Why functional neurological disorder is not feigning or malingering. Functional neurological disorder (FND) is one of the commonest reasons that people seek help from a neurologist and is for many people a lifelong cause of disability and impaired quality of life. Although the evidence base regarding FND pathophysiology, treatment and service development has grown substantially in recent years , a persistent ambivalence remains amongst health professionals and others as to the veracity of symptom reporting in those with FND and whether the symptoms are not, in the end, just the same as feigned symptoms or malingering. Here, we provide our perspective on the range of evidence available, which in our view provides a clear separation between FND and feigning and malingering. We hope this will provide
Detecting feigned symptoms of depression, anxiety, and ADHD, in college students with the structured inventory of malingered symptomatology. Research consistently shows how easily students can feign symptoms of ADHD on self-report checklists to determine eligibility for curricular and standardized testing accommodations. However, it is unclear how easily students can feign psychological symptoms ) and the Structured Inventory of Malingered Symptomatology (SIMS). The SIMS showed 100% specificity, but low sensitivity (36-52%) for detecting feigned symptoms with different cutoffs. Differences on SIMS subtests were apparent by group with elevated scores for the DA group on the Affective Disorders subscale and elevation for the ADHD group on the Low Intelligence and Amnestic subscales. Participants identified
Automatic identification of tinnitus malingering based on overt and covert behavioral responses during psychoacoustic testing. Tinnitus, or ringing in the ears, is a prevalent condition that imposes a substantial health and financial burden on the patient and to society. The diagnosis of tinnitus, like pain, relies on patient self-report, which can complicate the distinction between actual and fraudulent claims. Here, we combined tablet-based self-directed hearing assessments with neural network classifiers to automatically differentiate participants with tinnitus (N = 24) from a malingering cohort, who were instructed to feign an imagined tinnitus percept (N = 28). We identified clear differences between the groups, both in their overt reporting of tinnitus features, but also covert differences
Analysis of Medical Students' Book Reports on Shalamov's Kolyma Tales (1974): Would You Reveal the Truth About a Suspected Malingering Patient? The aim of this study was to investigate medical students' thought processes regarding whether to reveal the truth about a suspected malingering patient by analysing their book reports on Shalamov's (1974). The participants were 47 medical students the truth by fair means or foul, whereas 15 (32.0%) would turn a blind eye to a malingering patient. On the post-reading questionnaire, however, 17 (36.2%) answered that they would reveal the truth, while 22 (46.8%) answered that they would turn a blind eye. It is notable that among the 18 students (38.2%) who replied that whether they would reveal the truth depended on the situation on the pre-reading
The Detection of Malingered Amnesia: An Approach Involving Multiple Strategies in a Mock Crime. The nature of amnesia in the context of crime has been the subject of a prolonged debate. It is not uncommon that after committing a violent crime, the offender either does not have any memory of the event or recalls it with some gaps in its recollection. A number of studies have been conducted in order to differentiate between simulated and genuine amnesia. The recognition of probable malingering requires several inferential methods. For instance, it typically involves the defendant's medical records, self-reports, the observed behavior, and the results of a comprehensive neuropsychological examination. In addition, a variety of procedures that may detect very specific malingered amnesia
Reexamining performance validity cutoffs within the Complex Ideational Material and the Boston Naming Test-Short Form using an experimental malingering paradigm. This study was designed to cross-validate previously published performance validity cutoffs embedded within the Complex Ideational Material (CIM) and the Boston Naming Test-Short Form (BNT-15). Seventy healthy undergraduate students were randomly assigned to either a control condition (n = 40) and instructed to perform to the best of their ability or an experimental malingering (n = 30) condition and instructed to feign cognitive impairment while avoiding detection. All participants were administered the same battery of neuropsychological tests. Previously published validity cutoffs within the CIM (raw score ≤9 or T-score ≤29
Computerized Analysis of Verbal Fluency: Normative Data and the Effects of Repeated Testing, Simulated Malingering, and Traumatic Brain Injury. In verbal fluency (VF) tests, subjects articulate words in a specified category during a short test period (typically 60 s). Verbal fluency tests are widely used to study language development and to evaluate memory retrieval in neuropsychiatric disorders 3, we examined the performance of subjects from Experiment 2 when instructed to malinger: 38% showed abnormal (p< 0.05) performance in semantic conditions. Simulated malingerers with abnormal scores could be distinguished with 80% sensitivity and 89% specificity from subjects with abnormal scores in Experiment 1 using lexical, temporal, and semantic measures. In Experiment 4, we tested patients
Detecting malingering mental illness in forensics: Known-Group Comparison and Simulation Design with MMPI-2, SIMS and NIM Criminal defendants may often exaggerate psychiatric symptoms either to appear non-accountable for their actions or to mitigate their imprisonment. Several psychometric tests have been proposed to detect malingering. These instruments are often validated by Simulation Design defendants of three well-known malingering-detecting tests (MMPI-2, SIMS and NIM) by using both Known-Group Comparison (KGC) and Simulation Design (SD) protocols. The study involved 151 male inmates. Participants to the KGC protocol were all characterized by a positive psychiatric history. They were considered as genuine patients (KGC_Controls) if they had some psychiatric disorders already before
The Detection of Malingering: A New Tool to Identify Made-Up Depression Major depression is a high-prevalence mental disease with major socio-economic impact, for both the direct and the indirect costs. Major depression symptoms can be faked or exaggerated in order to obtain economic compensation from insurance companies. Critically, depression is potentially easily malingered, as the symptoms that characterize this psychiatric disorder are not difficult to emulate. Although some tools to assess malingering of psychiatric conditions are already available, they are principally based on self-reporting and are thus easily faked. In this paper, we propose a new method to automatically detect the simulation of depression, which is based on the analysis of mouse movements while the patient is engaged
The vulnerability of self-reported disability measures to malingering: a simulated ADHD study. Making diagnostic and accommodation decisions for potential Attention-Deficit/Hyperactivity Disorder (ADHD) in adults is difficult, as the assessor often relies more on self-reported symptoms and functional disability than in childhood evaluations. Malingering of ADHD occurs frequently in the educational setting and for a variety of reasons, including the potential benefits of access to stimulant medications and academic accommodations. The present study utilized a simulation design to examine the potential for malingering of self-reported functional disability on the World Health Organization Disability Schedule 2.0 (WHODAS). Participants were 167 students from two Midwestern universities
Malingering and Defensiveness on the Spanish Personality Assessment Inventory: An Initial Investigation with Mostly Spanish-Speaking Outpatients. Psychological assessments can be essentially invalidated by examinees' intentional response styles, such as (i.e., fabrication or marked overreporting of symptoms/impairment) and (i.e., denial or minimization of symptoms/impairment effectiveness in clinical populations. Using a between-subjects design, a sample of mostly Spanish-speaking outpatients was randomly assigned to genuine, feigning, or defensive conditions. For feigning, PAI malingering indicators using rare symptoms strategies (i.e., Negative Impression [NIM] and Negative Distortion [NDS] scales) demonstrated moderate to large effect sizes. For defensiveness, the Defensive
[Classification accuracy of the symptom validity tests Word Memory Test and the German version of the Structured Inventory of Malingered Symptomatology]. The symptom validity tests Word Memory Test (WMT) and "Strukturierter Fragebogen Simulierter Symptome" (SFSS, German version of the Structured Inventory of Malingered Symptomatology, SIMS) are used in psychiatric expert reviews in the context of social benefit proceedings to elucidate the validity of a patient's symptom presentation and to unveil possible malingering. Many of the studies on the WMT and the SFSS estimated the sensitivity and specificity of the tests by using student populations or healthy volunteers. The objective of the present study was to investigate the accuracy of the WMT and the SFSS in a clinical sample
Differentiating Factitious from Malingered Symptomatology: the Development of a Psychometric Approach Psychometric symptom validity assessment is becoming increasingly part and parcel of psychological and neuropsychological assessments. An unresolved and rarely addressed issue concerns the differentiation between factitious and malingered symptom presentations: present-day symptom validity tests with factitious and malingering conditions ( = 24-30 per condition) and a clinical control group ( = 34, = 40). Overall, the results were positive: The SDI was as effective in detecting feigned symptom presentations as a traditional symptom validity test and superior in differentiating factitious from malingered symptom presentations. We conclude that the SDI is not ready for clinical use
The Malingering Intussusception While intussusception is rarely seen in adults, it is typically obstructive in nature when it does occur. Even less commonly seen is transient intussusception, which occurs without a radiological lead point or any evidence of bowel obstruction. Such findings consist of a "target pattern" seen on computed tomography (CT) but are incidental and do not require any
The Bay Area Verbal Learning Test (BAVLT): Normative Data and the Effects of Repeated Testing, Simulated Malingering, and Traumatic Brain Injury Verbal learning tests (VLTs) are widely used to evaluate memory deficits in neuropsychiatric and developmental disorders. However, their validity has been called into question by studies showing significant differences in VLT scores obtained of traumatic brain injury. Although 37% of simulated malingerers showed abnormal ( < 0.05) omnibus z-scores, z-score cutoffs were ineffective in discriminating abnormal malingerers from control participants with abnormal scores. In contrast, four malingering indices (recognition scores, primacy/recency effects, learning rate across acquisition trials, and IWIs) discriminated the two groups with 80
Factitious disorders and malingering: challenges for clinical assessment and management. Compared with other psychiatric disorders, diagnosis of factitious disorders is rare, with identification largely dependent on the systematic collection of relevant information, including a detailed chronology and scrutiny of the patient's medical record. Management of such disorders ideally requires a team -based approach and close involvement of the primary care doctor. As deception is a key defining component of factitious disorders, diagnosis has important implications for young children, particularly when identified in women and health-care workers. Malingering is considered to be rare in clinical practice, whereas simulation of symptoms, motivated by financial rewards, is regarded as more common
A Systematic Review of Neuropsychological Malingering in Culturally, Ethnically and Linguistically Diverse Samples. PROSPERO International prospective register of systematic reviews Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms
Diagnosis of Depressive Disorder Malinger Using the Niacin Skin Response Test (NSRT) This study will explore the specific response characteristics of the niacin skin response test in the population with depressive disorder malinger. The investigators expect that depressive disorder malinger can be discriminated by the niacin skin reaction test. Depressive disorder malingers are prevalent , and it is difficult to recognize. As an objective and scientific endophenotype of depressive disorders, the blunted features in NSRT are determined by genetic factors and are not influenced by the mental state of individual subjects at a particular moment, which can provide a reliable retrospective biological index for the determination of mental and psychological state of depressive disorder malinger. This study
Religious stigmata as malingering artifact: Report of a case and review of the literature. Artifacts or simulated diseases are self-inflicted conditions caused by various means and for different purposes. Disease simulation can be motivated, among other things, by illegal purposes, to escape from civil duties or prison sentences, for example, or to exploit specific situations in order to receive