This study evaluated the efficacy of various attention-related, neuropsychological, and symptom validity measures in the detection of feigned ADHD in an undergraduate sample. Performance was compared between a group of presumed normal students (HON), a group of diagnostically "clean" ADHD students asked to respond to the best of their ability (ADHD), and a group of motivated, coached feigners (FGN). Feigners were educated about symptoms and characteristics of ADHD, provided with a scenario to help them relate to the plight of a student who might seek diagnosis, admonition to feign believably, and a significant monetary incentive for "successful feigning" ($45). They were not forewarned about the specific types of tests they would take nor alerted to the presence of malingering detection instruments. Results illustrated that the ADHD symptom-report measures, though sensitive to ADHD, were quite susceptible to faking. The ARS and CAARS—S:L (using a stringent cut score of four or more scale elevations) were successfully faked by 80% and 67% of students, respectively. The Conners CPT, in contrast to those measures, had both limited sensitivity to ADHD and specificity for FGN in this sample. Very high specificity and moderate sensitivity were noted for symptom validity measures across the board, translating into high positive predictive values. Binary logistic regression results indicate that the TOMM Trial 1 coupled with the DMT, LMT, or NV-MSVT may be used to identify feigners with high predictive accuracy.

Currently, only the TSI assesses complex traumatic reactions and patient response styles. However, its feigning scale, ATR, uses a flawed detection strategy and is potentially confounded by experiences of complex PTSD. As a consequence, clinicians using the TSI to evaluate severely traumatized patients have no useful method for discriminating genuine and feigned responding. Several detection strategies have demonstrated utility within evaluations of feigned trauma including the assessment of rare symptoms, symptom combinations, symptom selectivity, and symptom severity. The current study created scales on the TSI according to these strategies using a development sample of 107 severely traumatized patients. Validation of all TSI feigning scales was then performed with a second independent sample of 71 severely traumatized patients using a mixed simulation design. Results found support for each scale's convergent validity with SIRS primary scales (M rs = .52) and discriminant validity with measures of defensiveness on the SIRS (M rs = -.07) and TSI (M rs = -.19). Each scale also produced expectedly mild to moderate relationships with SADS-C clinical scales (M rs = .32) and the SCID-IV PTSD module (M rs = -.02). Support for their criterion validity was only moderate (M ds = .69) when comparing the scores of genuine patients to those simulating disability. Potential explanations for this trend were reviewed, including (a) the impact of comorbidity, (b) the restrictions associated with creating embedded feigning scales, and (c) the influence of simulator knowledge in analogue designs. Limitations of the study and future avenues of research were discussed.

No description available.

The FBS (Lees-Haley, 1992) is a relatively new validity scale for the MMPI-2 designed specifically to detect feigned neurocognitive deficit. The aim of the present study was to examine the FBSs efficacy in differentiating psychiatric and neurocognitive feigners using a known-groups design. Malingering tests were administered to 180 individuals undergoing forensic neuropsychiatric evaluations. Based on the malingering test results, participants were classified as honest responders, psychiatric feigners, neurocognitive feigners, or feigning both psychiatric and neurocognitive deficits. The FBS significantly differentiated the 3 feigning groups from the honest group, but it did not discriminate effectively between neurocognitive and psychiatric feigners.

Detection of malingering is a significant concern in forensic psychological assessments. The best-validated tests currently available are time-intensive for both test-takers and mental health professionals. Thus, well-validated, brief screening measures for malingering would be useful in a forensic environment. The Structured Inventory of Malingered Symptomatology (SIMS; Smith andamp; Burger, 1997) has demonstrated potential in this role. The present study attempts replication of previous studies while extending validation from analogue and male criminal forensic samples to both men and women in a civil forensic setting. The SIMS accuracy in the detection of both neurocognitive and psychiatric symptom feigning is evaluated by comparing its performance to stringent multi-scale criterion measures in a large forensic sample. Cut scores suggested by previous studies yield high sensitivity and negative predictive power in this sample when the SIMS is used to detect psychiatric symptom malingering; however, these cut scores perform inadequately here when screening for the feigning of neurocognitive impairment, and no alternative cut score functions well in this capacity. The results lend support to the utility of the SIMS as a screen for psychiatric symptom malingering by men and women in a civil forensic setting.

Individuals undergoing forensic neuropsychological evaluation frequently stand to gain in some manner if neurocognitive dysfunction is diagnosed. As a result, neuropsychologists are customarily asked to test for neurocognitive feigning during the assessment. The current study employed an analogue design with a clinical comparison group to examine the utility of the TOCA (Rogers, 1996) as a measure of feigned neurocognitive impairment. Two groups of simulators (one cautioned about the presence of detection strategies and one not cautioned) were compared to clinical and normal control groups. Fourteen scales were developed based on five detection strategies: symptom validity testing, performance curve, magnitude of error, response time, and floor effect. Each was employed during both verbal and nonverbal tasks. Significant differences were revealed among groups when subjected to ANOVA. Classification rates from subsequent utility estimates and discriminant function analyses on the scales ranged from 58.8% to 100%. Combining strategies yielded a classification rate of 95.7%. The effect of cautioning simulators was modest; however, a trend was noted on some scales for cautioned simulators to appear less obviously impaired than noncautioned. Although the results require crossvalidation, preliminary data suggest that the TOCA is a sensitive and specific measure of feigned neurocognitive performance. Strengths and weaknesses of the study are discussed and directions for future research are proposed.

The accurate determination of malingering relies on the use of validated and clinically relevant assessment measures. Simulation design is the most often-used research design to accomplish this. However, its external validity is sometimes questioned. The goal of the thesis was to systematically evaluate these major elements: situation, incentives, and coaching. The situation in simulation studies can vary from relevant (academic failure in a college population) to irrelevant (capital murder) for the samples being studied. Incentives refer to the external motivation given to improve simulators' performance and can be positive (extra credit and monetary reward) or negative (extra time and effort). Finally, coaching refers to whether the participant receives any information on detection strategies that are designed to identify feigners. Using a large undergraduate sample in a factorial design, results indicate that a scenario familiar to the participants generally improved the believability of their responses. Coaching also improved the ability to feign convincingly, while incentive type was not associated with any change in scores. The implications of these findings for future research designs and the connection to practice are discussed.

The Miller Forensic Assessment of Symptoms Test (M-FAST) is a relatively new measure shown to be a valid and effective tool for screening psychiatric malingering in criminal forensic and psychiatric inpatient settings. The present study attempts to cross-validate the M-FAST in civil forensic and neurologic samples. Three-hundred-eight civil forensic patients referred by their attorneys for neuropsychological testing were studied. Assessment batteries administered included tests of both psychiatric and neurocognitive feigning. Based on these gold standards, 4 sets of contrasts were formed in order to examine how the M-FAST performs in identifying psychiatric malingering, neurocognitive malingering, any malingering (including either or both types of malingering), as well as any malingering among a neurologic subset of this sample. At the level of group discrimination, the M-FAST Total score performed well in all contrasts. However, at the level of individual classification rates, although the M-FAST Total score was well supported for identifying psychiatric feigning, when neurocognitive malingering was present, performance dropped considerably. Thus, using the M-FAST recommended cutting score of 6, the M-FAST was able to successfully identify psychiatric malingering; however, the M-FAST is not an appropriate measure to use for identifying neurocognitive malingering within this sample.

This study examined the effectiveness of cautioning and education on simulating a mild traumatic brain injury on several neuropsychological measures. The measures used included the Word Memory Test (WMT), Wechsler Adult Intelligence Scales® - Third Edition (WAIS®-III), Wechsler Memory Scales®-3rd Edition instrument (WMS®-III), 16-item version of the Rey Memory Test, and a self-report symptom checklist. Five experimental groups were used including clinical and non-clinical controls, as well as three simulation groups. The design and implementation of this study also attempted to correct several methodological short comings of prior research by increasing the incentives for participants, expanding the generalizability of findings and examining research compliance and participant self-perception through debriefing. Discriminant analysis was utilized to determine if specific functions existed that would correctly classify and distinguish each experimental group. Several discriminant functions had at least moderate canonical correlations and good classification accuracy. Results also include utility estimates given projected varying base rates of malingering.

Competency to stand trial cases constitute the largest percentage of forensic referrals for clinical psychologists. Furthermore, research suggests that the use of forensic measures facilitates the decisions of competency made by forensic examiners. This study investigated the construct validity of three competency measures: (a) the GCCT-MSH, (b) the MacCAT-CA, and (c) the ECST with 100 adult males incarcerated at the Tarrant County Jail in Fort Worth, TX. Construct validity was investigated via the use of a multitrait-multimethod research design for the three-prong conceptualization of the Dusky standard. Results indicated that current competency measures do an adequate job of assessing for factual understanding, but lack construct validity for two prongs: rational understanding and the ability to consult with counsel. In addition, the atypical presentation scales of the both GCCT and the ECST performed well at screening individuals for feigning. Finally, prediction of competency from clinical variables was also investigated. Psychotic symptoms and overall impairment were the strongest predictors of incompetency.