Comparison of the Fake Bad Scale and Other MMPI-2 Validity Scales with Personal Injury Litigants

Abstract

Five MMPI-2 validity scales were evaluated with 120 personal injury litigation patients (LP) and 208 clinical patients (CP) along with 43 normal participants (NP). The validity measures included the Fake Bad Scale (FBS), Infrequency scale (F), Back Infrequency scale (Fb), Infrequency-Psychopathology scale (F[p]), and the Dissimulation scale-2 (Ds2). Results showed that only the FBS significantly differentiated the LP and CP, whereas the LP and CP scored significantly higher than the NP on FBS, F, Fb, and Ds2. The content of the FBS, with several items from the Hypochondriasis (Hs) and Hysteria (Hy) Scales, appears to enhance the FBS' ability to detect the somatic overreporting often observed with personal injury claimants. The authors suggest that the FBS may be a useful index of symptom magnification when employed within a comprehensive assessment of malingering in personal injury plaintiffs.

The MMPI-2 Symptom Validity Scale (FBS) Is an Empirically Validated Measure of Overreporting in Personal Injury Litigants and Claimants: Reply to Butcher et al. (2008)

“…For the data from the combined group, see Table 2. These results are almost identical to those for a no-incentive psychiatric outpatient sample (Greve et al 2006a, b;Tsushima and Tsushima 2001). In a combined chronic pain sample without incentive Meyers et al 2002), the percentage of patients scoring in the 23-28 range was 23.9% while 1.5% scored above 28.…”

“…For example, 13.0% of a combined noincentive psychiatric sample (n=230; Greve et al 2006a, b;Tsushima and Tsushima 2001; see Table 2) scored in the 23-28 range and with 1.3% at >28. Again, the combined no-incentive pain sample described above had somewhat more scores in the 23-28 range but the same rate at >28 (1.5%).…”

Potential for Bias in MMPI-2 Assessments Using the Fake Bad Scale (FBS)

“…In many research studies, an underlying assumption has been that personal injury litigants are more likely to consciously fake symptoms. Compensation-seeking examinees are presumed to score higher on FBS because they are typically motivated to lie and fabricate symptoms for material gain (e.g., Fox et al 1995;Lees-Haley et al 1991;Tsushima and Tsushima 2001). A plausible alternative explanation is that many people who have injuries that result in physical and emotional problems legitimately pursue compensation via litigation.…”

“…Damage to the central nervous system increases scores on FBS (Greiffenstein et al 2002) and can lead to raw score elevations that exceed 30 (Greve et al 2006). The effects of litigation-related stress may trigger emotional distress and other symptoms included in the FBS item pool, so that elevated FBS scores may be an outcome of participation in a lawsuit as opposed to being indicative of malingering (Tsushima and Tsushima 2001).…”

MMPI-2 validity, clinical and content scales, and the Fake Bad Scale for personal injury litigants claiming idiopathic environmental intolerance

“…The FBS contains infrequently endorsed items with an emphasis on unauthenticated symptoms that were identified by Lees-Haley et al in a sample of florid malingers. The FBS has been validated in controlled comparison studies as an indicator of positive response bias in litigants with a variety of injury claims including pseudo posttraumatic stress disorder (PTSD) [40,41] and malingered neurocognitive dysfunction in mild head injury cases from motor vehicle accidents or toxic exposure [42][43][44][45][46][47][48]. A metaanalysis, including 19 controlled studies of overreporting (e.g., traumatic brain injury, PTSD, chronic pain) on the MMPI-2 commonly used validity scales and FBS, suggests that the FBS performs as well as, if not superior to, other validity scales in discriminating overreporting and comparison groups [49].…”