Classification accuracy of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2)-Restructured form validity scales in detecting malingered pain-related disability.

Abstract

The symptom reports of individuals with chronic pain are multidimensional (e.g., emotional, cognitive, and somatic) and significantly contribute to increased morbidity and lost work productivity. When pain occurs in the context of a legally compensable event, reliable assessment of a patient's multifactorial symptom experience during psychological or neuropsychological evaluations is a necessity. The Validity Scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) have been shown useful in identifying symptom overreporting and feigning within chronic pain samples and a number of studies have emerged supporting the use of the MMPI-2-Restructured Form (MMPI-2-RF) in the detection of simulated or feigned impairment in a variety of populations. To date, only 1 other study exists examining the ability of the MMPI-2-RF to detect exaggerated complaints using a strict operationalization of malingering exclusive to chronic pain samples. The purpose of this study was to examine the classification accuracy of MMPI-2-RF Validity Scales in a group of patients with chronic pain using a criterion-groups design. The final sample consisted of 501 clinical chronic pain patients assigned to groups based on the Bianchini, Greve, and Glynn (2005) criteria for Malingered Pain-Related Disability (MPRD). Results showed that all MMPI-2-RF Validity Scales differentiated malingerers from nonmalingerers with a high degree of accuracy. At cut-offs associated with ≥95% Specificity, Sensitivities ranged from 15% (Fs) to 60% (Response Bias Scale; RBS). This study demonstrates that the MMPI-2-RF Validity Scales are capable of differentiating intentional symptom exaggeration from genuine complaints in a sample of incentivized chronic pain patients. (PsycINFO Database Record

The nature of faking: A homogeneous and predictable construct?

“…We will use the term faking from here on, which covers faking bad (malingering) and faking good and is meant in the sense of the definition by Ziegler, MacCann, and Roberts. It is important in both contexts that so-called SD scales are often used to detect faking even though some of those scales were designed to capture unintentional response distortions. As mentioned previously, whereas studies focusing on faking good often conclude that such scales are of little use (e.g., Griffith & Peterson, 2008), studies focusing on faking bad conclude the opposite just as often (Bianchini et al, 2017). It is interesting that despite the differences between a fake bad and a fake good situation that are to be assumed, prior research often only focused one of the two.…”

Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria

“…The MMPI-2 FBS contains only two items directly tapping cognition among its 43 items yet has been used in multiple studies to support a determination of MND, a condition that at least in theory should primarily reflect cognitive malingering, not somatic or psychiatric malingering. The RBS has nine cognitive items among its 28 items, the rest consisting of somatic or psychiatric items; compared to FBS, RBS therefore includes more cognitive items but despite this, the RBS is only slightly more sensitive to MND in some studies ( Bianchini et al, 2018 ; Peck et al, 2013 ; Tarescavage, Wygant, Gervais, & Ben-Porath, 2013 ), and in others, it is marginally less sensitive to MND ( Dionysus, Denney, & Halfaker, 2011 ; Jones, 2016 ). Nevertheless, studies on mixed scales such as FBS and RBS indicate that these SVTs have been used in the determination of MND in a number of patient groups.…”

“…One obvious practical limitation to this approach is that there still exist very few validated SVTs that exclusively measure one type of symptom exaggeration. Multi-domain SVTs from the MMPI-2 and MMPI-2-RF such as FBS/FBS-r and RBS are currently the most frequently used SVTs to detect cognitive malingering in the neuropsychological evaluation; they have also been used to detect MPRD in patients with chronic pain as well as psychiatric malingering in claimants with disability ( Bianchini et al, 2018 ; Chmielewski, Zhu, Burchett, Bury, & Bagby, 2017 ; Table 2 ). Other mixed symptom SVTs include the Validity-10 from the Neurobehavioral Symptom Inventory (NSI), a concussion scale, with two cognitive items out of its 10 items ( Lange, Brickell, Lippa, & French, 2015 ), and the Mild Brain Injury Atypical Scale (mBIAS), an SVT intended to detect feigned traumatic brain injury with items including both cognitive and PTSD symptoms, originally designed for military populations ( Lange, Edmed, Sullivan, French, & Cooper, 2013 ).…”

“…The MPRD model was an advancement in the field in that it was the only well-defined conceptual model for identifying an important facet of somatic malingering (e.g., exaggeration of pain-related disability). Like the MND criteria, the MPRD criteria were subsequently used to calibrate and validate several PVT and SVT cutoffs for use in examinees presenting with pain ( Bianchini et al, 2018 ; Wygant et al, 2011 ). However, the MPRD criteria were also criticized for using evidence of cognitive or psychiatric malingering (i.e., PVT or SVT test failure) as criteria for pain malingering ( Bender & Frederick, 2018 ; Tuck, Johnson, & Bean, 2019 ).…”

American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering

“…Markova et al, 2017) and actual cognitive dysfunction may accompany or result from extant psychiatric illness (East-Richard et al, 2020). Research shows a relationship between performance validity assessment and symptom validity assessment, indicating that cognitive and psychiatric feigning are related (Bianchini et al, 2018;Gottfried & Glassmire, 2016). However, although there is some evidence that failure on PVTs is associated with exaggeration, as indicated by specific SVT scales (Larrabee et al, 2017), failure on one does not necessarily predict failure on the other (Van Dyke et al, 2013).…”