Defining the Construct of Malingered PTSD in Civil Litigation: A Confirmatory Factor Analysis

The possibility of feigned or malingered psychological symptoms is a crucial concern in personal injury litigation and mental health professionals are often faced with the task of identifying falsified or exaggerated presentations. Current recommendations in malingering assessment encourage the use of multiple methods, including both symptom-validity and performance-validity based tests. Supporting these recommendations, findings from neuropsychological research with compensation-seeking patients with neurocognitive conditions suggests the underlying structure of malingering consists of both performance-based and symptom-based latent factors. The present study aimed to extend these findings to a simulated personal injury paradigm, in which PTSD is alleged without concurrent physical injury (e.g., traumatic brain injury). As a part of larger research initiative, 411 undergraduate students were randomly assigned to one of four conditions, which outlined a simulated motor vehicle accident and subsequent psychological and cognitive symptoms. Experimental conditions varied on the degree of suggestion to malinger symptoms and the presence of litigation. Participants completed four widely-used measures for the purpose of detecting malingering (the SIMS, M-FAST, TSI-2 ATR and TOMM). Utilizing confirmatory factor analyses, the present study aimed to delineate the underlying factor structure of malingered PTSD by comparing measures of goodness-of-fit across three hypothesized latent factor models. Hypothesized models included (1) a single, “general badness” factor, (2) cognitive and psychiatric-based factors, and (3) SVT and PVT-based factors. Consistent with prior research, it was found that the two-factor, SVT and PVT-based model demonstrated best fit with the data. These results suggest that practitioners should utilize a variety of methods when PTSD is alleged in personal injury settings, including both PVT and SVT approaches, even in the absence of physical injuries.