Advertisement

Malingering: Posttraumatic Stress Disorder and Depression

  • Keith Nicholson
  • Michael F. Martelli

Abstract

It has long been known that it is possible to feign mental or other disorders and not be detected. Barrows (1971) showed that a wide range of psychiatric, neurologic, pain, fatigue, or other problems, in which there are usually few physical findings, could be readily simulated in the context of teaching or examining medical students. Psychiatric symptoms or syndromes that were readily simulated included depression, agitation, psychosis, neurotic reactions, and thought disorder. Neurologic symptoms that could easily be feigned included paralysis, sensory loss, reflex changes, extensor plantar responses, gait abnormalities, cranial nerve palsy, altered levels of consciousness, coma, seizures, and hyperkinesias. Even after being warned that there were simulators among the examinees, experienced clinicians found it difficult to detect them. Rosenhan (1973) reported that 12 people posing as “pseudopatients” and presenting with some psychiatric symptoms were able to gain admission to psychiatric hospitals in five different states. All but one of the 12 were diagnosed with Schizophrenia and none of the pseudopatients were detected despite hospital stays of from 7 to 52 days.

Keywords

Posttraumatic Stress Disorder Validity Scale Incremental Validity Combat Veteran Psychological Assessment Resource 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bagby, R. M., Marshall, M. B., & Bacchiochi, J. R. (2005). The validity and clinical utility of the MMPI-2 Malingering Depression scale. Journal of Personality Assessment, 85, 304–311.PubMedCrossRefGoogle Scholar
  2. Bagby, R. M., Nicholson, R. A., Buis, T., & Bacchiochi, J. R. (2000). Can the MMPI-2 validity scales detect depression by feigned experts. Assessment, 7, 55–62.PubMedCrossRefGoogle Scholar
  3. Bagby, R. M., Rogers, R., Buis, T., Nicholson, R. A., Cameron, S. L., Rector, N. A., Schuller, D. R., & Seeman, M. V. (1997). Detecting feigned depression and schizophrenia on the MMPI-2. Journal of Personality Assessment, 68, 650–664.PubMedCrossRefGoogle Scholar
  4. Barrows, H. S. (1971). Simulated patients. Charles C. Thomas, Springfield, Il.Google Scholar
  5. Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.PubMedCrossRefGoogle Scholar
  6. Briere, J. (1995). Trauma Symptom Inventory professional manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
  7. Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A., & Kaemmer, B. (1989). Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for administration and scoring. Minneapolis: University of Minnesota Press.Google Scholar
  8. Cannizzaro, M., Reilly, N., & Snyders, P. J. (2004). Speech content analysis in feigned depression. Journal of Psycholinguistic Research, 33, 289–301.PubMedCrossRefGoogle Scholar
  9. Crawford, E. F., Greene, R. L., Dupart, T. M., Bongar, B., & Childs, H. (2006). MMPI-2 assessment of malingered emotional distress related to a workplace injury: A mixed group validation. Journal of Personality Assessment, 86, 217–221.PubMedCrossRefGoogle Scholar
  10. DeViva, J. C., & Bloem, W. D. (2003). Symptom exaggeration and compensation seeking among combat veterans with Posttraumatic Stress Disorder. Journal of Traumatic Stress, 16, 503–507.PubMedCrossRefGoogle Scholar
  11. Eakin, D. E., Weathers, F. W., Benson, T. B., Anderson, C. F., & Funderburk, B. (2006). Detection of feigned Posttraumatic Stress Disorder: A comparison of the MMPI-2 and PAI. Journal of Psychopathology and Behavioral Assessment, 28, 145–155.CrossRefGoogle Scholar
  12. Edens, J. F., Otto, R. K., & Dwyer, T. J. (1989). Susceptibility of the Trauma Symptom Inventory to malingering. Journal of Personality Assessment, 71, 379–392.CrossRefGoogle Scholar
  13. Elhai, J. D., Gray, M. J., Naifeh, J. A., Butcher, J. J., Davis, J. L., Falsetti, S. A., & Best, C. L. (2005). Utility of the Trauma Symptom Inventory’s atypical response scale in detecting malingered Post-traumatic Stress Disorder. Assessment, 12, 210–219.PubMedCrossRefGoogle Scholar
  14. Elhai, J. D., Naifeh, J. A., Zucker, I. S., Gold, S. N., Deitsch, S. E., & Frueh, B. C. (2004). Discriminating malingered from genuine civilian Posttraumatic Stress Disorder: A validation of three MMPI-2 Infrequency scales (F, Fp, and Fptsd). Assessment, 11, 139–144.PubMedCrossRefGoogle Scholar
  15. Elhai, J. D., Ruggiero, K. J., Frueh, B. C., Beckham, J. C., Gold, P. B., & Feldman, M. E. (2002). The Infrequency-Posttraumatic Stress Disorder scale (Fptsd) for the MMPI-2: Development and initial validation with veterans presenting with combat-related PTSD. Journal of Personality Assessment, 79, 531–549.PubMedCrossRefGoogle Scholar
  16. Frueh, B. C., Elhai, J. D., Gold, P. B., Monnier, J., Magruder, K. M., Keane, T. M., & Arana, G. W. (2003). Disability compensation seeking among veterans evaluated for Posttraumatic Stress Disorder. Psychiatric Services, 54, 84–91.PubMedCrossRefGoogle Scholar
  17. Greiffenstein, M. F., Baker, W. J., Axelrod, B., Peck, E. 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
  18. Griffin, G. A., Normington, J., May, R., & Glassmire, D. (1996). Assessing dissimulation among Social Security disability income claimants. Journal of Consulting and Clinical Psychology, 64, 1425–1430.PubMedCrossRefGoogle Scholar
  19. Guriel, G., & Fremouw, F. (2003). Assessing malingered Post-traumatic Stress Disorder: A critical review. Clinical Psychology Review, 23, 881–904.PubMedCrossRefGoogle Scholar
  20. Hathaway, S. R., & McKinley, J. C. (1967). Minnesota Multiphasic Personality Inventory manual. New York: Psychological Corporation.Google Scholar
  21. Lees-Haley, P. R., English, L. T., & Glenn, W. J. (1991). A Fake Bad Scale on the MMPI-2 for personal injury claimants. Psychological Report, 68, 203–210.CrossRefGoogle Scholar
  22. Mogge, N. L., & Lepage, J. P. (2004). The Assessment of Depression Inventory (ADI): A new instrument used to measure depression and to detect honesty of response. Depression and Anxiety, 20, 107–113.PubMedCrossRefGoogle Scholar
  23. Morel, K. R. (1998). Development and preliminary validation of a forced-choice test of response bias for Posttraumatic Stress Disorder. Journal of Personality Assessment, 70, 299–314.PubMedCrossRefGoogle Scholar
  24. Morey, L. C. (1991). Personality Assessment Inventory: Professional Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
  25. Nicholson, K., & Martelli, M. (2006). The confounding effects of pain, psychoemotional problems or psychiatric disorder, premorbid ability structure, and motivational or other factors on neuropsychological test performance. In G. Young, A. Kane & K. Nicholson (Eds.) Psychological Knowledge For Court: PTSD, Chronic Pain and TBI, pp. 335–351. Springer Science+Business Media: New York.CrossRefGoogle Scholar
  26. Rogers, R. (1992). Structured Interview of Reported Symptoms. Odessa, FL: Psychological Assessment Resources.Google Scholar
  27. Rogers, R. (1997). Introduction. In R. Rogers (Ed.), Clinical Assessment of Malingering and Deception (2nd ed., pp. 1–19). Guilford Press, New York.Google Scholar
  28. Rogers, R., Kropp, P. R., Bagby, R. M., & Dickens, S. E. (1992). Faking specific disorders: A study of the Structured Interview of Reported Symptoms (SIRS). Journal of Clinical Psychology, 48, 643–648.PubMedCrossRefGoogle Scholar
  29. Rogers, R., Sewell, K. W., Martin, M. A., & Vitacco, M. (2003). Detection of feigned mental disorders: A meta-analysis of the MMPI-2 and malingering. Assessment, 10, 160–177.PubMedCrossRefGoogle Scholar
  30. Rosenhan, D. L. (1973). On being sane in insane places. Science, 179, 250–258.PubMedCrossRefGoogle Scholar
  31. Sparr, L., & Pankratz, L. (1983). Factitious Posttraumatic Stress Disorder. American Journal of Psychiatry, 140, 1016–1019.PubMedGoogle Scholar
  32. Steffan, J. S., Clopton, J. R., & Morgan, R. D. (2003). An MMPI-2 scale to detect malingered depression (Md Scale). Assessment, 10, 382–392.PubMedCrossRefGoogle Scholar
  33. Viglione, D. J., Wright, D. M., Dizon, N. T., Moynihan, J. E., DuPuis, S., & Pizitz, T. D. (2001). Evading detection on the MMPI-2: Does caution produce more realistic patterns of responding? Assessment, 8, 237–250.PubMedCrossRefGoogle Scholar
  34. Walters, G. L., & Clopton, J. R. (2000). Effect of symptom information and validity scale information on the malingering of depression on the MMPI-2. Journal of Personality Assessment, 75, 183–199.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Keith Nicholson
    • 1
  • Michael F. Martelli
    • 2
  1. 1.Comprehensive Pain ProgramToronto Western HospitalToronto
  2. 2.Concussion Care Centre of VirginiaGlen Allen

Personalised recommendations