Practical guidelines in the use of symptom validity and other psychological tests to measure malingering and symptom exaggeration in traumatic brain injury cases

The detection of malingering or symptom exaggeration has become an essential component in forensic neuropsychological evaluations, particularly in cases involving personal injury claims. Symptom Validity Tests refer to those measures that can be utilized to detect test performance that is so poor that it is below the level of probability, oftentimes even among brain-damaged populations. This article outlines legal standards for expert testimony in regard to forensic neuropsychological personal injury evaluations. The article provides an outline of specific Symptom Validity Tests and Indicators, and reviews literature supporting test sensitivity and validity. In addition, the use of symptom checklists and questionnaires is discussed, as well as the appropriate use of Symptom Validity Tests and Indicators to establish the presence or absence of malingering or symptom exaggeration.     

Filial maturity: Analysis and reconceptualization

The concept of filial maturity has often been utilized to describe the nature and quality of the adult parent-child relationship. This paper will critically evaluate filial maturity as a central construct for understanding filial relations, present a reconceptualization of the concept, and identify areas for further empirical and conceptual elaboration.     

Electrocortical Responses to ecologically relevant visual stimuli among professional drivers with and without cardiovascular disease

Electrocortical responses were assessed using two simulated aspects of visual signals encountered in traffic: the Glare Pressor Test (GPT) and Event-Related Potential Avoidance Task (ERPAT) among four groups of male professional drivers: 12 with ischemic heart disease (IHD), 12 hypertensives, 10 borderline hypertensives, 34 who were apparently healthy and 23 nonprofessional driver healthy control subjects. The blood pressure (BP) responses immediately after the ERPAT were also measured. There was a significant between groups effect for the amplitude of the target N2 component in the ERPAT (p=0.02), with the lowest means among the drivers with IHD and the highest among those with hypertension. Drivers with IHD also showed the highest diastolic BP reactivity to the ERPAT. Significantly more than the expected number of drivers with IHD failed to recover alpha activity after the first glare impulse of the GPT. Professional drivers who failed to recover baseline levels of alpha activity after the GPT showed a significantly smaller N2 amplitude compared to those who recovered (p=0.01). There was a positive correlation between abundance of alpha activity at rest with P300 amplitude (p=0.02). An inverse relation was found between number of work hours behind the wheel and the amplitude of the target P300 (p=0.04). Results are interpreted in light of recent advances concerning integrative mechanisms of defence versus vigilance response patterns. The findings in this study justify further applications of these psychophysiologic methods to assess the relationship between simulated signals of the work environment and mechanisms of cardiac risk in this occupational group.     

Inferring the Meaning of Work From the Effects of Unemployment

Questionnaire data from 148 unemployed individuals were analyzed to investigate the meaning for work. Both economic and experiential functions of work were examined. The data revealed that, as predicted, increasing length of unemployment was associated with increasing economic and experiential deprivation. Economic deprivation, in turn, was associated with both more experiential deprivation and lower subjective well-being. Unexpectedly, experiential deprivation was not related to subjective well-being. The results indicate the importance of the economic functions of work in people's lives.     

Effects of counsellor interpretations and client reactance on social influence and the working alliance

These two studies investigated the main and interaction effects of client reactance and counsellor interpretation discrepancy and style on counsellor social influence and the working alliance. Undergraduate students who were divided into high and low reactant pups listened to low, moderate, or high discrepancy interpretations given by counsellors who used a tentative or absolute interpretation. Contrary to the hypotheses, results showed only one interaction effect for reactance, interpretation discrepancy, and interpretation style. Low reactant participants rated the working alliance higher with tentative interpretations while high reactant participants rated it higher with absolute. High reactant participants consistently tended to perceive the counsellor less positively than low reactant participants. There were unexpected gender differences, suggesting that females saw the counselling more positively in the low discrepancy condition while males did in the moderate. The results were not supportive of an interaction among reactance, discrepancy, and style, but are in line with macro-results in the counselling and psychotherapy literature indicating the primary importance of client variables.     

When accuracy is not enough: The moderating effect of perceived appraisal use

It is hypothesized that perceived appraisal use in making pay related decisions will moderate the relationship between instrumentality beliefs and appraisal accuracy related variables. Perceived appraisal use was found to moderate the relationship between instrumentality beliefs and perceived appraisal accuracy, supervisor appraisal behavior, and supervisor knowledge of performance.     

Variations in physician practice and covert rationing

The use of recent research on variations in medical practice to promote competitive market oriented cost containment strategies is critically examined. Research demonstrating widespread variations in physician practices for similar patient populations undermines the medical profession's claims about the scientific objectivity of medical practice and indicates the existence of widespread waste and inappropriate utilization of health care resources. Cost containment programs which rely on market-based care avoidance incentives, such as Medicare prospective payment or cost sharing plans, attempt to impact medical practice variations by creating economic barriers between doctor and patient. An alternative interpretation of research on practice variations is presented, emphasizing containing costs while improving quality of care and achieving greater equity through planning and regulation of medical supply factors.     

Effects of employment status and marital status on perceptions of mothers

Forty-eight female and 48 male adults at a shopping mall evaluated a briefly depicted adult female stimulus person on 24 7-point bipolar scales that described personality traits and professional performance characteristics. Each subject rated one of four mothers of a young child. The mother was portrayed as either employed or nonemployed, and as either divorced or married. Employed mothers were perceived as more professionally competent but as less dedicated to their families than were nonemployed mothers. Married mothers were rated as more nurturant and as better adjusted than divorced mothers.Portions of this paper were presented at the meeting of the American Psychological Association, Atlanta, Georgia, August 1988.     

Personality influences in the stability of early (teen-age) marriage in the United States

Previous research indicated that similarities and differences in specific personality factors are associated with differences in marital stability. Most findings were based on assessments of personality after marriage, thus confounding the effects of marriage on personality. The findings reported here relate congruence between spouses’ personality assessed prior to marriage with the status of the marriage three to five years after marriage. Each partner in a group of 72 teenage couples completed the 16PF prior to obtaining approval to marry. These data were examined using intraclass and multivariate analyses. The findings indicate that hypothesized patterns of personality factors differentiated stable from unstable marriages.