MALINGERING 1997

Abundant empirical research shows that Personal Injury litigants are a psychologically distinct group among injured patients. Their distinctness increases as the severity of injury decreases.

A well-respected and prolific researcher concluded from a study of the psychological profiles of nearly

500 Personal Injury litigants: "The modal plaintiff appears to be an unhappy somatizer involved in a social context which encourages rationalization, projection of blame, and complaining."[1] In a quarter there was some evidence of malingering.

PRACTICE POINT

Demonstrating the distinction between Somatisation and Malingering is a master skill for Personal Injury litigators

US neurologists have confirmed in clinical populations the Canadian findings in feigned Traumatic Brain Injury (Medical Litigation News Volume 1, Issue 5) that a number of tests of memory could identify probable malingerers[2]. Litigation as such did not significantly influence test results.

Computerised Dynamic Posturography, a clinical test for balance problems, has been developed and evaluated over the last few years. The patient's postural responses to unexpected unbalancing by movements of a foot-plate are analysed. A newly validated[3] profile for simulation or malingering of balance problems can and should be included in the forensic assessment of post-traumatic dizziness.

PRACTICE POINT

The growing list of conditions in which tests can detect malingering includes
1. memory deficits
2. Late Whiplash
3. balance problems
4. Depression

Late Whiplash, like other Pain Syndromes, has a characteristic profile on the Psychological Symptom Checklist (SCL-90-R). As the condition is suspected by some to be malingered, Australian researchers[4] asked university students to simulate it: they were unable to do so.

A Canadian team[5] found that sub-scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) identified feigned Depression but not as well as feigned Schizophrenia. Greater personal familiarity with the features of Depression probably explained the difference, but the test was valuable.