiatric Association.
Merten, T., & Merckelbach, H. (2020). Factitious disorder and malingering. In J. R Geddes, N. C. Andreasen, & G. M. Goodwin (Eds.), New Oxford Textbook of Psychiatry (3rd Ed.). Oxford University Press. https://doi.org/10.1093/med/9780198713005.001.0001
Merten, T., & Rogers, R. (2017). An international perspective on feigned mental disabilities: conceptual issues and continuing controversies. Behavioral Sciences & the Law, 35(2), 97–112. https://doi.org/10.1002/bsl.2274
Morey, L. C. (1991). The Personality Assessment Inventory professional manual. Psychological Assessment Resources.
Morey, L. C. (2007). Personality Assessment Inventory (PAI) professional manual (2nd ed.). Psychological Assessment Resources.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). McGraw-Hill.
Robinson, E. V., & Rogers, R. (2018). Detection of feigned ADHD across two domains: the MMPI-2-RF and CAARS for faked symptoms and TOVA for simulated attention deficits. Journal of Psychopathology and Behavioral Assessment, 40(3), 376–385. https://doi.org/10.1007/s10862-017-9640-8
Rogers, R. (1986). Conducting insanity evaluations. Van Nostrand Reinhold.
Rogers, R. (2001). Handbook of diagnostic and structured interviewing. Guilford.
Rogers, R. (2018a). An introduction to response styles. In R. Rogers & S. D. Bender (Eds.), Clinical assessment of malingering and deception (4th ed., pp. 3–17). Guilford Press.
Rogers, R. (2018b). Researching response styles. In R. Rogers & S. D. Bender (Eds.), Clinical assessment of malingering and deception (4th ed., pp. 592–614). Guilford Press.
Rogers, R., Bagby, R. M., & Dickens, S. E. (1992). Structured Interview of Reported Symptoms (SIRS) and professional manual. Psychological Assessment Resources, Inc. Widows & Smith should be 2005.
Rogers, R., Bagby, R. M., & Rector, N. (1989). Diagnostic legitimacy of factitious disorder with psychological symptoms. The American Journal of Psychiatry, 146(10), 1312–1314. https://doi.org/10.1176/ajp.146.10.1312
Rogers, R., Bagby, R. M., & Vincent, A. (1994). Factitious disorders with predominantly psychological signs and symptoms: a conundrum for forensic experts. Journal of Psychiatry & Law, 22(1), 91–106.
Rogers, R., & Gillard, N. D. (2011). Research methods for the assessment of malingering. In B. Rosenfeld & S. D. Penrod (Eds.). Research methods in forensic psychology (pp. 174–188). Wiley.
Rogers, R., Gillard, N. D., Berry, D. T. R., & Granacher, R. P., Jr. (2011). Effectiveness of the MMPI-2-RF validity scales for feigned mental disorders and cognitive impairment: a known-groups study. Journal of Psychopathology and Behavioral Assessment, 33(3), 355–367. https://doi.org/10.1007/s10862-011-9222-0
Rogers, R., Jackson, R. L., & Kaminski, P. L. (2005). Factitious psychological disorders: the overlooked response style in forensic evaluations. Journal of Forensic Psychology Practice, 5(1), 21–41. https://doi.org/10.1300/J158v05n01_02
Rogers, R., Pan, M., Drogin, E. Y. (in press). Response styles within the forensic context: conceptual issues and assessment methods. In D. DeMatteo & K. Scherr (Eds.), The Oxford Handbook of Psychology and Law. Oxford University Press.
Rogers, R., Robinson, E. V., & Gillard, N. D. (2014). The SIMS screen for feigned mental disorders: the development of detection-based scales. Behavioral Sciences and the Law, 32(4), 455–466. https://doi.org/10.1002/bsl.2131
Rogers, R., Sewell, K. W., & Gillard, N. D. (2010). Structured Interview of Reported Symptoms (SIRS) professional manual (2nd ed.). Psychological Assessment Resources, Inc.
Rogers, R. & Velsor, S. F. (2017). The Inventory of Self and Interpersonal Problems (I-SIP) [unpublished measure].
Rogers, R., Williams, M. M., Winningham, D. B., & Sharf, A. J. (2018). An examination of PAI clinical descriptors and correlates in an outpatient sample: Tailoring of interpretive statements. Journal of Psychopathology and Behavioral Assessment, 40(2), 259–275.
Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the Working Alliance Inventory. Psychological Assessment, 1(3), 207–210. https://doi.org/10.1037/1040-3590.1.3.207
van Impelen, A., Merckelbach, H., Jelicic, M., Niesten, I. J. M., & Campo, J. À. (2017). Differentiating factitious from malingered symptomatology: the development of a psychometric approach. Psychological Injury and Law, 10(4), 341–357. https://doi.org/10.1007/s12207-017-9301-y.
Velsor, S. F. (2020). Construct validity of the I-SIP and its clinical utility in differentiating between factitious psychological presentations (FPPS) and malingering. Unpublished doctoral dissertation, University of North Texas.
Velsor, S. F., & Rogers, R. (2019). Differentiating factitious psychological presentations from malingering: implications for forensic practice. Behavioral Sciences & the Law, 37(1), 1–15. https://doi.org/10.1002/bsl.2365
Wechsler, D. (2002). Wechsler Individual Achievement Test-Second Edition (WIAT-II): Examiner’s Manual. Psychological Corporation.
Widows, M. R., & Smith, G. P. (2005). Structured Inventory of Malingered Symptomatology professional manual. Psychological Assessment Resources.
Wilkinson, G. S., & Robertson, G. J. (2006). Wide Range Achievement Test-Fourth Edition (WRAT-4) professional manual. Psychological Assessment Resources.
Yates, G. P., & Feldman, M. D. (2016). Factitious disorder: a systematic review of 455 cases in the professional literature. General Hospital Psychiatry, 41, 20–28. https://doi.org/10.1016/j.genhosppsych.2016.05.002
Yates, G. P., Mulla, M. M., Hamilton J. C., & Feldman, M. D. (2018). Factitious disorders in medical and psychiatric practices. In R. Rogers & S. D. Bender (Eds.), Clinical Assessment of Malingering and Deception (4th ed.). Guilford Press.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Velsor and Rogers are authors of the Inventory of Self and Interpersonal Problems (I-SIP). The I-SIP is considered to have no commercial value.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Velsor, S.F., Rogers, R., Donnelly, J.W. et al. Assessment of Factitious Psychological Presentations (FPP): an Overlooked Response Style in Forensic Practice. Psychol. Inj. and Law 14, 201–212 (2021). https://doi.org/10.1007/s12207-021-09413-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12207-021-09413-1