Comparison of the MMPI-2 Restructured Demoralization Scale, Depression Scale, and Malingered Mood Disorder Scale in Identifying Non-credible Symptom Reporting in Personal Injury Litigants and Disability Claimants

Abstract

A known groups design compared the ability of the 24-item MMPI-2 Restructured Clinical Demoralization Scale (RCd), the 57-item Depression Scale (Scale 2), and the 15-item Malingered Mood Disorder Scale (MMDS) to identify non-credible symptom response sets in 84 personal injury litigants and disability claimants compared to 77 non-litigating head-injured controls. All three scales showed large effect sizes (>0.80). Scale 2 was associated with the largest effect size (2.19), followed by the MMDS (1.65), and the RCd (0.85). Logistic regression analyses revealed that a cutscore of > or =28 on the 57-item Scale 2 was associated with high specificity (96.1%) and sensitivity (76.2%), while a cutscore of > or =16 on the 24-item RCd was less accurate (87% specificity and 50% sensitivity). Cutscores for the MMDS were not calculated as they were reported in a previous study. Results indicated that like the 15-item MMDS, the 57-item MMPI-2 Scale 2 may provide another empirically derived index with known error rates upon which examiners may rely to investigate hypotheses relative to exaggeration of illness-related behavior and impression management in forensic contexts involving PI litigants and disability claimants.

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

“…This is consistent with some past civilian research that has shown that there is a significant relationship between failure on cognitive effort measures and increased likelihood of exaggeration of symptoms on measures of emotional and personality functioning (Boone & Lu, 1999;Gervais et al, 2008;Gervais et al, 2004;Henry et al, 2009;Iverson et al, 2010;Larrabee, 2003aLarrabee, , 2003bSuhr et al, 2008;Suhr et al, 1997;Tsanadis et al, 2008;Tsanadis et al, 2007;Wygant et al, 2007). However, it is important to note that not all researchers have found a relation between symptom validity failure and symptom reporting on the PAI (Haggerty, Frazier, Busch, & Naugle, 2007;Sumanti, Boone, Savodnik, & Gorsuch, 2006).…”

“…In a civilian setting, researchers have reported that exaggeration of symptoms and poor effort on neurocognitive measures is common following MTBI (Ardolf, Denney, & Houston, 2007;Binder & Rohling, 1996;Larrabee, 2005;Mittenberg, Patton, Canyock, & Condit, 2002). Poor effort has been shown to be associated with exaggeration of self-reported symptoms (Boone & Lu, 1999;Gervais, Ben-Porath, Wygant, & Green, 2008;Gervais, Rohling, Green, & Ford, 2004;Henry, Heilbronner, Mittenberg, Enders, & Domboski, 2009;Larrabee, 2003aLarrabee, , 2003bSuhr, Hammers, Dobbins-Buckland, Zimak, & Hughes, 2008;Suhr, Tranel, Wefel, & Barrash, 1997;Tsanadis et al, 2008;Tsanadis, Montoya, Millis, Hanks, & Fichtenberg, 2007;Wygant et al, 2007) and lower neurocognitive test scores (Fox, 2011;West, Curtis, Greve, & Bianchini, 2011). Of particular mention, some researchers have demonstrated that poor effort alone accounts for more than 50% of the variance in cognitive test performance (Green, Rohling, Lees-Haley, & Allen, 2001;Meyers, Volbrecht, Axelrod, & Reinsch-Boothby, 2011), and that the effects of MTBI are very small in comparison to the effects of poor effort on neurocognitive measures (Brenner, Vanderploeg, & Terrio, 2009;Constantinou, Bauer, Ashendorf, Fisher, & McCaffrey, 2005;Green et al, 2001;Stevens, Friedel, Mehren, & Merten, 2008).…”

Subjective cognitive complaints and neuropsychological test performance following military-related traumatic brain injury

“…However, it is important to note that we also excluded people if they were identified as providing exaggerated symptom reporting based on the PAI validity scales. The relation between symptom exaggeration and poor cognitive effort is well established [68][69][70][71][72][73][74][75][76][77][78][79]. As such, the combination of the WMT and PAI validity scales together greatly reduces the likelihood of misidentification and is unlikely to have affected the overall results.…”

Influence of poor effort on self-reported symptoms and neurocognitive test performance following mild traumatic brain injury

“…However, other studies have examined the relationship between effort test performance and psychological test results, such as the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2), in both TBI and non-TBI samples with mixed results. Some researchers have reported that failure on effort tests is associated with (a) exaggerated memory complaints in non-head-injury disability claimants (Gervais, Ben-Porath, Wygant, & Green, 2008); (b) MMPI-2 scale elevations (i.e., Hs1, D2, Hy3, Pt7, Sc8) in personal injury litigants (78% alleged MTBI; Larrabee, 2003b), MTBI personal injury litigants (Boone & Lu, 1999;Suhr, Tranel, Wefel, & Barrash, 1997), and personal injury litigants and disability claimants (Henry, Heilbronner, Mittenberg, Enders, & Domboski, 2009); (c) MMPI-2 scale elevations (i.e., RC1, RC8) in civil personal injury litigants (33% MTBI) and criminal 1 It is important to note that postconcussional disorder is not an official DSM-IV diagnostic category. DSM-IV presents only research criteria for postconcussional disorder in an effort to provide a common language for researchers and clinicians who are interested in studying this disorder.…”