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Abstract: Base rates of malingering and symptom exaggeration [Fibromyalgia & Chronic Fatigue Syndrome news]

  [ 19 votes ]   [ Discuss This Article ] • March 27, 2003

J Clin Exp Neuropsychol 2002 Dec;24(8):1094-102

Mittenberg W, Patton C, Canyock EM, Condit DC.

Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL 33314, USA.

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).

PMID: 12650234 [PubMed - in process]

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