Symptom validity assessment in European countries: Development and state of the art

Abstract

A B S T R A C TIn the past, the practice of symptom validity assessment (SVA) in European countries was considerably lagging behind developments in North America, with the topic of malingering being largely taboo for psychological and medical professionals. This was being changed in the course of the past decade with a growing interest in methods for the assessment of negative response bias. European estimates of suboptimal test performance in civil and social forensic contexts point at base rates similar to those obtained in North America. Symptom over-reporting and underperformance in neuropsychological examinations appear to occur in a sizable proportion of patients. Although there is considerable progress in establishing SVA as an integral and indispensable part of psychological and neuropsychological assessment in some countries, others appear to lag behind. In some countries there is still enormous resistance against SVA from part of the neuropsychological and psychiatric communities. Evaluación de la validez de los síntomas en Europa: evolución y situación actual R E S U M E NHasta no hace mucho tiempo la evaluación de la validez de los síntomas en Europa, tanto en su vertiente científico-académica como en la práctica profesional, estaba muy por detrás de los avances que se producían en Norteamérica y particularmente la simulación se consideraba un tema tabú entre los profesionales de la Psicología y la Medicina. En la última década las cosas parecen haber cambiado, observándose un incremento en el interés por la evaluación del sesgo de respuesta negativo. Las tasas base de prevalencia obtenidas utilizando pruebas de rendimiento subóptimo en contextos civiles y forenses son similares a las obtenidas en Norteamérica. Los fenómenos de exageración de síntomas en autoinformes y rendimiento insuficiente en pruebas neuropsicológicas parecen ocurrir en semejante proporción de pacientes. Aunque se han producido avances notables en el establecimiento de la evaluación de la validez de los síntomas como una parte integral e indispensable de la evaluación psicológica y neuropsicológica en algunos países europeos, en otros sin embargo la situación es mucho más incipiente. De hecho, en algunos países sigue existiendo una gran resistencia a la evaluación de la validez de los síntomas proveniente de algunos profesionales de la psiquiatría y la neuropsicología.

Prevalence Estimates of Symptom Feigning and Malingering in Spain

“…Given that the use of subjective clinical judgment is not an efficient method for symptom validity assessment (Sweet et al, 2021 ), it is possible that experts who rely on its use detect fewer cases, which would influence their perception of the occurrence of feigning and cause them to underestimate it. In addition to the high use of SVTs, the erroneous belief has been identified in Spain that SIMS is a “malingering test” and that a positive result is equivalent to malingering detection (Merten et al, 2013 , 2021 ). This could increase the number of detected cases and alter the psychologist perception of the occurrence of the event, in this case overestimating it.…”

“…About 10 years ago, the state of the art of symptom and performance validity assessment in the country was described as “quality seeds [being] available to get a good harvest in Spain (but) further research and educational effort will be necessary for establishing sound practice guidelines and protocols, both for researchers and professionals” (Merten et al, 2013 , p.134). At present, there are more open questions than answers, and there is still a need for such an effort, especially at the research level.…”

Using the inventory of problems – 29 (IOP-29) with the Test of Memory Malingering (TOMM) in symptom validity assessment: A study with a Portuguese sample of experimental feigners

“…To our knowledge, only one published study (in Portuguese language) tested the TOMM in Portugal, with a sample of inmates (Mota et al, 2008). In fact, in an interesting paper by Merten et al (2013), concerning European practitioners working in the field of symptom validity assessment, only two studies were authored by Portuguese psychologists (i.e., Martins & Martins, 2010;Simões et al, 2010). One focused on the WMT, the other one on the Rey 15 item test (Rey, 1958); neither used the TOMM.…”

Knowledge of depression and malingering: An exploratory investigation

“…One situation which presents itself to those willing to commit this type of behaviour is the road traffic accident (RTA). Research has alluded to fraud being rife within UK RTA claims through figures illustrating that between 2006-2011 the number of RTAs reduced by 20%, whilst the number of personal injury claims because of such accidents increased by 60% ( Merten et al, 2013 ). A similar paradox to the one outlined within RTA claims is also evident within UK disability claims through a 44% increase in claims whilst the average health status according to the Department for Health and Pensions continues to improve ( Merten et al, 2013 ).…”