Fraud in emotional harm and neuropsychological injury claims.
Four sources of information are vital in assessing feigned PTSD in a forensic setting:
- Semi-structured interviews that thoroughly cover the claimant’s life, including everyday functional behaviors (e.g., shopping, recreational activities, etc.), before, during, and after the traumatic incident.
- The examiner’s observations of the claimant’s manner both during and outside of the interview.
- Specialized psychological testing designed to identify malingering.
- Collateral information from family members, treatment providers, private investigators, witnesses to the traumatic event, and persons who are not a party to related litigation but are familiar with the claimant’s daily behavior.
Very few forensic examiners complete all four steps and they almost never are performed in a clinical setting.
Psychological Testing to Detect Feigned Emotional Harm
The MMPI-2 is among the most commonly used psychological tests in the world. It has numerous indices to detect inconsistent responding, defensiveness, exaggeration, or feigning. Unfortunately, some of the most sensitive and commonly used validity scales perform quite differently across varying settings and populations, so that the cut scores that are most effective at separating the honest from the feigning have differed from study to study. Recent meta-analytic studies that combine the results from dozens of well-conducted studies have identified two scales—F(p) and Ds—that discriminate well and show consistent cut scores across populations and studies. Claims examiners may wish to ask forensic experts to comment specifically on claimant’s scores on those scales.
The Structured Interview of Reported Symptoms (SIRS) is considered the “gold standard” for detecting malingering of severe mental illnesses, such as psychosis and PTSD. However, no study has been conducted to demonstrate if it is capable of distinguishing simulators from legitimate PTSD patients. Legitimate PTSD patients with severe and bizarre symptoms are at risk of being falsely identified as malingering.
Unfortunately, a recent comprehensive review of the scientific literature on the assessment of malingered PTSD found that empirical investigation is still in its infancy. There is no method or single instrument that is recognized universally as being the best for detecting malingered PTSD. There also is no test with acceptable sensitivity and specificity for PTSD that has validity scales that effectively detect malingering.
