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Forensic researchers and practitioners continue to face challenges when attempting to differentiate deceptive response styles, notably when comparing malingering and factitious disorder. However, due to the great disparities in research available, forensic examiners may not be adequately informed for considering factitious presentations as a competing hypothesis to malingering. De-emphasis of factitious disorders may also be attributed to the lack of empirical research and poor conceptual understanding of the disorder. Velsor and Rogers conducted a thorough review of various factitious motivations, drawing a parallel to Rogers' explanatory models of malingering. Due to the need for a systematic measure of FPPs, the Inventory of Self and Interpersonal Problems (I-SIP) was developed, largely based on the explanatory models of FPP. The current study employed a construct validity approach to the I-SIP to examine its convergent and discriminant validity in a sample of 80 inpatients from a private psychiatric hospital. Providing strong evidence of construct validity of the I-SIP, dramatic differences emerged between malingered and factitious presentations with extremely large effect sizes (ds = 1.09 – 3.62). In particular, results indicated strong support for the nurturance explanatory model of FPPs, as over-investment in treatment providers was an especially strong discriminator (d = 3.62). Moreover, results highlighted the potential problem of misclassification of response styles, as the SIMS did not effectively distinguish between simulation groups. To avoid diagnostic issues, arguments are presented for the consideration of FPPs as a dimensional construct that vary over time and circumstances. Professional implications are discussed, including practical guidelines for evaluating FPPs in clinical and forensic contexts.

Compromised validity of test data due to exaggeration or fabrication of cognitive deficits inhibits the capacity to establish appropriate conclusions and recommendations in neuropsychological examinations. Detection of feigned neurocognitive impairment presents a formidable challenge, particularly for evaluations involving possibilities of significant secondary gain. Among specific populations examined in this domain, litigating mild traumatic brain injury (mTBI) samples are among the most researched. One subpopulation with potential to contribute significantly to this body of literature is that of retired athletes undergoing fixed-battery neuropsychological evaluations within an assessment program. Given the considerable prevalence of concussions sustained by athletes in this sport and the substantial monetary incentives within this program, a unique opportunity exists to establish rates of feigning within this population to be compared to similar forensic mTBI samples. Further, a fixed battery with multiple validity tests (VT) offers a chance to evaluate the classification accuracy of an aggregated VT failure paradigm, as uncertainty abounds regarding the optimal approach to the recommended use of multiple VTs for effort assessment. The current study seeks to examine rates of feigned neurocognitive impairment in this population, demonstrate prediction accuracy equivalence between models based on aggregated VT failures and logistic regression, and compare classification performance of various individual VTs.

Malingering is the deliberate production of feigned symptoms by a person seeking external gain such as: financial compensation, exemption from duty, or leniency from the criminal justice system. The Test Translation and Adaptation Guidelines developed by the International Test Commission (ITC) specify that only tests which have been formally translated into another language and validated should be available for use in clinical practice. Thus, the current study evaluated the psychometric properties of a Spanish translation of the Structured Interview of Reported Symptoms (SIRS). Using a simulation design with 80 Spanish-speaking Hispanic American outpatients, the Spanish SIRS was produced reliable results with small standard errors of measurement (SEM). Regarding discriminant validity, very large effect sizes (mean Cohen's d = 2.00) were observed between feigners and honest responders for the SIRS primary scales. Research limitations and directions for future research are also discussed.

Thesis (MOccTher)-- University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Malingering, the intentional simulation or exaggeration of symptoms for secondary gain, has a significant financial impact on disability insurance given its prevalence. Multidisciplinary professionals involved in disability determination therefore require a tool which would assist in the screening of suspected malingerers. AIM: The Credibility Assessment Tool (CAT), a tool which was developed as part of the Performance APGAR, was reviewed in terms of its validity and application to the screening of malingering. Research objectives included the review of face and content validity through a literature review and concept analysis, as well as the review of construct and concurrent validity by comparing the results with the operationalised malingering construct and available malingering protocols. The adapted Slick criteria as proposed by Aronoff, applicable to chronic pain, neurocognitive, neurological and psychiatric symptoms, was identified as the most suitable criterion standard for use of comparison. DESIGN: The research design was a descriptive analytical design, which was performed retrospectively with a report review from insurance referrals to the researcher. Informed consent was obtained from insurers who legally own the reports. A saturated sample of convenience of 184 cases with depression and pain as predominant symptoms were analysed. Recall bias were minimised through omission of personal identifiers and the use of a peer check of 20 random cases. Results in the peer check were suggestive of poor inter-rater reliability, rather than recall bias. METHOD: Cases were analysed according to the guidelines from the respective authors of the CAT and adapted Slick criteria, however this was further defined to ensure that the study could be replicated. RESULTS: Face validity was adequate in terms of purpose, item selection and association between consistency criteria, however require improvement in terms of standardised instruction and weighting of the scale. Content validity was rated as adequate to excellent, given that it supports criteria linked to the malingering construct. Construct validity was adequate as demonstrated by association between concepts obtained through concept analysis. Correlation between the CAT and adapted Slick was strong (r>0.5) however caution is expressed that this requires further research. CONCLUSION: Recommendations for further research included the review of content validity with subject experts, criterion and predictive valid through a case-control study of known-groups, as well as the reliability of the CAT, and the use of specialised ADL indices for malingering detection. Adaptation to the CAT was depicted in the proposed Consistency Assessment Tool. / AFRIKAANSE OPSOMMING: Malingering, die opsetlike nabootsing of oordrywing van simptome vir sekondêre gewin, het ‘n beduidende finansiële impak op ongeskiktheidsversekering as gevolg van die prevalensie daarvan. Multidissiplinêre professionele persone betrokke by ongeskiktheidsevaluasies het daarom ‘n meetinstrument nodig om moontlike malingeerders te identifiseer. DOEL: Die Credibility Assessment Tool (CAT), wat ontwikkel was as deel van die Performance APGAR, was ondersoek in terme van geldigheid en toepassing op malingering. Navorsingsdoelwitte het die ondersoek van voorkoms- en inhoudsgeldigheid deur ‘n literatuurstudie en konsep analise behels, sowel as konstruk- en korrelasie geldigheid deur die vergelyking van die resultate met beskikbare malingering protokolle en operasionele konstrukte. Die aangepaste Slick kriteria soos voorgestel deur Aronoff, wat toepaslik is op kroniese pyn, neurokognitiewe, neurologiese en psigiatriese simptome, was ge-identifiseer as die meeste gepaste kriterium standaard vir vergelyking. ONTWERP: Die studieontwerp was ‘n beskrywende analitiese studie wat retrospektief uitgevoer was deur ‘n ondersoek van verslae van versekeraars. Ingeligte toestemming was verkry van versekeraars wat die wetlike eienaars van die verslae is. ‘n Gerieflikheidsteekproef van 184 gevalle met depressie en pyn as hoof simptome was geanaliseer. Sydighede was verminder deur persoonlike inligting te verwyder en die gebruik van ‘n eweknie evaluasie van 20 ewekansige getrekte gevalle. Voorlopige resultate dui onbevredigende betroubaarheid aan, eerder as sydighede. METODE: Gevalle was ge-evalueer volgends die riglyne van die verskeie outeure van die CAT en aangepaste Slick kriteria, en was sodanig verder gedefinieer om te verseker dat die studie herhaal kan word. RESULTATE: Voorkomsgeldigheid was voldoende, maar verbetering is aanbeveel in terme van gestandardiseerde instruksie en skaal verdeling. Inhoudsgeldigheid was beduidend in vergelyking met die wetenskaplike literatuur en die geoperasionaliseerde konstrukte. Konstrukgeldigheid was bevestig deur die positiewe verhoudings tussen die aangepaste Slick en CAT kriteria. ‘n Sterk korrelasie was gevind tussen die aangepaste Slick en CAT, maar hierdie moet versigtig geinterpreteer word aangesien verdere navorsing verlang word. GEVOLGTREKKING: Aanbevelings vir verdere navorsing sluit in die ondersoek van die inhoudsgeldigheid met eksperte, kriterium- en voorspellingsgeldigheid, sowel as die betroubaarheid van die CAT en die gebruik van gespesialiseerde ADL indekse vir uitkenning van malingering. Aanpassing vir die CAT word ook voorgestel.

Muscle strength capabilities are a determinant in the ability to successfully accomplish everyday tasks. As such, the quantification of this aspect of human performance is of interest in many settings. Currently, the validity of muscle strength test results is reliant on the notion that during testing, the participant exerted an effort that is sincere, and that consisted of maximal voluntary contractions. Therefore, the ability to differentiate between maximal and non maximal muscular exertions is of importance. The purpose of this dissertation was to develop and validate probability-based decision rules for differentiating between maximal and non-maximal voluntary exertions of the knee and shoulder joint musculature during isokinetic dynamometry-based testing. For development of the decision rules, healthy participants performed a series of maximal and non-maximal exertions at different testing velocities through a prescribed range of motion. Two different theory-based approaches were subsequently used for decision rule development: the first approach was based on expected better consistency in strength waveform shapes and relative magnitudes during performance of maximal efforts in comparison to non-maximal efforts. The second approach was based on the known force-velocity dependency in skeletal muscles. In terms of discriminatory performance, several of the decision rules pertaining to the knee joint markedly improve upon those previously reported. In addition, a separate investigation demonstrated that the decision rules offer excellent discriminatory performance when applied to test results of participants that have undergone surgical reconstruction of their anterior cruciate ligament. As such, clinicians and researchers may be able to ascertain voluntary maximal effort production during isokinetic testing of the knee joint musculature with a high degree of confidence, and thus be able to rely on such scores for decision-making purposes With regards to the shoulder musculature decision rules, several methodological issues related to test positioning and signal processing need to be addressed prior to consideration of their use in the clinical domain. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2013-06-19 01:12:53.454

Psychological assessment of mentally disordered offenders requires a systematic consideration of response styles, including malingering and defensiveness. Important components of these evaluations are standardized diagnostic interviews. However, the ability of offenders to feign mental disorders on such measures to achieve such external incentives as treatment, placement on safer units, or possible release from jail remains uninvestigated. With a known-groups comparison with the data from the Structured Interview of Reported Symptoms as a criterion, 24 suspected malingerers were compared to 64 genuine patients on the Schedule of Affective Disorders and Schizophrenia (SADS), the abbreviated SADS-C, the Suicide Probability Scale, and the Referral Decision Scale.

Deficits in executive function are commonly reported following Traumatic Brain Injury (TBI) and are important for establishing functional impairments. Understanding the nature of executive dysfunction following TBI is often complicated by secondary factors that can impact measured ability. This study sought to clarify the persistent effects of TBI on executive function, as measured by the Wisconsin Card Sorting Test (WCST), while accounting for effort given during testing, as measured by the Portland Digit Recognition Test. Results suggested a dose-response relationship between TBI severity and subsequent WCST deficits. Mild TBI patients who provided good effort during testing showed no observable differences from locally matched controls on WCST performance. Effort during testing was found to have a larger overall effect on WCST performance than moderate-to-severe TBI or dementia. The present study highlights the need to account for secondary factors, such as effort during testing, to accurately measure cognitive dysfunction following compensable injuries.

Different psychosocial factors influence the experience and adaptation to pain. Previous cluster analytic studies using the Minnesota Multiphasic Personality Inventory-2nd edition described psychologically different subgroups of pain patients that had been shown valuable in determining outcome. However, these studies had limited applicability to medico-legal pain populations because they did not use newly developed scales or describe important medico-legal factors that have large effects on symptom endorsement. Using three methods of clustering, the current investigation explored the subgroups that resulted when using all the MMPI-2 and the newly developed MMPI-2-RF (Restructured Form) scales on a large and well-described population of medico-legal spine pain patients. Result demonstrated that the best solution for the current sample was the two-cluster solution when a traditional method was used. However, the best solution was the three-cluster solution when all MMPI-2 scales and a method that used all MMPI-2-RF scales were used. Thus, the three-cluster solution was considered the most adequate solution to differentiate patients in medico-legal settings. Moreover, results demonstrated that subgroup membership was not conditioned to spine related organic factors. Instead, malingering, education, ethnic background and legal status differentiated pain subgroups. Lastly, results demonstrated a dose-response relationship between perceived outcome and subgroup profile elevation. The current results are relevant for understanding the circumstances that can influence spine pain recovery and for informing decisions regarding possible interventions.