Standard Symptom Inventories for Asylum Seekers in a Psychiatric Hospital: Limited Utility Due to Poor Symptom Validity

Heide, Douwe van der; Bošković, Irena

doi:10.1007/s12207-017-9302-x

Cited by 8 publications

(6 citation statements)

References 37 publications

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“…Third, replicating earlier studies (Van der Heide & Merckelbach, 2016;Van der Heide, Boskovic, & Merckelbach, 2017), referral center patients with a positive incentive made significantly more errors on the forced-choice PVT than patients with a mixed or a negative incentive to produce deviant scores. This indicates that our PVT was sensitive to incentives.…”

Section: Discussionsupporting

confidence: 71%

“…The extent to which both factors, disturbances inherent to psychosis and side-effects of medication, are prominently present in samples of psychiatric patients may explain why some researchers reported relatively low rates of PVT failures in psychotic patients (Schroeder & Marshall, 2011), whereas others found considerable proportions failing PVTs (e.g. Van der Heide & Merckelbach, 2016;Van der Heide, Boskovic, & Merckelbach, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Why do patients who have no reason to exaggerate their illness fail on a forced-choice PVT? In the studies of Van der Heide and Merckelbach (2016), Van der Heide, Boskovic, and Merckelbach (2017), compulsory admission was regarded as an incentive to deny impairment, the reason being that symptom exaggeration would extend the compulsory admission. Could it be that psychotic patients were overrepresented in the negative incentive group, resulting in artificially inflated error scores on the forced-choice PVT?…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Psychosis as a confounder of symptom credibility testing in a transcultural sample

Heide

Bošković

Harten

2019

The Journal of Forensic Psychiatry & Psychology

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Psychosis as a confounder of symptom credibility testing in a transcultural sample

Heide

Bošković

Harten

2019

The Journal of Forensic Psychiatry & Psychology

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“…In the first case that we described, just obtaining collateral information from staff workers in the asylum seeker center already turned out to be informative (34). In the second case, a high error score on the MENT, even though by itself no proof of feigning or exaggeration, could have alerted the clinical staff to this possibility at a much earlier stage (35) and might have prevented her subsequent exposure to a protracted period of admission and the side effects of antipsychotic medication. Thus, an open and active attitude toward collateral information may alert the clinician to the option of feigning, whereas a SVT or a PVT may serve as a preliminary screener before a decision to start more comprehensive investigations along the criteria of Slick needs to be made.…”

Section: A Remedy?mentioning

confidence: 97%

Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering

Heide

Bošković

Harten

2020

Journal of Forensic Sciences

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Clinicians tend to overestimate their ability to recognize feigning behavior in psychiatric patients, especially if it concerns patients who have been admitted for observation. Feigning can be either externally motivated (e.g., for financial compensation, known as malingering) or internally motivated (e.g., to assume the “sick role,” known as factitious disorder). Persistent presentation of severe symptoms is usually associated with the factitious disorder. We present two patients with strong external incentives who consistently and convincingly feigned severe psychiatric symptoms during a protracted period of inpatient observation in a specialized center; both were engaged in a procedure for medical asylum. The first case presented with the clinical picture of a psychotic depression with severe motor symptoms, and the second case showed symptoms of a chronic post‐traumatic stress disorder with secondary psychotic symptoms. Both cases were thoroughly investigated but feigning was overlooked, and unnecessary and harmful treatment interventions were given. To prevent iatrogenic damage, we recommend a critical attitude that takes malingering as an option into account in settings where patients are often involved in high stake legal procedures. A clinical sign that might indicate feigning is therapy‐resistant symptoms. To rule out feigning a comprehensive, multimethod approach is required, but an active stance toward collateral information is essential. Specialized psychological tests may be useful for preliminary screening, but for their use in culturally diverse populations as in refugee mental health more research is needed.

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“…Studies on patients with schizophrenia spectrum disorders indirectly support a relationship between cognitive dysregulation and symptom overreporting. That is, such diagnoses in patients are associated with failure on SVTs (e.g., Van Impelen et al, 2014), and on embedded validity indicators or PVTs (e.g., Peters et al, 2013;Gorissen et al, 2005;Van der Heide & Merckelbach, 2016, Van der Heide et al, 2017; but see Schroeder & Marshall, 2011). Several authors have suggested that deficits in reality monitoring, illness insight, and cognitive functions may drive such failures on validity tests (Radaelli et al, 2013;Shad et al, 2006;Schaefer et al, 2013; but see Stevens et al, 2014).…”

Section: Fantasy Proneness and Cognitive Dysregulationmentioning

confidence: 99%

Traits and Distorted Symptom Presentation: a Scoping Review

Helvoort

Nieuwenhuizen

Otgaar

2022

Psychol. Inj. and Law

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Are personality traits related to symptom overreporting and/or symptom underreporting? With this question in mind, we evaluated studies from 1979 to 2020 (k = 55), in which personality traits were linked to scores on stand-alone validity tests, including symptom validity tests (SVTs) and measures of socially desirable responding (SDR) and/or supernormality. As to symptom overreporting (k = 14), associations with depression, alexithymia, apathy, dissociation, and fantasy proneness varied widely from weak to strong (rs .27 to .79). For underreporting (k = 41), inconsistent links (rs − .43 to .63) were found with narcissism, whereas alexithymia and dissociation were often associated with lower SDR tendencies, although effect sizes were small. Taken together, the extant literature mainly consists of cross-sectional studies on single traits and contexts, mostly offering weak correlations that do not necessarily reflect causation. What this field lacks is an overarching theory relating traits to symptom reporting. Longitudinal studies involving a broad range of traits, samples, and incentives would be informative. Until such studies have been done, traits are best viewed as modest concomitants of symptom distortion.

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Standard Symptom Inventories for Asylum Seekers in a Psychiatric Hospital: Limited Utility Due to Poor Symptom Validity

Cited by 8 publications

References 37 publications

Psychosis as a confounder of symptom credibility testing in a transcultural sample

Psychosis as a confounder of symptom credibility testing in a transcultural sample

Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering

Traits and Distorted Symptom Presentation: a Scoping Review

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