Malingering and PTSD: Detecting malingering and war related PTSD by Miller Forensic Assessment of Symptoms Test (M-FAST)

Ahmadi, Khodabakhsh; Lashani, Zeynab; Afzali, Mohammad H.; Tavalaie, Seyed Abbas; Mirzaee, Jafar

doi:10.1186/1471-244x-13-154

Cited by 23 publications

(28 citation statements)

References 18 publications

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“…En cuanto a los resultados comparativos entre ambos grupos, los participantes en el grupo forense presentan de forma significativa una gravedad de los síntomas mayor que los del grupo clínico, tanto en la escala global como en todas las subescalas específicas (intrusión, evitación, alteraciones cognitivas/estado de ánimo negativo, hiperactivación y disociación), con un tamaño del efecto más bien grande (especialmente en los síntomas de disociación) o mediano. Todo ello hace pensar que los participantes del grupo forense tienden a sobresimular los síntomas del TEPT, lo que es congruente con otros estudios (Ahmadi, Lashani, Afzali, Tavalaie y Mirzaee, 2013;Cartwright y Roach, 2016;Goodwin, Sellbom y Arbisi, 2013;Resnick et al, 2008;Young, 2015).…”

Section: Discussionunclassified

Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático según el DSM-5: versión forense (EGS-F)

Echeburúa

Amor

Múñoz

et al. 2017

Anuario de Psicología Jurídica

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postraumático (TEPT) según los criterios diagnósticos del DSM-5. Se analizan la gravedad de los síntomas, así como la probable simulación y exageración de síntomas en víctimas de violencia de género en un contexto forense. La muestra contó con 526 víctimas de violencia familiar o sexual que buscaron ayuda terapéutica y con 74 víctimas del mismo tipo que presentaron una denuncia en el Juzgado. La gravedad en el TEPT fue mayor en el grupo forense que en el clínico. Los ítems de la subescala de simulación discriminaron adecuadamente entre los dos grupos (t = 7.3, g = 0.97). Un punto de corte de 2 es apropiado para clasificar correctamente el 74% de los probables simuladores. Esta escala resulta útil para evaluar el TEPT en víctimas de delitos violentos en el contexto forense.

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Section: Discussionunclassified

Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático según el DSM-5: versión forense (EGS-F)

Echeburúa

Amor

Múñoz

et al. 2017

Anuario de Psicología Jurídica

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“…The highest estimated accuracy rate for the M-FAST was obtained with data provided on PTSD in the Iranian military (Ahmadi's study [3]). However, in the majority of the studies (3 out of 5) in Table II, the proportions of false positives with the M-FAST suggest an alarmingly high iatrogenic potential.…”

Section: E Estimate Of % Of Patients Scoring At or Above 6 Pointsmentioning

confidence: 99%

“…M-FAST has been used with increased frequency in the last 10 years, as evidenced also by its translations into other languages such as Turkish [4], Persian [3], or Armenian [2]. The evidence damaging to M-FAST's validity is also growing.…”

Section: Epidemic Of the M-fastmentioning

confidence: 99%

“…The M-FAST has been translated into other languages, including also Armenian [2], Persian [3], and Turkish [4] and is used by thousands of psychologists who appear unaware that the M-FAST is essentially an iatrogenic test, misclassifying too many genuine patients as "malingerers," thus depriving them of therapies and of other legally owed benefits.…”

Section: Introductionmentioning

confidence: 99%

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

Cernovsky

2021

EJMED

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Background: The Miller Forensic Assessment of Symptoms Test (M-FAST) is used widely for the assessment of malingering of medical symptoms. Its validity has allegedly been supported by meta-analytic study of M-FAST in 2019 by Detullio et al. Credibility of Detullio’s results is damaged by an inclusion of data based on analog validation and also on dubious convergent validation procedures that falsify estimates of M-FAST’s validity. Method: In the present study, the meta-analysis was calculated on 3 types of M-FAST data: (1) 5 samples of scores of healthy persons instructed to respond honestly, (2) 5 samples of scores of medical patients, and (3) 10 samples of scores of healthy persons instructed to feign mental illness (so called “instructed malingerers”). Results: In an ANOVA (F(2,815)=398.50, p<.0001), significantly lowest M-FAST scores were those of healthy controls (mean=1.59, SD=2.80), the next significantly higher scores were those of legitimate patients (mean=4.85, SD=4.22), and the instructed malingerers had significantly highest scores (mean=12.34, SD=5.71). Discussion: The significant difference between healthy controls and patients shows that inferences from analog validations of the M-FAST are inherently false. Furthermore, data of legitimate patients with severe psychiatric illness suggested that they may face the risk of about 50% to be falsely classified as malingerers by the M-FAST. Moreover, almost all validations of the M-FAST were done only with “instructed malingerers” (healthy volunteers instructed to feign symptoms). This overestimates the test’s capacity to detect real-life malingerers. Montes and Guyton documented that “instructed malingerers” warned to avoid detection score much lower than the unwarned ones (effect size: Cohen’s d=3.05). M-FAST’s capacity for detection of real-life malingerers may be extremely low, in particular those more genuinely motivated to evade detection, well prepared, better educated, and systematically feigning only a few specific symptoms such as depression, pain, and insomnia. Conclusion: The M-FAST should no longer be used.

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“…Guy et al (2006) provided evidence of the M-FAST's robustness regarding its ability to detect a variety of malingered disorders including major depressive disorder and PTSD. More recently, Ahmadi et al (2013) demonstrated that the M-FAST was excellent in identifying malingered war related PTSD at a rate of 92 per cent. To the author's knowledge there has not been a systematic review of the M-FAST but clearly from the literature available this test meets the criteria set by Cartwright et al (2018) and would be of use within the UK medico legal arena.…”

Section: The Miller Forensic Assessment Toolmentioning

confidence: 99%

May the choice be with you: assisting practitioners with selecting appropriate psychometric assessments for the medico legal arena

Cartwright

2019

JCP

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Purpose Fraudulently claiming symptoms of mental disorder can be very lucrative for those in society who are willing to do so. One context that lends itself well to those willing to fraudulently claim symptoms of mental disorder is the road traffic accident. Previous research has indicated that the assessment practices of those charged with investigating psychological damages in the UK are not suitable in terms of detecting malingering. The purpose of this paper is to provide a “practitioner ready review” that outlines the structured psychometric assessment tools that are recommended and validated by academic research for aiding with the detection of feigned mental disorder. Design/methodology/approach The paper takes a primarily conceptual approach utilising a narrative literature review which is aimed at the forensic practitioner who conducts assessments for psychological damages in contexts where malingering may be of concern. Findings The findings of the present paper will be of use not only to forensic practitioners, but also will be of interest to those who instruct assessments in similar contexts, those who conduct research within this area and those who interpret reports written by forensic practitioners such as the courts. Originality/value To the author’s knowledge the present paper is the first of its kind, which attempts to bridge the gap between academic literature and professional practice to assist forensic examiners incorporate suitable psychometric instruments within their practice. As a result, the paper makes a substantial contribution to the improvement of forensic reporting in the disciplines of psychology and psychiatry.

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Malingering and PTSD: Detecting malingering and war related PTSD by Miller Forensic Assessment of Symptoms Test (M-FAST)

Cited by 23 publications

References 18 publications

Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático según el DSM-5: versión forense (EGS-F)

Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático según el DSM-5: versión forense (EGS-F)

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

May the choice be with you: assisting practitioners with selecting appropriate psychometric assessments for the medico legal arena

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