Detecting symptom exaggeration in combat veterans using the MMPI–2 symptom validity scales: A mixed group validation.

2010 ◽  
Vol 22 (4) ◽  
pp. 729-736 ◽  
Author(s):  
David F. Tolin ◽  
Maria M. Steenkamp ◽  
Brian P. Marx ◽  
Brett T. Litz
Author(s):  
Francesca Ales ◽  
Laszlo Erdodi

AbstractThis systematic review was performed to summarize existing research on the symptom validity scales within the Trauma Symptom Inventory–Second Edition (TSI-2), a relatively new self-report measure designed to assess the psychological sequelae of trauma. The TSI-2 has built-in symptom validity scales to monitor response bias and alert the assessor of non-credible symptom profiles. The Atypical Response scale (ATR) was designed to identify symptom exaggeration or fabrication. Proposed cutoffs on the ATR vary from ≥ 7 to ≥ 15, depending on the assessment context. The limited evidence available suggests that ATR has the potential to serve as measure of symptom validity, although its classification accuracy is generally inferior compared to well-established scales. While the ATR seems sufficiently sensitive to symptom over-reporting, significant concerns about its specificity persist. Therefore, it is proposed that the TSI-2 should not be used in isolation to determine the validity of the symptom presentation. More research is needed for development of evidence-based guidelines about the interpretation of ATR scores.


2017 ◽  
Vol 23 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Derek K. Tracy ◽  
Keith J. B. Rix

SummaryMalingering is the dishonest and intentional production of symptoms. It can cause considerable difficulty as assessment runs counter to normal practice, and it may expose clinicians to testing medicolegal situations. In this first part of a two-article review, we explore types of psychiatric malingering and their occurrence across a range of common and challenging scenarios, discussing presentations that may help delineate true from feigned illness. A framework is provided for undertaking an assessment where malingering is suspected, including recommendations on clinician approach, the use of collateral information, and self-evaluation of biases. The uses, and limitations, of psychometric tests are discussed, including ‘general’, malingering-specific and ‘symptom validity’ scales.Learning Objectives• Understand the challenges of determining ‘real’ from ‘malingered’ symptomatology across a range of psychiatric conditions• Have a rational strategy for approaching a clinical assessment where malingering is suspected• Appreciate the role and limitations of various psychometric tests that can be used in such assessments


2021 ◽  
Vol 36 (6) ◽  
pp. 1232-1232
Author(s):  
Chad Grills ◽  
Douglas B Cooper ◽  
Jennifer M Yamashita ◽  
Patrick Armistead-Jehle

Abstract Objective To evaluate the classification statistics of the Clinical Assessment of Attention Deficit – Adult (CAT-A) Negative Impression (NI) scale, relative to the MMPI-2-RF in an active duty military sample. We hypothesized that MMPI-2-RF RBS would have the largest AUC. Method Retrospective review of 108 active duty service members consecutively referred to neuropsychology for clinical ADHD evaluations in a Midwest Army Health Center. Cases with missing data (10) and failures of MMPI-2-RF response consistency scales (3) were removed from analysis, resulting in final sample of 95. Average age was 32.62 (SD = 8.87) and average education was 14.66 (SD = 2.66). MMPI-2-RF symptom validity scales (F-r, Fp-r, Fs, FBS-r, and RBS) were employed as criterion measures at all standard cut-offs to evaluate the CAT-A NI scale. Results ROC analyses for the MMPI-2-RF over-reporting symptom validity scales ranged from 0.599 to 0.808, with the MMPI-2-RF RBS scale >79 demonstrating the lowest AUC (0.599; p 52. With specificity held at or above 0.90, sensitivities ranged from 22.86 to 60.00, with positive and negative predictive values ranging from 11.1 to 58.8 and 66.7 to 98.8, respectively. Conclusions The CAT-A NI scale demonstrated reasonable AUC values for nearly all MMPI-2-RF over-reporting scales. Psychologically-based over-reporting scales were superior to cognitively-based over-reporting scales in terms of classification statistics. The optimal cut in the current data (>52) is slightly higher (though roughly commensurate) to the cut score for atypical responses in the CAT-A manual (>45).


2015 ◽  
Vol 45 (2) ◽  
pp. 103-109
Author(s):  
Shanil Ebrahim ◽  
Sheena Bance ◽  
Sohail M. Mulla ◽  
Luis Montoya ◽  
Cindy Malachowski ◽  
...  

Introduction Measures that help detect exaggeration of symptoms can be valuable for informing more accurate diagnoses and aid in treatment and case management. We completed a systematic review to identify measures that assess symptom exaggeration in mental health disorders. Methods Eligible studies assessed exaggeration of symptoms with a psychometrically validated measure in patients presenting with a mental health disorder. We searched MEDLINE and PsycINFO from inception to June 2013 for relevant studies. To determine study eligibility, reviewers screened title and abstracts of identified citations, and reviewed full texts of all potentially eligible citations. Data extractors completed data abstraction of eligible studies. Results Of 8435 unique citations, 105 studies consisting of 112 cohorts were eligible, and we identified 36 unique, validated measures assessing exaggeration of symptoms. The most frequently used measures were symptom validity indicators embedded in the Minnesota Multiphasic Personality Inventory (MMPI-2) (n=48, 46%), the Structured Interview of Reported Symptoms (SIRS) (n=12, 11%), and the Personality Assessment Inventory (PAI) (n=11, 10%). Most studies (n=96; 91%) failed to test reliability of their measure of symptom exaggeration. The symptom validity indicators in the MMPI/MMPI-2 and the SIRS both showed moderate to high internal consistency, range 0.47 to 0.85 and 0.48 to 0.95, respectively. Conclusions Multiple measures assessing symptom exaggeration have been used in patients with mental health disorders. The symptom validity indicators of the MMPI/MMPI-2 are the most widely used measures to assess symptom exaggeration. Assessment and reporting of reliability is poor across studies; we require further assessment of psychometric properties for existing measures of symptom exaggeration.


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