PSYCHOLOGY: Psychological Assessment of Malingering and Symptom Validity
Plaintiffs and other petitioners often sue for damages due to reported cognitive or emotional impairment. These impairments are often said to be the result of traumatic brain injuries suffered in accidents, toxic exposures or medical procedures. Such im
Plaintiffs and other petitioners often sue for damages due to reported cognitive or emotional impairment. These impairments are often said to be the result of traumatic brain injuries suffered in accidents, toxic exposures or medical procedures. Such impairments can often be subtle, unrecognizable by nonprofessionals and when bona fide, can change a person’s life.
In these cases, how can claims be assessed for their reliability? In other words, is Mr. Smith really a victim who deserves compensation or is he a “malingerer” who is pulling a fast one? Reliable data on the validity of plaintiff’s neuro-cognitive and emotional symptoms is necessary for psychological assessments to be of any worth in legal proceedings.
Based on the research, malingering, or the exaggeration and/or fabrication of deficits in the pursuit of external gain, occurs in a significant minority of civil and more so criminal cases.
Clinical psychologists strongly suspect malingering when any of the following are documented or evident on examination:
- Symptom exaggeration – pre-existing mild symptoms are inflated in their severity during examination;
- Fabrication – Creation of false deficits where none exist, or the creation deficits that are not associated with known pathology of brain dysfunction.
Psychologists measure these examination behaviors with a procedure that is now called “Symptom Validity Testing.” Since 1985, over 300 articles have published in the psychology and neuropsychology literature to document so-called “feigned” cognitive and emotional symptoms and how to perform symptom validity testing.
Psychologists aid attorneys in their deliberation or negotiations by distinguishing between Malingering and Factitious Disorder. In the latter case, the person reports symptoms to assume a “sick role” and obtain treatments. Such patterns are not motivated by external gain.
Psychologists can also make the distinction between Malingering and persons with a Somatoform Disorder, who produce physical symptoms for a psychological need that is unconscious and outside of their awareness.
Clinicians also assess bias when a person’s performance is at odds with known pathology of brain dysfunction. For example, a person may exaggerate motor deficits such as stamina or speed in relation to orthopedic injuries.
Suspected malingerers also engage in misrepresenting psychological/emotional dysfunction in the area of mood (depression) and thinking (hallucinations). To assess those reported symptoms, psychologists use the MMPI where clinical and validity scores can suggest when a person is exaggerating a mood disorder versus exaggerating psychosis.
Per the National Academy of Neuropsychology and the American Psychological Association, all examinations of plaintiffs who report neuro-cognitive or psychological deficits should include an assessment of symptom validity or malingering.