Malingering Workup

Updated: Jan 04, 2022
  • Author: David Bienenfeld, MD; Chief Editor: Ana Hategan, MD, FRCPC  more...
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Approach Considerations

In applying psychological test results to assist with the recognition of malingering, it is most effective to examine the pattern of performance across multiple evaluations. The examiner looks for the commission of uncommon mistakes, performance across varying levels of difficulty, inconsistency of scores across multiple examinations that measure comparable functions and comparison with available scores from groups of known malingerers, when available. Distraction will affect the performance of one who is malingering more than that of one who suffers from a physical or psychiatric injury or illness. [9]


Other Tests

The Minnesota Multiphasic Personality Inventory (MMPI) can detect inconsistent or atypical response patterns associated with malingering. The F scale and the F-K index are the most valuable indicators. Several subscales, such as the Fake Bad Scale, have been extracted from MMPI profiles.

Multiple other psychological tests have been validated for detection of malingering, including the Test of Memory Malingering, the Negative Impression Management Scale, and the Rey 15-Item Test. [11]

The Temporal Memory Sequence Test (TMST) is a measure of negative response bias (NRB) that was developed to enrich the forced-choice paradigm. In one study, the TMST had high reliability and significantly high positive correlations with the Test of Memory Malingering and Word Memory Test effort scales. [14]

During Social Security Disability evaluations, it is necessary to validate the findings for disability claims. The "A" Random Letter Test of Auditory Vigilance (A-Test) has proven to be effective and easily administered during disability evaluations. [15]