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Detecting Malingering
Definitions
- Malingering
- Faking bad, exaggerating symptoms
- Examples
- Defendants pleading NGRI
- Inmates getting their own prison cells
- Veterans claiming PTSD - Dissimulation - Faking good, downplaying symptoms - Examples - Inmates applying for parole - Applicants applying for police jobs - Patients being released from mental hospitals
Methods for Detecting
Malingering and Dissimulation
- Nonverbal cues during clinical interview
- Scores on psychological tests
- Comparison of symptoms to norms
Most NGRI Patients are Schizophrenic
(Rogers & Shuman, 2000)
Personality disorder 12.
Other 11.
Mood disorder 5.
Organic disorder or mental retardation 5.
Schizophrenic 62.
Disorder Percentage
Comparing Symptoms to Norms The Psychological Disorder
- Malingerers
- Overact their part
- Are eager to call attention to their symptoms
- Use absurd and inconsistent thoughts
- Symptoms may not fit a diagnostic category
- Claim the sudden onset of a delusion
- Present themselves as blameless within their feigned illness
Rogers & Shuman (2000) 6 Signs of Malingering
- Rare symptoms
- Improbable and absurd responses
- Indiscriminant symptom endorsement
- Unlikely symptom combinations
- Contradictory symptoms
- Symptom severity
Comparing Symptoms to Norms The Hallucination
- Real hallucinations are intermittent rather than continuous
- 56% of real psychotics say that their hallucinations could be due to their imagination
- Real schizophrenics try to make the hallucinations go away
Comparing Symptoms to Norms Auditory Hallucinations
- 88% of real hallucinations are from outside the head
- Usually outside the body
- Sometimes from a body part
- 75% of real psychotics hear both male and female voices
- 76% hear the hallucination in both ears
- 98% of hallucinations are spoken in the person’s native language
- Most auditory hallucinations are brief (<20 seconds)
- Real psychotics can identify
- Sex, race, age, and emotional state of the voice
- The tone, volume, and rate of the voice
- Most auditory hallucinations ask for an interaction or a response from the person
Comparing Symptoms to Norms Visual and Other Hallucinations
- Real visual hallucinations
- Normally are in color
- Usually of normal sized people
- Real olfactory hallucinations are usually of unpleasant odors
Comparing Symptoms to Norms Responses to Questions
- Malingerers
- More likely to repeat or answer questions slowly
- Have contradictions in their accounts of a crime
- Will often repeat their words exactly when asked to repeat what they said
- Show concentration
- Seldom remember things correctly
Delusions
- A delusion is a patently false belief about external reality that is firmly held, despite obvious and incontrovertible proof to the contrary
- An insane delusion in a delusion that caused the crime or behavior under legal question to occur
- Delusions differ from overvalued ideas
- The certainty of the inaccuracy
- The firmness and permanency of the belief
- Delusions are found in 77% of people found to be insane versus less than 3% of the sane
Malinger - 4
Practice 2
Below you will find a description of a person claiming NGRI. Highlight or underline
each description that you think indicates the person is malingering. Circle the statements
you think support insanity.
Q: Tell me about the voices that told you to kill radical feminists
A: There were several voices that were always outside my head. They were usually
male but sometimes were female.
Q: You mentioned to the detective that you also had hallucinations?
A: Yes. I didn't always have them. But when I did, they were in color and seemed
to involve Playboy centerfolds.
Q: Do you think that you could have been imagining these images?
A: No! They were real. I did everything I could to make them go away.
Q: Have these voices been talking to you for a long time?
A: No, they started about a week ago.
Q: Did your partner also hear these voices?
A: I don't know.
Q: What did the voices say to do with the money you would inherit?
A: They didn't say.
Q: Anything else you want to tell me?
A: Is there anything else I want to tell you? I also smelled things. Terrible odors
that reminded me of the death I saw in Vietnam.
Malinger - 5
Practice 3
Below you will find a description of a killer who is pleading NGRI. Highlight or
underline each statement that you think indicates he is malingering and briefly indicate
why you think the statement is a sign of malingering. Circle each statement that would
be consistent with an actual schizophrenic. Write a short (a few words) explanation for
your decision next to your underline or circle.
Q: Mr. Spiccolli, You told the arresting officer and the desk sergeant that you are
hearing voices.
A: Yes, I hear them every now and then.
Q: Tell me about them.
A: The voices have been in my head for years. Sometimes the voices sound like my
mother and other times they sound like Mr. Hand, my old high school teacher.
Q: Does your partner also hear voices?
A: No. That's why I am not responsible for the killing and he is.
Q: What else can you tell me?
A: I have hallucinations of 20-feet tall people chasing me. They are all wearing very
bright red hats, yellow socks, and blue suede shoes.
Q: I'm sorry, I didn't quite hear that.
A: I said I have visions of these huge people chasing me. They are all wearing very colorful clothing.
Q: That's what I thought you said. Do you think you could be imagining all this?
A: I might be.
Q: Did you know the person you are accused of killing?
A: It was my estranged spouse.
MMPI-
Standard Validity Scales
- L (deliberate, unsophisticated, faking good)
- F (faking bad)
- K (subtle, defensiveness)
- Back page infrequency scale (Fb)
- 40 items; Measures faking bad on items in the later part of the test)
- Variable response inconsistency scale (VRIN)
- 67 pairs of items
- Measures inconsistent responses
- Scores of greater than 14 indicate inconsistent responding and invalidate the clinical scores
- True response inconsistency Scale (TRIN)
- 23 pairs of items
- Measures tendency to pick true or to pick false
0
20
40
60
80
100
120
140
L F K
Fake good Defensive Malinger Normal
MMPI- Special Malingering Scales
- Gough’s F-K Scale
- Cofer’s Malingering Scale (MP or Cof)
- Wiener’s Subtle-Obvious Scale
MMPI- Special Dissimulation Scales
- Gough’s F-K
- Wiggins Social Desirability Scale (Sd)
- Edwards’ Social Desirability scale (SD)
- Desirability Scale (L + K)
MMPI- Standard Clinical Scales
- Hypochondriasis (Hs)
- Depression (D)
- Hysteria (Hy)
- Psychopathic Deviate (Pd)
- Masculinity- femininity (Mf) - Paranoia (Pa) - Psychasthenia (Pt) - Schizophrenia (Sc) - Hypomania (Ma) - Social Introversion (Si)
Amnesia Claims Methods to Detect Malingering
- Electronic Methods
- Guilty Knowledge Test (Polygraph)
- Brain Fingerprinting (P300 Spike)
- Feeling of knowing
- How likely would you be to remember
- With more time
- With hints
- With a recognition task
Amnesia Claims Methods to Detect Malingering
- Symptom Validity Testing – Episodic
Memory
- Series of 2-alternative questions (e.g., was the victim’s hair brown or black)
- Fakers will score below chance, people with amnesia will score at chance levels
- Indirect Memory Tests
- What is this word kn_ _ _?
x x x
