Thirty-nine patients in a forensic mental hospital were evaluated using the Structured Interview of Reported Symptoms (SIRS) and several tests used for detecting malingered psychiatric and neuropsychological dysfunction. Patients were initially classified by a multidisciplinary team as nonmalingering participants (n = 12) and known malingerers (n = 9). All participants in both groups were pretrial and had been found incompetent to stand trial by the court. Eighteen more patients found to be not guilty by reason of insanity by the courts were included in the study. Using the SIRS alone, 95% overall classification accuracy was obtained. When the scores on the Dot Counting Test, Memory for Fifteen Items Test, and the M-Test were added to the discriminant function, all patients were correctly classified to the respective groups. The results are discussed in terms of complimenting interdisciplinary team diagnosis with psychological tests for malingering.
The present study examined the ability of analog malingerers to feign postconcussion symptoms and neuropsychological performance patterns seen in mild head-injured patients. Experimental subjects were randomly assigned to either a control condition, asked to feign deficits consistent with mild head injury without task specific instruction, or feign deficits while given task-specific instruction. A separate group of mild head-injured patients served as a clinical comparison group. Analog malingering groups accurately simulated levels of postconcussive symptoms seen in the mild head-injured patients. However, poorer performance was displayed by the analog malingerers on the objective malingering tests. Coaching did not facilitate realistic patterns of performance for analog malingerers. The results of this study indicate that analog malingerers accurately replicated self-reported postconcussive symptoms, but were less able to simulate objective clinical malingering test performance. These results suggest that self-report measures of postconcussive symptoms and clinical tests are differentially vulnerable to simulation attempts.
The present study investigated the effects of personal knowledge, experience and beliefs about traumatic brain injury (TBI) on persons' ability to successfully feign neuropsychological impairment. Head-injured and non-injured subjects completed the Head Injury Misconception Survey, and were evenly divided into malingering or control (do best) conditions. Subjects were given a scenario which asked them to imagine that they had been in a prior accident and were involved in litigation. They were then asked to either malinger or respond in the best way possible to a battery of neuropsychological tests. While instructions to malinger had a pronounced effect, knowledge of brain injury did not significantly influence an individual's ability to feign neuropsychological impairment. Future directions in the study of malingering are also discussed.
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