Malingering Assessment, Interpretation, and Expert Testimony

Malingering, or the deliberate exaggeration or fabrication of psychological symptoms, is a central issue in virtually all forensic mental health evaluations. To maintain the integrity of the legal process and to protect those who are genuinely physically or mentally ill, it is important to be able to identify those individuals who are malingering and distinguish them from those suffering from genuine mental disorders. Chapter 15 in the Litigator’s Handbook of Forensic Medicine, Psychiatry, and Psychology authored by Barry Rosenfeld, Ph.D., Ellen Quick, Ph.D., & Jacomina Gerbrandij, Ph.D., highlights a range of concerns related to the assessment of malingering in forensic mental health evaluations. 

This chapter’s comprehensive coverage of malingering and feigned symptoms includes the following particular topics:

• Review of criminal and civil cases in which malingering was raised

• Discussion of the difficulty of assessment, including when feigned symptoms appear in the context of a mental disorder

• Review of the process for assessing malingering and coverage of detection strategies

• Discussion of the psychological instruments that detect exaggerated or feigned symptoms

• Review of instruments used to detect exaggerated impairment in a psycho-legal ability

• Discussion of cross-cultural challenges to assessment and how to address them 

• Discussion of the implications of malingering for clinical practice and legal proceedings 

• Identification of the symptoms of minimization 

• Discussion of the different malingering models, including the adaptational model 

• Review of the instruments that detect insufficient cognitive effort/exaggerated cognitive impairment

• Identification of sources of evidence of malingering (or its rejection) other than psychological tests 

In addition to a detailed review of the vast array of tools and their relative strengths and weaknesses, demographic and cultural variables that can impact the accuracy of feigning instruments are discussed as well. Specific recommendations to improve the accuracy of the assessment process are provided, as are recommendations for determining when a formal assessment of malingering is indicated, how to select an appropriate battery of instruments to use in the evaluation (including how many instruments to use), and strategies to integrate test results with clinical observations, and collateral and any other available and relevant information. 

Providing a thorough treatment of the subject, this Malingering Assessment, Interpretation, and Expert Testimony chapter is an invaluable resource for lawyers, judges and experts who are faced with this difficult intersection of psychology and the law.