Identifying feigning in trauma-exposed African immigrants.

Abstract

As the populations of Western countries become more diverse, the risk of inaccurately generalizing knowledge from majority ethnic groups to minority groups is increasing. However, few of the measures used in forensic assessment are based on normative samples that represent the considerable diversity present in forensic settings. This study examined 4 commonly used measures of feigning: the Dot Counting Test (DCT; Boone, Lu, & Herzberg, 2002); the Miller Forensic Assessment of Symptoms (M-FAST; Miller, 2001); the Test of Memory Malingering (TOMM; Tombaugh, 1996); and a validity scale (atypical responding; ATR) on the Trauma Symptom Inventory-2 (Briere, 2011). The study compared performance on these measures of feigning among 3 groups of African immigrants: honest participants with and without posttraumatic stress disorder, and participants asked to feign distress-related symptoms. The data were used to assess the classification accuracy of each measure and the effect of demographic and cultural variables. Three of the 4 measures (M-FAST, TOMM, and ATR) significantly differentiated between participants asked to respond honestly and those asked to feign, although no measure produced higher than moderate classification accuracy. The M-FAST and DCT produced high false positive rates in the honest groups, ranging from 33% to 63%. Surprisingly, demographic and cultural variables were not significantly associated with test scores. The results emphasize the need for future related research. (PsycINFO Database Record

Meta-analytic Re-assessment of the Validity of Miller Forensic Assessment Test for Detection of Malingering

“…However, such approximate ranking is flagrantly unreliable and inadequate, with an undue overlap. For instance, mean M-FAST score of genuine patients in the sample by Weiss and Rosenfeld [9] exceeds mean scores of 3 samples of instructed malingerers or presumed malingerers, see Table I. Such irregularities undermine the criterion validity of the M-FAST, show that the cutoff score of 6 points is unreliable, and indicate that the M-FAST is not an appropriate test to determine malingering in individual cases, i.e., in routine forensic or clinical work.…”

“…In some of the studies, the "instructed malingerers" were specifically warned to be cautious to avoid detection. The mean M-FAST score calculated by pooling the group of 34 warned instructed malingerers from the study by Montes and Guyton [24] with 28 warned instructed malingerers from the study by Weiss and Rosenfeld [9] was 11.14 (SD=5.01).…”

“…Damaging evidence against M-FAST comes from reviews of item content of the M-FAST by experienced clinicians, [5] from published rates of false positives found with genuine patients [9] from statistics on the nature of most frequently endorsed M-FAST items by US combat veterans with PTSD [10] and from psychometric studies of scientists in the US Veterans Administration (VA) led by Erika Wolf [11].…”

On the assessment of symptom validity in refugee mental health

“…In refugee mental health, there are additional confounding factors. For instance, as most SVTs are developed in high-income countries, they are, in view of the differences in language and culture worldwide, not necessarily suitable for migrants from low-or middle-income countries (Weiss & Rosenfeld, 2017). Some translated SVTs were found to function reasonably well in other populations (Nijdam-Jones & Rosenfeld, 2017), but for populations as diverse as refugee mental health patients properly translated and validated instruments are usually not available.…”

“…Over the past two decades or so, several tests have been developed that can effectively screen for distorted symptom presentation (see for reviews, e.g., Smith, 2008;Sollman & Berry, 2011;. Some authors (e.g., Weiss & Rosenfeld, 2017) have referred to these instruments as feigning measures. However, as these tests are often not able to clarify whether distorted symptom presentation is intentional or not, we prefer the more neutral label of Symptom Validity Tests (SVTs).…”