Malingering Considerations In Forensic Neuropsychological Assessment

Malingering Considerations in Forensic Neuropsychological Assessment
Malingering is not a formal psychiatric diagnosis and there continues to be little agreement about its definition (Bass & Halligan, 2014). Malingering is an important and complicated component to forensic assessment especially when considering competency evaluations. Individuals may feign symptoms for secondary gain dependent on the forensic situation they find themselves in. Therefore utilizing various psychological assessments along with clinical knowledge is important when obtaining the larger picture as to whether the individual is genuinely malingering for secondary gain and an important component when conducting a forensic neuropsychological competency evaluation.

Drob, Meehan, & Waxman (2009) indicate that the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) “classifies malingering with a V-code, thus indicating that it is not a mental disorder,” but rather an additional condition that may warrant clinical attention. According to Scott (2015) malingering was removed from the index in the DSM-5, but remains a V-code, and the criteria for when to consider malingering has remained unchanged. Malingering has also been removed from the differential of a number of diagnoses as well, and one striking exception to this is dissociative identity disorder (Scott, 2015). According to Scott (2015) the DSM-5 provides specific criteria for evaluating if the disorder is feigned, and the criteria for several diagnoses have changed potentially resulting in an increase or decrease of the likelihood of malingering. Drob, Meehan, & Waxman (2009) emphasize that malingering does not represent a set of enduring characteristics, and it is merely a product of context. Bass & Halligan (2014) emphasize that despite malingering falling outside of the remit of a recognized diagnosis, many clinicians have difficulty avoiding to medicalize the illness. “Malingering is by definition the result of a

Building rapport with the individual and exploring reasons for poor effort can help identify potentially causes, but due to the very nature of conducting forensic assessments building the level of rapport necessary may be challenging. It is important for clinicians to consider areas contributing to lack of effort that may not be the result of true malingering. I can reflect on several assessments I conducted as a neuropsychology psychometrician where the client failed certain validity measures, and often times there were other factors (e.g., double vision from the traumatic brain injury making it difficult to see the computer screen on the Conner’s Continuance Performance Test). In the instance of my example, I remembered the symptoms the client reported during the intake session, and asked non-leading questions about experiences with their eyesight at the end of