Detection of coached general malingering on the MMPI-2

The current study examined the effects of validity-scale coaching on one's ability to feign general psychopathology. College students were coached on malingering strategies and completed the MMPI-2. Their responses were compared with students asked to malinger psychopathology without validity-scale coaching and with psychiatric inpatients completing the MMPI-2 under standard instructions. In accordance with previous research (e.g., J. R. Graham, D. Watts, & R. E. Timbrook, 1991), uncoached malingerers were adequately discriminated from patients by using the Infrequency (F) scale. However, as suggested by previous research (R. Rogers, R. M. Bagby, & D. Chakraborty, 1993), the F scale was not as effective at classifying coached malingerers. It was found that other validity indicators, such as the Infrequency Psychopathology Scale were more accurate at discriminating between coached malingerers and hospitalized patients.     

The utility of the MMPI-2 malingering discriminant function index in the detection of malingering: a study of criminal defendants

This study examined the utility of the Minnesota Multiphasic Personality Inventory-2's (MMPI-2) malingering discriminant function index (M-DFI), recently developed by Bacchiochi and Bagby, in the detection of malingering in a forensic sample. Criminal defendants were divided into "malingering" and "not malingering" groups using the structured interview of reported symptoms (SIRS) criteria proposed by Rogers. Logistic regression analysis (LRA) revealed that the MMPI-2 infrequency (F) scale had the best predictive utility of the traditional infrequency scales. Although the M-DFI did significantly differentiate the malingering from the not malingering groups, it did not add significantly to the predictive utility of the MMPI-2 F scale. Receiver operating characteristics analyses demonstrated acceptable sensitivity and specificity for the MMPI-2 F scale, but poor sensitivity for the M-DFI scale. The results are discussed in terms of the utility of the M-DFI in detecting malingering and problems of extending the findings of simulation studies to the forensic context.     

The detection of feigned mental disorders on specific competency measures

Psychologists have standardized competency-to-stand-trial (CST) assessments through the development of specialized CST measures. However, their research has largely neglected the possibility that CST measures may be stymied by feigning mental disorders and concomitant impairment. The current study is the first systematic examination of (a) how feigned mental disorders may affect CST measures and (b) which scales are effective at identifying feigned cases. Bona fide patients (n = 65) were compared with suspected malingerers (n = 22) on 3 CST measures: the Georgia Court Competency Test (GCCT), the MacArthur Competence Assessment Tool--Criminal Adjudication, and the Evaluation of Competency to Stand Trial--Revised (ECST-R). Results indicated that these CST measures are vulnerable to feigning. The development of specialized GCCT and ECST-R scales yielded moderately effective screens for feigned mental disorders in the context of CST evaluations.     

Classification accuracy of MMPI-2 validity scales in the detection of pain-related malingering: a known-groups study

The purpose of this study was to determine the accuracy of Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) validity indicators in the detection of malingering in clinical patients with chronic pain using a hybrid clinical-known groups/simulator design. The sample consisted of patients without financial incentive (n = 23), nonmalingering patients with financial incentive (n = 34), patients definitively determined to be malingering based on published criteria ( n = 32), and college students asked to simulate pain-related disability (n = 26). The MMPI-2 validity scales differentiated malingerers from nonmalingerers with a high degree of accuracy. Hypochondriasis and Hysteria were also effective. For all variables except Scale L, more extreme scores were associated with higher specificity. This study demonstrates that the MMPI-2 is capable of differentiating intentional exaggeration from the effects on symptom report of chronic pain, genuine psychological disturbance, and concurrent stress associated with pursuing a claim in a medico-legal context.     

Specificity of the MMPI-2 Fake Bad Scale as a marker for personal injury malingering

Psychologists who evaluate patients in medicolegal contexts should utilize objective assessment data with empirically established sensitivity and specificity for identifying negative response bias. The purpose of this study was to investigate the specificity of the Fake Bad Scale for identifying negative response bias in personal injury claimants. The cutoff scores proposed by Lees-Haley and colleagues were applied a federal prison, medical outpatients, and patients from to inmate volunteers from substance abuse unit. Half of the inmates were given instructions to malinger psychopathology to affect the adjudication process, and the remaining inmates and all of the hospital patients were given standard instructions. The original cutoff scores correctly identified the majority of inmates instructed to malinger psychopathology, but these scores resulted in unacceptably high rates of false positive classifications. The revised cutoff scores resulted in fewer false positives, i.e., 8%-24%.     

Malingering as a categorical or dimensional construct: the latent structure of feigned psychopathology as measured by the SIRS and MMPI-2

The 6 nonoverlapping primary scales of the Structured Interview of Reported Symptoms (SIRS) were subjected to taxometric analysis in a group of 1,211 criminal and civil examinees in order to investigate the latent structure of feigned psychopathology. Both taxometric procedures used in this study, mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV), produced dimensional results. A subgroup of participants (n = 711) with valid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols were included in a second round of analyses in which the 6 nonoverlapping primary scales of the SIRS and the Infrequency (F), Infrequency-Psychopathology (Fp), and Dissimulation (Ds) scales of the MMPI-2 served as indicators. Again, the results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingering-honest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one. The theoretical and clinical practice implications of these findings are discussed.     

Diagnosing personality disorders: an examination of the MMPI-2 and MCMI-II

Personality disorders are highly prevalent in clinical populations and affect outcomes across all forms of intervention. This investigation examined the diagnostic efficiency of two widely used, self-report measures of personality disorder (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989; MCMI-II; Millon, 1987), as compared to a structured interview (SCID-II; Spitzer et al., 1987) diagnosis. The measures were administered to 150 residential and outpatient volunteer subjects. Persons with primary organic or psychotic-spectrum disorders were excluded from participation. Results were variable across disorders measured, with low to moderate levels of diagnostic agreement observed. The MCMI-II appears to be a more sensitive measure, whereas the MMPI-2 is more specific. The two self-report measures demonstrated greater convergence with each other than with the interview measure. Both the MMPI-2 and MCMI-II were more accurate at identifying the absence of a given disorder. Although overall diagnostic powers exist at acceptable levels. the results suggest that diagnoses generated by self-report versus interview are not interchangeable.     

Screening for feigned psychiatric symptoms in a forensic sample by using the MMPI-2 and the structured inventory of malingered symptomatology

Fifty-five men undergoing pretrial psychological evaluations for competency to stand trial or criminal responsibility in the federal justice system were administered the Structured Interview of Reported Symptoms (SIRS), the Minnesota Multiphasic Personality Inventory--2 (MMPI-2), and the Structured Inventory of Malingered Symptomatology (SIMS). On the basis of results from the SIRS, 31 were classified as honest responders and 24 as feigning. Significant differences between the 2 groups were found on all SIMS scales as well as on all tested MMPI-2 fake bad validity scales. The SIMS total score and the MMPI-2 Backpage Infrequency (Fb) scale had relatively high negative predictive power (100% and 92%, respectively). On the basis of this clinically relevant methodology, both tests have potential usefulness as screens for malingering.     

Effect of symptom information and validity scale information on the malingering of depression on the MMPI-2

MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) data from college students who were attempting to malinger depression (199 women and 171 men) were compared to MMPI-2 data from students who responded honestly (50 women and 45 men). Mean MMPI-2 scores were compared with analyses of variance, and students' success in malingering depression was evaluated with criteria based on cutting scores for validity indexes and on the clinical scales commonly associated with depression. Students who were given information about the validity scales or about the symptoms of depression were more successful at malingering than students who received no information, indicating that malingerers of depression may be able to elude detection by the MMPI-2 if they are informed about the validity scales or the symptoms of depression.     

The detection of feigned uncoached and coached posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims

In this study research participants completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) under standard instructions and then were asked to fake posttraumatic stress disorder (PTSD) when completing the MMPI-2 for a 2nd time in 1 of 4 conditions with different instructions on how to fake PTSD: (a) uncoached, (b) coached about PTSD symptom information, (c) coached about MMPI-2 validity scales, or (d) coached about both symptoms and validity scales. These MMPI-2 protocols were then compared with protocols of claimants with workplace accident-related PTSD. Participants given information about the validity scales were the most successful in avoiding detection as faking. The family of F scales (i.e., F, FB, FP), particularly FP, produced consistently high rates of positive and negative predictive power.     

Diagnostic accuracy of the MMPI-2 Malingering Discriminant Function Index in the detection of malingering among inmates

The MMPI-2 Malingering Discriminant Function Index (M-DFI) was designed to detect malingerers educated about MMPI-2 validity indicators. However, given current attorney practices, the clinical utility of the M-DFI lies in its ability to detect examinees who are cautioned about the indicators. In this study, we compared 45 inmate simulators cautioned to avoid detection on the MMPI-2 with 46 psychiatric inmates who completed the MMPI-2 under standard instructions. Logistic regression analyses indicated that although the M-DFI performed better than several individual indicators, results were mixed for combinations of indicators, and the M-DFI did not outperform different sets of existing indicators. These findings support existing strategies to detect malingering on the MMPI-2. We discuss considerations concerning the clinical applicability of M-DFI.     

Detection of a Cry for Help on the MMPI-2: an analog investigation

We compared Minnesota Multiphasic Personality Inventory (MMPI-2) results from 2 groups of mildly to moderately disturbed psychiatric outpatients (N=60) answering under either Standard or Cry for Help instructions. Results from previously completed intake MMPI-2 protocols were obtained for each participant. The two groups were comparable on intake MMPI-2 variables and demographic characteristics. Analysis of feedback data from the second, experimental observation indicated that the two groups had equivalent self-estimates of understanding of their role and success in simulating their role. Significant differences were found between the two groups on their experimental MMPI-2 protocols. The Cry for Help group had significantly higher scores on F, F-K, Fb, Ds2, and Fp scales as well as significantly lower scorns on the K scale. The Cry for Help group also had significantly higher scores on all clinical scales with the exception of 5, which was not tested. Cutting scores derived by Rogers, Sewell, and Ustad (1995) for the detection of a Cry for Help in outpatients were cross-validated with fairly positive results. Although these results are promising, particularly in light of the shrinkage expected on cross-validation, further research is needed in this area.     

Normative data for the F(p) scale of the MMPI-2: implications for clinical and forensic assessment of malingering

Data from several clinical samples and the Minnesota Multiphasic Personality Inventory--2 standardization group are presented to familiarize the reader with response patterns of different groups on a new validity scale designed to assist in the identification of exaggeration or fabrication of psychological disturbance. Sensitivity-specificity analyses are included along with suggestions for use of the F(p) Scale with other validity scales. Cautions about setting single cutoff scores are also discussed.     

MMPI-2 in the inpatient assessment of women with eating disorders

The MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) reveals similar patterns across all Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) eating-disorder diagnoses. In this study, 550 women with eating disorders completed the MMPI-2. The 3 highest mean elevations for all eating-disorder diagnostic groups occurred on the same scales in the same order: 2, 7, and 3. The modal code for all groups was 2-7/7-2. However, multivariate analyses using the 16 validity and clinical scales, as well as the 27 content and supplementary scales, indicated that the MMPI-2 also distinguishes among eating disorders, especially in that patients with restricting anorexia report less psychopathology than other groups. These results are compared with the results of past eating-disorder research that used the older MMPI (Hathaway & McKinley, 1983).     

Integrating psychopathology and personality disorders conceptualized by the MMPI-2-RF and the MCMI-III: a structural validity study

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008 ) Restructured Clinical scales and Higher Order scales were linked to the Millon Clinical Multiaxial Inventory-III (Millon, Millon, Davis, & Grossman, 2009 ) personality disorder scales and clinical syndrome scales in a Flemish/Dutch sample of psychiatric inpatients and outpatients, substance abuse patients, correctional inmates, and forensic psychiatric patients (N = 968). Structural validity of psychopathology and personality disorders as conceptualized by both instruments was investigated by means of principal component analysis. Results reveal a higher order structure with 4 dimensions (internalizing disorders, externalizing disorders, paranoid ideation/thought disturbance, and pathological introversion) that parallels earlier research on pathological personality dimensions as well as research linking pathological personality traits with mental disorders. Theoretical and clinical implications are considered.     

Malingering on the Personality Assessment Inventory: identification of specific feigned disorders

Profile validity is a primary consideration in the clinical assessment of psychopathology. Several indicators of negative impression management have been developed for the Personality Assessment Inventory (PAI; Morey, 1991) that can both indicate its presence and help differentiate effortful negative distortion from distortion arising from cognitive sets associated with psychopathology. In this study, we tested a method designed to delineate the specific Clinical scales relevant for interpretation of deliberately feigned disorders. We used associations between the Negative Impression Management (NIM) scale and Clinical scales in the normative standardization sample to derive NIM predicted scale scores in a regression framework. We contrasted these predicted scores with observed scores on Clinical scales to yield NIM predicted discrepancies hypothesized to identify those Clinical scales most salient for the interpretation of negative distortion. We found this method to be effective in identifying particular distortion on the relevant scales for individuals attempting to feign 3 specific diagnoses (major depressive disorder, generalized anxiety disorder, and schizophrenia).     

Detection of feigned memory impairments using a Chinese word task

In this study the detection of feigned memory impairments was investigated using a forced-choice task with Chinese words as stimuli. Task difficulty on accuracy and response time and the faking strategies employed were examined for 85 participants, 42 men and 43 women, who were administered the experimental task. Following a simulation design, all participants performed under control and faking conditions. Their accuracy of performance and response times were measured. Analysis indicated significant differences on both outcome measures for the two conditions. Further, a significant difference in accuracy, but not in response time, among levels of task difficulty was observed. For classification accuracy, using the cut-off score criterion seemed more effective than using the below-chance criterion or response time. Implications for relying on chance criterion to identify deception are discussed.     

Detection of Feigned Posttraumatic Stress Disorder: A Comparison of the MMPI-2 and PAI

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Personality Assessment Inventory (PAI) were compared for detecting feigned posttraumatic stress disorder (PTSD) in a simulation research design. Participants were 85 undergraduates in one of three groups: PTSDs (n = 23), Fakers (n = 31), and Controls (n = 31). As expected, both the MMPI-2 and PAI discriminated PTSDs and Controls, with PTSDs scoring significantly higher on fake-bad validity scales and PTSD-relevant clinical scales. However, only the MMPI-2 discriminated Fakers and PTSDs, with Fakers scoring significantly higher on all MMPI-2 scales considered, but on only one PAI scale. Further, in logistic regression analyses the MMPI-2 demonstrated higher overall correct classification of PTSDs and Fakers than did the PAI. Although the MMPI-2 outperformed the PAI in detecting feigned PTSD, a substantial proportion of Fakers avoided detection by MMPI-2 fake-bad validity scales, suggesting that both tests are vulnerable to feigning of PTSD by motivated respondents with relatively limited coaching.     

Use of the MMPI-2 in American Indians: I. Comparability of the MMPI-2 between two tribes and with the MMPI-2 normative group

The comparability of the MMPI-2 in American Indians with the MMPI-2 normative group was investigated in a sample of 535 Southwestern and 297 Plains American Indian tribal members with contrasting sociocultural and historical origins. Both American Indian tribal groups had clinically significant higher T scores (> 5 T points) on 5 validity and clinical scales, 6 content scales, and 2 supplementary scales than did the MMPI-2 normative group. There were no significant differences between the 2 tribal groups on any of the MMPI-2 clinical, content, or supplementary scales. Matching members of both tribes with persons in the MMPI-2 normative group on the basis of age, gender, and education reduced the magnitude of the differences between the 2 groups on all of these scales, although the differences in T scores still exceeded 5 T points. It appears likely that the MMPI-2 differences of these 2 American Indian groups from the normative group may reflect their adverse historical, social, and economic conditions.