The Fake Bad Scale and MMPI-2 F-Family in Detection of Implausible Psychological Trauma Claims

Abstract

We tested the validity of the Lees-Haley Fake Bad Scale (FBS) and the family of MMPI-2 F scales (F-family; F, F(p), and F-K scales) in predicting improbable psychological trauma claims in an applied setting. Litigants reporting implausible symptoms long after minor scares and nonlitigants clinically referred following severe stressors completed the MMPI-2. Both groups were naturally matched on social class. The FBS demonstrated sensitivity, specificity, and positive predictive power in the detection of atypical problems but the F-family showed poor utility. FBS cutting scores derived from logistic regression were applied to a third group made up of litigants with histories of undeniably severe traumas. A substantial number of this third group scored above cutoffs for exaggeration, but this finding is ambiguous. Reasons for the F-family's insensitivity to real-world exaggeration may include using student simulators for validation and content reflective of psychotic simulation. The superiority of the FBS in applied forensic settings could derive from its development in actual litigants and content reflective of nonpsychotic exaggerations. The FBS appears acceptable for use in applied forensic settings where persons seek compensation for nonpsychotic syndromes.

Potential for Bias in MMPI-2 Assessments Using the Fake Bad Scale (FBS)

“…Greiffenstein et al (2004) examined FBS scores in three groups drawn from four settings: clinical patients with probable posttraumatic syndrome (Prob-PTS; n=15 men, 33 women); a major trauma and litigation group (Lit-MPTS; n=11 men, 21 women); and an improbable posttraumatic syndrome group (Imp-PTS; n=26 men, 31 women).…”

“…The criteria for inclusion in this study were documented exposure to a traumatic event, presence of psychological symptoms attributed to the event, and known litigation status (Greiffenstein et al 2004). Litigation status, time of posttraumatic event, and prescribed psychotropic medications (i.e., narcotic analgesics, antidepressants, sedatives and hypnotics, stimulants and xanthines, and mood stabilizers) were the primary objective indices that differed across the groups.…”

“…Although initially developed to assess malingering of emotional distress in personal injury claimants, use of the FBS spread to the assessment of malingering for other types of personal injuries seen in forensic settings, for example, posttraumatic stress disorder (PTSD) and somatic complaints, including the feigning of cognitive deficits during neuropsychological evaluations (e.g., Ben-Porath and Tellegen 2007a, b;Greiffenstein et al 2004;Larrabee 1998;Lees-Haley 1992;Pearson Assessments 2007;Wygant et al 2007).…”

Damages and rewards: assessment of malingered disorders in compensation cases

“…Specific data are available for men in the study by Butcher et al with the following percentages meeting the optimized cut score (FBS > 21): 19.2% of psychiatric inpatients, 34.0% of chronic pain patients, and 22.2% of general medical patients. As noted by Greiffenstein et al (2004), however, the problems with false positives can largely be eliminated if a higher cut score is used. We recommend an FBS cut score > 30; this substantially minimizes false positives for both male and female clinical populations (see Greiffenstein et al, 2004, p. 582 , Table 4).…”

Neuropsychological and Psychological Aspects of Malingered Posttraumatic Stress Disorder

“…In other words, only the former patient types tend to fake or exaggerate psychiatric symptoms. In similar work, Greiffenstein et al (2004) found that the Fake Bad Scale (FBS) was more sensitive to what was termed "atypical posttraumatic syndrome" than traditional validity measures in a forensic context. These patients were more likely to present with cognitive impairment, pain, and/or various types of physical complaints versus frank psychotic symptoms.…”