Exaggerating Psychopathology Produces Residual Effects That Are Resistant to Corrective Feedback: An Experimental Demonstration

Abstract

We explored the effects of feedback on symptom reporting. Two experimental groups (n=15 each) were given a scenario with the option to exaggerate symptoms. Compared with a control condition (n=15), both groups scored significantly higher on the Structured Inventory of Malingered Symptomatology. Next, one group was confronted in a sympathetic way about their symptom validity test failure, whereas the other group was confronted in a neutral manner. Both groups subsequently completed the Brief Symptom Inventory (BSI). BSI scores of both feedback groups remained significantly higher than those of control participants. Participants who had been provided with sympathetic feedback or neutral feedback did not differ in their BSI scores. Even participants who indicated during the exit interview that they had given up symptom exaggeration attained significantly higher BSI scores than those of controls, indicating that exaggeration has residual effects that are resistant to corrective feedback. We discuss cognitive dissonance as a model for understanding the residual effects of symptom exaggeration.

A Lab Model for Symptom Exaggeration: What do we Need?

“…Thirdly, we did not obtain strong residual effects of feigning when purely looking at symptom scores over time. This finding is inconsistent with previous studies, including those using instructed feigning paradigms (Merckelbach et al, 2011;Merckelbach et al, 2013;Niesten et al, 2015). In Study 1, residual symptoms may not have occurred because participants did not feel personally responsible for their behavior (i.e., a prerequisite for dissonance; Gosling, Denizeau, & Oberle, 2006) or were highly aware that the symptoms they endorsed did not truly belong to them, whereas in Study 3 no significant feigning occurred to begin with and therefore residual effects could not be detected.…”

“…Participants who had been provided with little external justification (1 dollar) for duping the other participant rated the task as more interesting than controls and those who could easily justify their behavior (i.e., 20 dollars) (see for replications Cooper, 2007). Recently, several studies found that such self-serving biases may also occur in the context of feigning (e.g., Kunst, Aarts, Frolijk, & Poelwijk, 2015;Merckelbach, Jelicic, & Pieters, 2011;Merckelbach, Dandachi-FitzGerald, van Mulken, Ponds, & Niesten, 2013). For example, students who had willingly agreed on writing a fake sick note to their teacher subsequently reported more somatic symptoms at a stage where they were asked to be honest.…”

Antisocial features and “faking bad”: A critical note

“…There are, however, reasons to question this distinction. For example, simulation research in our lab (Merckelbach, Dandachi-FitzGerald, van Mulken, Ponds, & Niesten, 2013;Merckelbach, Jelicic, & Pieters, 2011) suggests that faking bad produces residual symptoms. Undergraduates were provided with a forensic scenario and then instructed either to fake bad or to respond honestly while completing selfreports of symptoms.…”

When lying changes memory for the truth

“…Relatedly, the issue of simulating amnesia can be considered to fall under the more general umbrella theme of malingering and the current discussion is linked to recent research concerning the residual effects of other types of malingering (e.g., Merckelbach, Dandachi-Fitzgerald, Van Mulken, Ponds, & Niesten, 2015;Merckelbach, Jelicic, & Pieters, 2011). Malingering in a medical and legal setting refers to the feigning of symptoms motivated by external reasons (e.g., financial compensation; American Psychiatric Association, 2000) and thus can be treated as a type of lie.…”