Handbook of Forensic Psychiatric Practice in Capital Cases
Malingering
Malingering, which can be amnesia or a wide range of other mental symptoms, is common in forensic psychology assessments.
Malingering of psychological difficulties, such as poor memory, is sometimes referred to as ‘faking bad’, which is in contrast to another phenomenon of deception that is, attempting to ‘fake good’, where the person attempts to present themselves in a more favourable light than would be discovered upon objective review.
Many tests of personality, including the Millon Clinical Multi-axial Inventory (third edition) and the Personality Assessment Inventory have built-in validity scales that detect ‘faking good’ as part of a global assessment of personality functioning.
Other measures have been designed to concentrate in more detail on the detection of those who are trying to ‘fake good’. Te most commonly used of these is the Paulhus Deception Scale. Tis measure contains scores for both ‘self-deceptive enhancement’ and ‘impression management’.
Six potential strategies to detect malingering are well recognised:
1. Floor effect – identification of the individual as performing at the bottom of a particular test, being unable to provide even the most basic information or manage a very simple task (the ‘coin in the hand’ test is an example of testing using this strategy).
2. Symptom validity testing – individuals are presented with a forced choice alternative and may perform significantly below what would be expected by chance, raising the suspicion of
malingering.
3. Performance curve – attempts at malingering fail when fakers fail easy items but pass more difficult ones.
4. Magnitude of error – the qualitative and quantitative features of wrong answer are examined for evidence of symptom exaggeration or fabricated deficits.
5. Atypical presentations – where performance is different across similar tests, or across re- administration of the same tests over time. Caution is needed with this approach as some head
injuries may also cause this phenomenon.
6. Psychological sequelae – malingerers may fake symptoms that are not directly related to their alleged complaint.
Many tests have been developed to detect malingering of mental illness. Te best known of these are the Millar Forensic Assessment of Symptoms (MFAST), the Structured Interview of Reported Symptoms (SIRS) and the Structured Inventory of Malingered Symptomatology (SIMS). Tese interview methods offer information that may guide the identification of malingerers, in tandem with collateral information. Caution should be exercised when using these measures as they are vulnerable to false positive conclusions in individuals with a highly acquiescent personality style (see above).
In regard to malingered amnesia it will be important to administer the Tombaugh Test of Memory Malingering (TOMM).
40
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156