Assessing and Addressing Response Bias

Exaggerating Psychopathology Produces Residual Effects That Are Resistant to Corrective Feedback: An Experimental Demonstration

“…In the context of symptom exaggeration, clinicians have argued that corrective feedback will be more easily accepted if it is presented in a warm and friendly manner (e.g., Martelli et al, 2012). Alternatively, one could argue that such an approach might intensify the self-deceptive justification inherent to cognitive dissonance, thereby producing stronger residual effects of intentional over-reporting (e.g., Bayer, 1985).…”

“…The research assistant had a brief informal conversation with the participants. This was all done to build rapport (see Martelli et al, 2012). In the honest control group, participants filled out the SIMS, had a filler task of about 20 min, and then completed the BSI.…”

“…Based on clinical experience, some authors have formulated tentative desiderata about how to provide examinees who engage in symptom exaggeration with feedback (e.g., Bush, 2009;Martelli, Nicholson, Zasler, & Bender, 2012;McMillan et al, 2009). A recurrent theme in this literature is that neuropsychologists should avoid an accusatory tone and that corrective feedback should be grounded in a nonconfrontational attitude toward the examinee.…”

“…We compared two types of feedback: sympathetic confrontation, in which the examinee is told that (s)he failed a test without mentioning that this SYMPTOM EXAGGERATION AND CORRECTIVE FEEDBACK indicates malingering; and neutral feedback, in which test failure is blamed on a technical error. Cognitive dissonance theory would lead one to predict that sympathetic feedback provided by an empathetic examiner (as recommended by, e.g., Martelli et al, 2012) exacerbates the dissonance between defining oneself as an honest person and engaging in deliberate misrepresentation of symptoms. Following the analysis of Bayer (1985), one would expect increased dissonance to produce more self-deception and, on balance, more residual symptom inflation.…”

“…Using the current paradigm-symptom exaggeration as a behavioral option that participants can avoid-the systematic evaluation of various feedback styles warrants further study. Further research along these lines is important because the empirical literature on this issue is scarce despite the fact that testable ideas about effective feedback have been proposed (Martelli et al, 2012;McMillan et al, 2009).…”