Base rates of malingering and symptom exaggeration.
Base rates of probable malingering and symptom exaggeration are reported from a survey of the American Board of Clinical Neuropsychology membership. Estimates were based on 33,531 annual cases involved in personal injury, (n = 6,371). disability (n = 3,688), criminal (n = 1,341), or medical (n = 22,131) matters. Base rates did not differ among geographic regions or practice settings, but were related to the proportion of plaintiff versus defense referrals. Reported rates would be 2-4% higher if variance due to referral source was controlled. Twenty-nine percent of personal injury, 30% of disability, 19% of criminal, and 8% of medical cases involved probable malingering and symptom exaggeration. Thirty-nine percent of mild head injury, 35% of fibromyalgia/chronic fatigue, 31% of chronic pain, 27% of neurotoxic, and 22% of electrical injury claims resulted in diagnostic impressions of probable malingering. Diagnosis was supported by multiple sources of evidence, including severity (65% of cases) or pattern (64% of cases) of cognitive impairment that was inconsistent with the condition, scores below empirical cutoffs on forced choice tests (57% of cases), discrepancies among records, self-report, and observed behavior (56%), implausible self-reported symptoms in interview (46%), implausible changes in test scores across repeated examinations (45%), and validity scales on objective personality tests (38% of cases).
Mittenberg
Wiley
W
Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL 33314, USA. wiley@nova.edu
Patton
Christine
C
Canyock
Elizabeth M
EM
Condit
Daniel C
DC
D003710:Demography; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D005104:Expert Testimony; D006801:Humans; D008306:Malingering / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D009483:Neuropsychological Tests / Q000592:standards*; D015203:Reproducibility of Results; D012803:Sick Role; D014942:Workers' Compensation / Q000706:statistics & numerical data