Symptom Validity Testing in Claimants with Alleged Posttraumatic Stress Disorder: Comparing the Morel Emotional Numbing Test, the Structured Inventory of Malingered Symptomatology, and the Word Memory Test

Abstract

In independent medical examinations, unjustified claims of posttraumatic stress disorder (PTSD) are to be expected at an increased rate. In a prospective study, consecutive cases of patients claiming PTSD who underwent independent neuropsychiatric evaluation were analyzed. For 61 adult patients, results of three symptom validity tests (Morel Emotional Numbing Test, Structured Inventory of Malingered Symptomatology, and Word Memory Test) were available. Seventy percent of all claimants showed probable negative response bias in at least one of the three tests, 25% in all three tests. High probability of negative response bias was associated with symptom overreporting and demonstration of cognitive deficits in performance tests. The results indicate that high rates of uncooperativeness must be expected in civil forensic patients with claimed PTSD. A multi-method approach to the assessment of response distortion in PTSD claimants is indicated.

Neuropsychological and Psychological Aspects of Malingered Posttraumatic Stress Disorder

“…In other work, in a sample of German litigants with allegations of PTSD studied by Merten et al (2009), 51% failed the WMT, and 23% failed Reliable Digit Span. On psychological symptom validity tests, 51% failed the Structured Inventory of Malingered Symptoms, and 40% failed the Morel Emotional Numbing Test.…”

Posttraumatic Stress Disorder: Controversies, Diagnosis, and Malingering

“…The test gives a total error score. Its reliability and validity are reported as acceptable in Anglophone and foreign (German) cultures (respectively : Morel 2008: Morel , 2010Morel and Shepherd 2008a , b ;Merten et al 2009 ). Rubenzer ( 2009 ) has supported its use in PTSD malingering determinations.…”

“…Moreover, 49 % scored above the cut-scores for either the MMPI-2 (Minnesota Multiphasic Personality Inventory, Second Edition; Butcher et al 1989Butcher et al , 2001 ) validity indicators (predetermined ones for the F, Fp, and FBS; respectively, Infrequency Scale, Butcher et al 1989 Demakis and Elhai ( 2011 ) referred to several studies that implicated a base rate of malingering of around 50 % in PTSD determinations (Demakis et al 2008 ;Elhai et al 2001 ;Merten et al 2009 ).…”

“…Another study reported a rate of 75.7 % (Morel 2008 , the patients were PTSD and not neuropsychological referrals). The MENT has been used in a civilian study, as well, by Merten et al ( 2009 ). Nevertheless, Andrikopoulos and Greiffenstein ( 2012 ) indicated that the test needs validation for civilian use, for example, using a known-groups design.…”

“…Self-report checklists are "problematic" because they are easily feigned (Lees-Haley 1990 ) and they have not been well-established for specifi city and sensitivity (e.g., the TSI; Rosen et al 2006 ). If there are cognitive problems, SVTs can be used (Merten et al 2009 ;Rosen and Powel 2003 ). As for physiological assessment, the measures lack suffi cient specifi city and sensitivity (Rosen et al 2010 ).…”