Diagnostic and Construct Validation of Symptom and Performance Validity Tests of Malingering in a Civil Litigation Context

The extent to which persons may malinger psychiatric symptoms is a legitimate concern in civil litigation. The consequences inherent in personal injury cases involving psychological distress necessitate an understanding of how malingering presents in medico-legal contexts and the validity and usefulness of available methods to detect malingering. The present study evaluated the construct and diagnostic validity of symptom-based (SVT) and performance-based (PVT) measures of malingering in a simulated personal injury paradigm. We evaluated the interrelationships between malingering measures and whether these measures were able to discriminate between “honest responders” and “malingerers.” Using a simulation design, 411 undergraduates were randomly assigned into four experimental conditions, which outlined the experience of a motor vehicle accident and subsequent psychological and cognitive symptoms. Conditions varied on the degree of suggestion to malinger symptoms as related to a personal injury case. Under this paradigm, participants completed measures of malingered symptomatology, including the TOMM, M-FAST, SIMS, and TSI-2 ATR. As predicted, we found weaker correlations between PVT and SVTs, but moderate significant correlations were found across symptom validity measures. These findings support conceptualization of malingering as a non-unitary construct. Results from ROC analysis suggest that only the TSI-2 ATR was useful in discriminating between simulation groups. Contrary to expectations, prominent measures of malingering (TOMM, M-FAST, and SIMS) did not discriminate between groups. Results may mean that these tests may operate differently than intended within a civil litigation context and depending on the type of psychopathology feigned.