1. AUTHOR Lees-Haley-P-R. INSTITUTION Lees-Haley Psychological Corporation, CA, USA. TITLE MMPI-2 base rates for 492 personal injury plaintiffs: implications and challenges for forensic assessment. SOURCE J-Clin-Psychol 1997 Nov, VOL: 53 (7), P: 745-55, ISSN: 0021-9762. ABSTRACT This study reports base rates of MMPI-2 clinical scales. PTSD scales, and validity scales for 492 personal injury plaintiffs, 230 men and 262 women. Scales studied included L, F, K, F minus K, Ds-r, Fake Bad, Ego Strength, Back F. Total Obvious minus Subtle, VRIN, and TRIN. Forensic high points resembled outpatient profiles but not the MMPI-2 psychiatric sample and shared only code type 13/31 with the normative sample. The most common two-point code type for men was 13 /31, followed by 12/21 and 23/32, and for women was 13/31, followed by 23/32 and 12/21. Fifty percent of the forensic sample were code type 13/31, 12/21, or 23/32. Validity measures suggested possible malingering on approximately 20 to 30% of the profiles but the majority of profiles were valid. Validity problems discussed include attorney coaching and the congruence of plaintiff personality characteristics with the demand characteristics of litigation. Examples of attorney coaching are provided. The modal plaintiff appears to be an unhappy somatizer involved in a social context which encourages rationalization, projection of blame, and complaining. Author. 2. AUTHOR Suhr-J, Tranel-D, Wefel-J, Barrash-J. INSTITUTION Department of Neurology, University of Iowa, College of Medicine, Iowa City 52242, USA. TITLE Memory performance after head injury: contributions of malingering, litigation status, psychological factors, and medication use. SOURCE J-Clin-Exp-Neuropsychol 1997 Aug, VOL: 19 (4), P: 500-14, ISSN: 1380-3395. ABSTRACT Impaired memory test performance can reflect a host of factors, such as head injury/postconcussive syndrome, involvement in litigation, malingering behavior, psychological distress, and medication use. Such factors are important in interpreting memory test performances in patients referred in the context of litigation. We examined memory test performance in mild head-injured patients in litigation, mild to moderate head-injured patients not in litigation, severely head- injured patients not in litigation, depressed patients, and patients with somatization disorders. Findings showed that several memory tests were useful in distinguishing probable malingerers from the other groups. There was a complex interaction among malingering status, psychological status, and medication use in the prediction of memory test results. Although nonneurological factors were related to memory impairment, litigation status alone was not predictive of memory performance. The results emphasize the need to consider nonneurological factors in the interpretation of poor memory performance in patients seen for forensic evaluation. Author. 3. AUTHOR Goebel-J-A, Sataloff-R-T, Hanson-J-M, Nashner-L-M, Hirshout-D-S, Sokolow-C-C. INSTITUTION Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. TITLE Posturographic evidence of nonorganic sway patterns in normal subjects, patients, and suspected malingerers. SOURCE Otolaryngol-Head-Neck-Surg 1997 Oct, VOL: 117 (4), P: 293-302, ISSN: 0194-5998. ABSTRACT During the last 10 years, computerized dynamic posturography has yielded various patterns of sway on the sensory organization test and the motor control test that have been associated with a variety of organic balance disorders. Some aspects of performance during computerized dynamic posturography, however, are under conscious control. Voluntary movements not indicative of physiologic response to balance system stimulation can also affect computerized dynamic posturography results. Quantification of nonorganic or "aphysiologic" response patterns in normal subjects, patients, and suspected malingerers is crucial to justify use of computerized dynamic posturography for identification of physiologically inconsistent results. For this purpose the computerized dynamic posturography records of 122 normal subjects, 347 patients with known or suspected balance disorders, and 72 subjects instructed to feign a balance disturbance were critically evaluated by use of seven measurement criteria, which were postulated as indicating aphysiologic sway. Each criterion was scored with a standard calculation of the raw data in a random, blinded fashion. The results of this multicenter study show that three of the seven criteria are significantly different in the suspected "malingerer" group when compared with either the normal or patient group. The relative strength of each criterion in discerning organic from nonorganic sway provides the examiner with a measure of reliability during platform posture testing. This study demonstrates that computerized dynamic posturography can accurately identify and document nonorganic sway patterns during routine assessment of posture control. Author. 4. AUTHOR Wallis-B-J, Bogduk-N. INSTITUTION Cervical Spine Research Unit, Faculty of Medicine, University of Newcastle, Callaghan, NSW, Australia. TITLE Faking a profile: can naive subjects simulate whiplash responses? SOURCE Pain 1996 Aug, VOL: 66 (2-3), P: 223-7, ISSN: 0304-3959. ABSTRACT The psychological symptom checklist, the SCL-90-R (Derogatis 1983), has been used to assess patients with a number of chronic pain syndromes. For whiplash injury, a characteristic profile has been found (Wallis et al. 1995). However, there is still a belief that patients with neck pain following whiplash injury may be malingering, and therefore the utility of the SCL-90-R as a screen for possible malingering is assessed here. Forty pain-free university students were asked to simulate chronic pain 6 months after a motor vehicle accident in order to ensure compensation. The SCL-90-R, McGill Pain Questionnaire and a visual analogue pain scale were used. Students' scores were compared with those of a group of 132 whiplash patients (Wallis et al. 1995). Differences between the two groups were striking; the students scored significantly higher than patients on all subscales of the SCL-90-R and on the visual analogue pain scale (Mann-Whitney P-values all less than 0.001). However, pain scores for both groups on the McGill Pain Questionnaire were similar. The conclusion was that it is very difficult for an ingenuine individual to fake a psychological profile typical of a whiplash patient. Author. 5. AUTHOR Bagby-R-M, Rogers-R, Buis-T, Nicholson-R-A, Cameron-S-L, Rector-N-A, Schuller-D-R, Seeman-M-V. INSTITUTION Clarke Institute of Psychiatry, University of Toronto. TITLE Detecting feigned depression and schizophrenia on the MMPI-2. SOURCE J-Pers-Assess 1997 Jun, VOL: 68 (3), P: 650-64, ISSN: 0022-3891. ABSTRACT Increasingly, investigations evaluating the effectiveness of the MMPI-2 in the assessment of malingering employ methodologies whereby research participants are asked to feigned specific disorders rather than just to "fake bad." Yet there is little research addressing the issue of whether different validity scales and indicators work differently in the detection of different feigned disorders. In this study the comparative effectiveness of a number of validity scales and indicators on the MMPI-2 to assess feigned depression and feigned schizophrenia were evaluated. Overall, the validity scales and indicators were better at detecting feigned schizophrenia than they were in detecting feigned depression, attributable, most likely, to closer familiarity with depressive experiences. The validity scales F, Fb, and F(p) best distinguish patients with schizophrenia from participants feigning schizophrenia, and F and Fb best distinguish patients with depression from participants feigning depression. Author.
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