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Symptom feigning and malingering should be evaluated in forensic contexts due to their important socio-economic consequences. Despite this, to date, there is little research in Spain that evaluates its prevalence. The aim of this study was to investigate this issue using the perception of the general population, students, and professionals of medicine and forensic psychology. Three adapted questionnaires were applied to a total of 1003 participants (61.5% women) from 5 different groups. Approximately two-thirds of participants reported knowing someone who feigned symptoms, and one-third disclosed feigning symptoms themselves in the past. Headache/migraine, neck pain, and anxious–depressive symptoms were the most commonly chosen. Experts in psychology and forensic medicine estimated a prevalence of 20 to 40% of non-credible symptom presentations in their work settings and reported not having sufficient means to assess the distorted presentation of symptoms with certainty. Professionals and laypersons alike acknowledge that non-credible symptom presentations (like feigning or malingering) are relevant in Spain and occur at a non-trivial rate, which compares with estimates in other parts of the world.

When patients fail symptom validity tests (SVTs) and/or performance validity tests (PVTs), their self-reported symptoms and test profiles are unreliable and cannot be taken for granted. There are many well-established causes of poor symptom validity and malingering is only of them. Some authors have proposed that a cry for help may underlie poor symptom validity. In this commentary, we argue that cry for help is a (1) metaphorical concept that is (2) difficult to operationalize and, at present, (3) impossible to falsify. We conclude that clinicians or forensic experts should not invoke cry for help as an explanation for poor symptom validity. To encourage conceptual clarity, we propose a tentative framework for explaining poor symptom validity.

The Self-Report Symptom Inventory (SRSI) was developed to expand the toolbox of self-report instruments available to detect symptom overreporting. Such instruments, today known as symptom validity tests, play a crucial role in both forensic evaluations and in a range of clinical referral questions. The SRSI was originally designed in the German language; items were selected from a larger pool on the basis of empirical results. Scores on the Structured Inventory of Malingered Symptomatology served as external criterion for the item selection procedure and empirical cut-score determination (gold standard). The SRSI is composed of five subscales describing potentially genuine symptoms and five pseudosymptoms subscales. Ten different language test versions have been developed so far. The article describes the background of the construction of the scale, the main empirical results with the SRSI, the conditions of use, and the limits of applicability. With research ongoing in several countries and with a variety of language versions, a larger body of empirical evidence can be expected to accumulate in the coming years.

Among embedded measures of performance validity, reaction time parameters appear to be less common. However, their potential may be underestimated. In the German-speaking countries, reaction time is often examined using the Alertness subtest of the Test of Attention Performance (TAP). Several previous studies have examined its suitability for validity assessment. The current study was conceived to examine a variety of reaction time parameters of the TAP Alertness subtest with a sample of 266 Austrian civil forensic patients. Classification results from the Word Memory Test (WMT) were used as an external indicator to distinguish between valid and invalid symptom presentations. Results demonstrated that the WMT fail group performed worse in reaction time as well as its intraindividual variation across trials when compared to the WMT pass group. Receiver operating characteristic analyses revealed areas under the curve of .775–.804. Logistic regression models indicated the parameter intraindividual variation of motor reaction time with warning sound as being the best predictor for invalid test performance. Suggested cut scores yielded a sensitivity of .62 and a specificity of .90, or .45 and .95, respectively, when the accepted false-positive rate was set lower. The results encourage the use of the Alertness subtest as an embedded measure of performance validity.

Psychometric symptom validity instruments (SVTs) can be vulnerable to coaching, which can negatively affect their performance. Our aim was to assess the impact that different types of coaching may have on the sensitivity of the Structured Inventory of Malingered Symptomatology (SIMS).A simulation design was used with 232 non-clinical adults divided into five experimental simulation conditions and 58 patients with anxious-depressive symptomatology derived from a traffic accident. All simulators received a basic scenario and, in addition, the second group was instructed on the symptomatology, the third was warned about the risk of exaggerating the presentation, the fourth received a combination of the two previous groups and the fifth received specific training on SVTs.The discriminative ability of the SIMS was higher in the basic and symptom information groups, and it decreased significantly in the specific training group on SVTs.SIMS seems not to be severely impacted by a variety of symptom coaching styles, although test coaching diminished its performance.

Strategies of malingering detection have brought about a wealth of neuropsychological studies in the last decades. However, the investigation of physiological measures to reliably differentiate between authentic and manipulated symptom presentations is still in its infancy. The present study examined event-related potentials (ERP) to identify feigned memory impairment. We tested instructed malingerers (n = 25) and control participants (n = 22) with a recognition task similar to the Test of Memory Malingering. No differences between groups were found for P1 (70–110 ms) but for N1 (120–170 ms) and P300 components, with lower amplitudes for instructed malingerers. Behavioral data showed a typical pattern of unrealistically high errors in a forced-choice recognition task and less overall recalled stimuli in instructed malingerers. We also found study-phase repetition and old/new effects in the P300, but no interactions with groups (control vs. malingering). Post-hoc analyses revealed that the P300 effect is greater when participants reported an attention-based faking strategy, as opposed to response-based malingerers and controls. The employment of physiological measures can yield additional information on the validity of test data without the need to perform additional tests.

Abstract. The recently developed Self-Report Symptom Inventory (SRSI) intends to provide an alternative approach to the detection of symptom over-reporting. Unlike other measures, the SRSI includes both non-existent symptoms (i.e., pseudosymptoms) and genuine symptoms. Previous research using the German SRSI showed that people who exaggerate their complaints over-endorse both types of symptoms. In the current simulation experiment, we tested whether the Dutch and English SRSI are effective in identifying over-reporting by comparing SRSI scores of an honest group ( n = 51) with those of two experimental simulator groups (pain, n = 54; anxiety, n = 53). The pain and anxiety simulators endorsed significantly more genuine symptoms and pseudosymptoms than honest participants (ηp2 = .50 and ηp2 = .30, respectively). Furthermore, pain and anxiety over-reporters specifically over-endorsed symptoms corresponding to their simulation instructions (Cohen’s ds > 0.77). Using the recommended cut-off score, the SRSI detected 48% of pain over-reporters and 73% of anxiety over-reporters, with areas under the curve (AUC) ranging from .88 to .91. These results indicate that the SRSI is a promising tool for identifying over-reporting, but further research with clinical samples is needed.

Objective: Noncredible symptom claims, regularly expected in forensic contexts, may also occur in clinical and rehabilitation referral contexts. Hidden motives and secondary gain expectatio...

Abstract. Against the background of the growing importance of symptom validity assessment both in forensic and clinical or rehabilitation contexts, a new instrument for identifying overreporting was developed. In order to study the equivalence of the German and the French versions, we divided the item pool of the Self-Report Symptom Inventory (SRSI) into two presumably equivalent half-forms. A sample of 40 adult bilingual Swiss nationals with a mean age of 39.9 years responded honestly to one of the half-forms in German and to the other in French. In a subsequent experimental malingering condition, they were asked to simulate sequelae of a whiplash injury and to respond to the SRSI again. In both conditions, they also filled out the Structured Inventory of Malingered Symptomatology (SIMS). The results showed no differences between the two language versions in both conditions. Classification accuracy was very high (100% specificity, 90% sensitivity for the standard cutoff score). Reliability estimates were 0.93 for endorsement of genuine symptoms and 0.97 for pseudosymptom endorsement. In the malingering condition, the correlation between the number of reported pseudosymptoms and the SIMS scores was 0.69. The current results add to the database available for the SRSI and support the appropriateness of the French version.

Performance validity testing has developed into an indispensible element of neuropsychological assessment, mostly applied in forensic determinations. Its aim is to distinguish genuine patient performance from invalid test profiles. Limits to the applicability of performance validity tests (PVTs) may arise when genuine cognitive symptoms are present.We studied the robustness of four commonly used PVTs in a sample of 15 acute patients after cerebrovascular stroke, with first manifestations of aphasia. Severity of aphasia varied from very mild to severe. Subsequent neuroimaging revealed left-hemisphere infarction for all participants.The Test of Memory Malingering was the only measure found to be robust against effects of genuine language impairment (one positive on Trials 1 and 2, none on Trial 3), while unacceptable false-positive rates were found for the Fifteen-Item Test (60%) and two embedded measures, Reliable Spatial Span (40%) and Reliable Digit Span (73.3%). Four patients (26.7%) scored positive on at least three of the four PVTs.These data add to the ongoing discussion about the risk of false-positive classifications in genuine patient populations. Misdiagnosis with severe consequences for the patient in question may arise if results of PVTs are interpreted without concurrently considering the whole context of clinical evidence.

Factitious disorder and malingering are two forms of abnormal illness behaviour in which mental or somatic symptoms are deliberately fabricated or grossly exaggerated or otherwise grossly misrepresented. They are forms of other-deceit, with the person in question assumed to be fully aware of this deceit. The central distinguishing feature of both is that factitious disorder is commonly thought to be motivated by internal incentives (primary gain: medical treatment, assuming the sick role), while malingering is directed towards an external goal (secondary gain, for example monetary compensation, sick leave). The utility of distinguishing between the two forms of feigning has long been questioned. Similarly, it must be questioned why factitious disorder is apprehended as a mental disorder in its own right. Neither the Diagnostic and Statistical Manual of Mental Disorders (DSM) nor the International Classification of Diseases (ICD) contains useful diagnostic guidelines for reliably diagnosing feigned illness presentations; in particular, several decades of malingering research and conceptual developments have found no repercussion there.

Manipulative, interessengeleitete Darstellungsformen finden sich haufig in gutachtlichen Vorstellungskontexten unterschiedlicher Rechtsgebiete. Eine regelmasige Aufgabe im Rahmen der Sachverstandigentatigkeit liegt in der Differenzierung zwischen authentischen und vorgetauschten oder ubertriebenen Beschwerdedarstellungen. Neunundreisig Schweizer im Alter von 23 bis 59 Jahren wurden hinsichtlich ihrer Annahmen und Einstellungen zu simulativem Verhalten strukturiert befragt. Die Teilnehmenden schilderten vielfaltige eigene Erfahrungen mit vorgetauschten Gesundheitsstorungen und schatzten ihre Pravalenz in 7 unterschiedlichen Rechtskontexten mit 39 % (Rentenbegutachtung) bis 63 % (Militardienstverweigerung) sehr hoch ein. Die Mehrzahl der Befragten verurteilte Simulationsversuche zwar, bevorzugte aber gleichzeitig ein adaptatives Erklarungsmodell fur Simulation. Der Fahigkeit von Gutachtern, korrekt authentische von manipulativen Beschwerdendarstellungen zu unterscheiden, wurde ein schlechtes Zeugnis ausgestellt. Die von den Laien vermutete hohe Auftretenshaufigkeit simulativer Tendenzen im Gutachtenkontext korrespondiert im Trend mit einer Reihe einschlagiger empirischer Forschungsergebnisse. Die hohe Brisanz der Thematik vorgetauschter Gesundheitsstorungen und der Qualitat gutachtlicher Arbeit wird durch die Ergebnisse der vorliegenden Studie unterstrichen.

In medicolegal contexts, the expert is confronted with a number of apparent or seemingly paradox constellations that are mostly not even explicit to the assessor involved, yet when they occur, they may have a profound effect on the shaping of the expert’s opinion and, subsequently, on the outcome of litigation. Because the paradoxes in this forensic work have not been made explicit for the most part in the field, it can be assumed that forensic experts themselves are often unaware of paradoxical situations and logical incoherence to be found in many cases. Difficulties to positively diagnose somatoform and dissociative disorders in disability claimants and compensation-seeking litigants are among the most prominent of these paradoxes. For example, in these diagnoses, presumably unconscious core motives and an involuntarily, unconsciously distorted symptom presentation (both being central for the diagnosis) might contrast with conscious symptom magnification and pursuit of monetary interests on the part of the complainant (external incentives in the form of disability or compensation seeking). Other paradoxes discussed in more detail are linked with symptom validity assessment in forensic psychology. Logical dilemmas and paradoxes, if not placed at the forefront in forensic psychological evaluations, potentially undermine the quality of forensic determinations.

In forensic contexts, an increased prevalence of feigned symptom presentations should be expected, although it will probably vary by the context and specific forensic issue. Forensic experts should examine this possibility proactively while maintaining a balanced perspective that actively considers clinical data for both feigning and genuine responding. Psychological measures and standardized methods developed for feigning and other response styles can facilitate these often complex determinations. The current article provides an international perspective on the issue of feigned mental disabilities. In particular, important conceptual issues are discussed, such as the categorical versus dimensional approaches to feigning, and the advisability of well-defined rather than single-point cut scores for accuracy in clinical decision-making. Salient problems of differential diagnosis include a spectrum from malingering and factitious disorders to somatoform and conversion disorders. In rendering these important diagnostic distinctions, the questions of motivations and intentions remain key. However, the establishment of motivation cannot be facilely assumed from the context. Instead, forensic psychologists and psychiatrists bear the professional burden of carefully evaluating motivation and recognizing the clinical reality that sometimes the motivation in especially challenging cases may not be fully determined. Copyright © 2017 John Wiley & Sons, Ltd.

Some researchers argue that the Modified Stroop Task (MST) can be employed to rule out feigning. According to these authors, Modified Stroop interference effects are beyond conscious control and therefore indicative of genuine psychopathology. We examined this assumption using a within-subjects design. In the first session, students (N = 22) responded honestly, while in the second session they were asked to read a vignette about test anxiety and then fake this condition. During both sessions, we administered an MST consisting of neutral, anxiety-related, and test anxiety-related words. Participants also completed the Self-Report Symptom Inventory (SRSI; Merten et al., 2016) that focuses on over-reporting of pseudosymptoms. Our feigning instructions were successful in that students succeeded in generating the typical MST effect by providing longer response latencies on anxiety related (r = 0.43) and test anxiety – related (r = 0.31) words, compared with neutral words. Furthermore, students endorsed significantly more pseudosymptoms on the SRSI (r = 0.62) in the feigning session than in the honest control condition. We conclude that the MST effect is not immune to feigning tendencies, while the SRSI provides promising results that require future research. Keywords Feigning; Over-reporting; Feigning; Test anxiety; SRSI; Modified Stroop task

False symptom claims and distorted symptom presentations are not at all rare in civil and criminal forensic cases where secondary gain is immanent. They reach from reported nonspecific memory and attention problems to intellectual disability, full-blown autobiographical memory loss, or crime-related amnesia. Symptom validity assessment has, to a large extent, been developed by clinical neuropsychologists to distinguish between authentic and nonauthentic symptom presentations. Malingering is only one of several manifestations of uncooperativeness. Today, most forensic neuropsychology experts would agree that neuropsychological testing is incomplete if not adequately checked for possible negative distortions. This chapter reviews modern methods of symptom validation, with emphasis on forced-choice response formats.

When patients present with unusual, atypical, and difficult-to-understand complaints known as dissociative and somatoform disorders or medically unexplained symptoms, clinicians may administer symptom validity tests (SVTs) to determine whether or not the patient exhibits negative response bias. Such tests are especially informative in a context where incentives play a substantial role (e.g., the legal arena). If patients fail SVTs and exhibit negative response bias, how should that bias be interpreted? Some authors have argued that psychological problems (e.g., unconscious conflicts and depression) and circumstances (e.g., a cry for help) may explain such bias. In the current article, we critically review this “psychopathology = superordinate” position. We argue that (1) there is no empirical evidence to suggest that psychological problems may foster SVT failure per se and (2) that the “psychopathology = superordinate” position invites circular argumentation: to clarify the nature of the atypical symptoms, SVTs are administered and a negative response bias is found, which is explained away by the atypical symptoms. Negative response bias allows for only one conclusion: the patient’s self-report of symptoms and life history can no longer be taken at face value.

Los resultados encontrados en la evaluación de la validez de los síntomas (SVT) deberían ser inmunes a las variables sociodemográficas. Así, los sujetos sanos y cooperadores deberían superar los tests de SVT. El ob- jetivo de este estudio es obtener datos de referencia de una serie de pruebas utilizadas en la evaluación de la validez de los síntomas, en una muestra representativa de 100 ciudadanos suizos, germano-hablantes, de entre 18 y 60 años: Medical Symptom Validity Test, Structured Inventory of Malingered Symptomatology, Amsterdam Short-Term Memory Test, Emotional Numbing Test, Reliable Digit Span y Maximum Span Forward. Los análisis de regresión múltiple reflejaron que las variables edad e inteligencia verbal afectaron a los resultados de varias de las pruebas, mientras que no fue así para las variables sexo y nivel educativo. La tasa de resultados positivos osciló entre el 1% (Emotional Numbing Test, Structured Inventory of Malin- gered Symptomatology) y el 4% (Maximum Span Forward). Una cuestión relevante que se desprende de este estudio es si dichos resultados positivos en las muestras de referencia

Hasta no hace mucho tiempo la evaluación de la validez de los síntomas en Europa, tanto en su vertiente científico-académica como en la práctica profesional, estaba muy por detrás de los avances que se producían en Norteamérica y particularmente la simulación se consideraba un tema tabú entre los profesionales de la Psicología y la Medicina. En la última década las cosas parecen haber cambiado, observándose un incremento en el interés por la evaluación del sesgo de respuesta negativo. Las tasas base de prevalencia obtenidas utilizando pruebas de rendimiento subóptimo en contextos civiles y forenses son similares a las obtenidas en Norteamérica. Los fenómenos de exageración de síntomas en autoinformes y rendimiento insuficiente en pruebas neuropsicológicas parecen ocurrir en semejante proporción de pacientes. Aunque se han producido avances notables en el establecimiento de la evaluación de la validez de los síntomas como una parte integral e indispensable de la evaluación psicológica y neuropsicológica en algunos países europeos, en otros sin embargo la situación es mucho más incipiente. De hecho, en algunos países sigue existiendo una gran resistencia a la evaluación de la validez de los síntomas proveniente de algunos profesionales de la psiquiatría y la neuropsicología.

In forensic contexts, an increased prevalence of feigned symptom presentations should be expected, although it will probably vary by the context and specific forensic issue. Forensic experts should examine this possibility proactively while maintaining a balanced perspective that actively considers clinical data for both feigning and genuine responding. Psychological measures and standardized methods developed for feigning and other response styles can facilitate these often complex determinations. The current article provides an international perspective on the issue of feigned mental disabilities. In particular, important conceptual issues are discussed, such as the categorical versus dimensional approaches to feigning, and the advisability of well-defined rather than single-point cut scores for accuracy in clinical decision-making. Salient problems of differential diagnosis include a spectrum from malingering and factitious disorders to somatoform and conversion disorders. In rendering these important diagnostic distinctions, the questions of motivations and intentions remain key. However, the establishment of motivation cannot be facilely assumed from the context. Instead, forensic psychologists and psychiatrists bear the professional burden of carefully evaluating motivation and recognizing the clinical reality that sometimes the motivation in especially challenging cases may not be fully determined. Copyright © 2017 John WileySons, Ltd.

Nachhaltig will heute fast jede Organisation sein. Dabei wird „Nachhaltigkeit“ oft als Leit- und Sinnbild für alles Mögliche genutzt, ohne den konkreten ökonomischen, ökologischen und sozialen Nutzen zu erfassen. Nachhaltigkeit wird auch nur selten nach strategischen oder operativen Leistungskriterien auf den Prüfstein gestellt und konsequent in diesem Sinne optimiert. Wer Nachhaltigkeitsmaßnahmen methodisch belastbar erfassen, beurteilen und verbessern möchte, findet hier den richtigen Werkzeugkasten - auch für externe Darstellungen, z.B. einer Entsprechenserklärung zum Deutschen Nachhaltigkeitskodex.

Symptom validity testing has become a prolific research field in neuropsychology. Its original and most powerful version is the forced-choice procedure that continues to play an important role because it allows for an experimental approach to test the hypothesis of intentional symptom distortion. When conducting forced-choice tests, below-chance response patterns are considered to be indicative of this type of distortion. In this article, we discuss the rationale behind the forced-choice technique and its historical development. We also present three case vignettes that illustrate the experimental background of forced-choice testing and how it may help to clarify diagnostic issues. The diagnostic considerations in these cases concerned (1) complete memory loss, (2) Ganser syndrome, and (3) dementia. Employing forced-choice methodology, intentional false symptom production could be demonstrated in all three patients. Thus, the cases demonstrate how, in the context of substantial external benefits, forced-choice testing may help to determine whether healthy individuals try to appear psychologically impaired.

In the context of criminal forensic evaluations, experts are often confronted with the problem of offenders' claims of crime-related amnesia. Because of the far-reaching legal consequences of the expert opinion, the nature of the suspected memory disorder has to be investigated with special care and due consideration of differential diagnoses. While the diagnosis of organic amnesia is comparatively easy to make, the same is not true for dissociative amnesia. Despite existing theoretical explanations such as stress, peritraumatic dissociation or repression, to date there is no sound, scientifically based and empirically supported explanation for the occurrence of genuine, non-organic crime-related amnesia. In the criminal context of claimed amnesia, secondary gain is usually obvious; thus, possible malingering of memory loss has to be carefully investigated by the forensic expert. To test this hypothesis, the expert has to resort to methods based on a high methodological level. The diagnosis of dissociative amnesia cannot be made by mere exclusion of evidence for organic amnesia; instead, malingering has to be ruled out on an explicit basis.

Claims of crime-related amnesia appear to be common. Using a mock crime approach, the diagnostic power of seven symptom validity instruments was investigated. Sixty participants were assigned to three conditions: responding honestly; feigning crime-related amnesia; feigning amnesia with a warning not to exaggerate. High sensitivity and specificity were obtained for the Structured Inventory of Malingered Symptomatology, the Amsterdam Short-Term Memory Test, and the Morel Emotional Numbing Test. Only three warned malingerers went undetected. The results demonstrate that validated instruments exist to support forensic decision making about crime-related amnesia. Yet, warning may undermine their effectiveness, even when using a multi-method approach.

Das Auftreten kognitiver Storungen ist fur eine Vielzahl von Krankheiten und psychischen Storungen dokumentiert worden, mit so bedeutsamen Auswirkungen auf das Funktionsniveau in Alltag und Berufsausubung, dass ihrer Untersuchung bei gutachtlichen Fragestellungen ein besonderer Stellenwert zukommt. Leistungstests sind die geeignete Methode zur Erfassung kognitiver Storungen, doch sind ihre Ergebnisse einfach zu verfalschen. Nur durch eine sorgfaltige und an den modernen Entwicklungen der jungeren Vergangenheit ausgerichtete Diagnostik der Beschwerdenvaliditat kann der Gutachter die Authentizitat der Testprofile und der in Leistungstests gezeigten Leistungseinschrankungen bestimmen. Wo eine solche Uberprufung unterbleibt, muss ein neuro- oder testpsychologisches Gutachten als unvollstandig bewertet werden.

Die Verwendung psychologischer Mess- und Testverfahren ist von fehlerhaften Annahmen zur Leistungsfahigkeit dieser Verfahren mitbestimmt. Aus der Auseinandersetzung mit einigen dieser Annahmen wird begrundet, dass Tests notwendig sind, um die Datenbasis fur die Beurteilung zu erweitern und die Messung psychischer Storungen und Funktionen gegen Fehler und Zufalle abzusichern. Fur verschiedene Ebenen der Funktions- und Partizipationsbeurteilung werden exemplarisch geeignete Testverfahren genannt. Die Interpretation von Mess- und Testwerten setzt regelmasig geeignete Validierungsmasnahmen voraus. Die Praxis, Testdiagnostik einer messmethodisch unsicheren, eher intuitiven Beurteilungspraxis unterzuordnen, wird kritisch beleuchtet.

The study aimed to provide independent data on the specificity of the Nonverbal Medical Symptom Validity Test (NV-MSVT; Green, 2008 ), a new test that combines conventional decision making based on cutoffs with profile analyses in order to identify invalid test performance and to reduce false positive classifications. The results of 65 bona fide neurological patients (with 21 of them meeting Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, DSM-IV, core criteria for dementia) were compared to 50 healthy volunteers. One patient was wrongly classified as malingering, resulting in a specificity of 98.5% for neurological patients and 100% for controls. A total of 13 patients with dementia (62%), 6 patients without dementia (14%), and 1 healthy participant exhibited a dementia profile in the NV-MSVT. While these results confirm the high specificity of the NV-MSVT for the classification insufficient effort, its sensitivity has to be verified by independent research data.

In independent medical examinations, unjustified claims of posttraumatic stress disorder (PTSD) are to be expected at an increased rate. In a prospective study, consecutive cases of patients claiming PTSD who underwent independent neuropsychiatric evaluation were analyzed. For 61 adult patients, results of three symptom validity tests (Morel Emotional Numbing Test, Structured Inventory of Malingered Symptomatology, and Word Memory Test) were available. Seventy percent of all claimants showed probable negative response bias in at least one of the three tests, 25% in all three tests. High probability of negative response bias was associated with symptom overreporting and demonstration of cognitive deficits in performance tests. The results indicate that high rates of uncooperativeness must be expected in civil forensic patients with claimed PTSD. A multi-method approach to the assessment of response distortion in PTSD claimants is indicated.

Zeichnungen von Fahrrädern werden seit langem in der neuropsychologischen Diagnostik eingesetzt. Lezak schlug ein formales System zu ihrer Bewertung vor. Anhand einer Stichprobe von 200 neurologischen Patienten werden Daten zur Reliabilität und Validität vorgestellt. Die Interrater-Übereinstimmung betrug 0,95; die Retestreliabilität wurde bei einem Intervall von einem bzw. drei Tagen auf 0.67 geschätzt. Männliche Patienten erreichten bessere Testwerte als weibliche, rechtshemisphärisch geschädigte Patienten höhere als linkshemisphärisch geschädigte; in der Gesamtstichprobe waren die Testwerte schwach mit dem Lebensalter und dem Bildungsniveau assoziiert. Substanzielle Korrelationen wurden mit anderen neuropsychologischen Testvariablen erhalten. Der BDT stellt ein kurzes, rasch und auch bettseitig einsetzbares Instrument für eine siebtestmäßige Erfassung visuo-konstruktiver Leistungen dar, das kognitive Störungen bei zerebral Geschädigten abzubilden in der Lage ist.

Symptom validity testing is a major topic in the field of neuropsychological research, but until now, few studies focus on effort testing in children. Three symptom validity tests (SVTs), the Medical Symptom Validity Test, the Test of Memory Malingering, and the Fifteen Item Test plus several standard neuropsychological tests were administered to 73 German-language school children from 6 to 11 years. Participants were either instructed to give full effort or to follow a malingering scenario. It could be demonstrated that, except for one child, all participants with a basic reading level of grade 2 were able to pass all administered SVTs according to established cutoffs for poor effort (i.e., earned a score higher than the cutoff). For the experimental malingerers, however, it was fairly difficult to act according to the scenario throughout the session. While they scored worse in the neuropsychological tests, all but one of them failed at least one SVT. The results support the use of SVTs in childhood age. More elaborate experimental designs and studies with bona-fide patients and suspected malingerers are needed in order to evaluate both the appropriateness of available effort tests and the capabilities of children to fake poor performance.

Bei der Diagnostik von Gedächtnisleistungen im Rahmen neurologischer Erkrankungen ist auch eine Untersuchung des semantischen Gedächtnisses von Bedeutung. Das Semantische Altgedächtnisinventar von Schmidtke und Vollmer-Schmolck (1999 ) stellt einen Versuch zur standardisierten Erfassung von Störungen auf diesem Gebiet dar. Es wurde eine retrospektive Datenanalyse von 300 Testprotokollen neurologischer Patienten einer Akutklinik vorgenommen, um Daten zur Reliabilität und Validität des Verfahrens zu erhalten, die bislang in der Literatur nur in geringem Umfang vorzufinden sind. Zusätzlich waren zahlreiche andere Testdaten verfügbar. 59 % der Analysestichprobe erreichten Testwerte unterhalb des vorgeschlagenen Trennwertes. Die interne Konsistenz des Instruments ist zufrieden stellend, wenngleich auf Itemebene Revisionsbedarf sichtbar wurde. In einer Hauptachsenanalyse mit schiefwinkliger Rotation wurde eine Drei-Faktoren-Lösung erhalten, die ein Konstrukt semantisches Altgedächtnis nicht unterstützt. Ein erster varianzstarker Faktor, der 49 % der Varianz aufklärt, wurde als «globale» oder «nicht-verbale kognitive Fähigkeiten» interpretiert. Der zweite Faktor lud am höchsten auf Variablen des Sprachgedächtnisses und der Kategorienflüssigkeit, während der dritte Faktor allgemein verbales Gedächtnis abbildete und auch das Zahlennachsprechen vorwärts und rückwärts einschloss. Obwohl das Instrument als ein wichtiger Versuch zur standardisierten Erfassung semantischen Altgedächtnisses anzusehen ist, sind Anstrengungen zur Verfeinerung psychodiagnostischer Verfahren zur Konstrukterfassung notwendig, die ihrerseits positiv auf weitere konzeptionelle Fortschritte rückwirken können.

Objective: This study used the Medical Symptom Validity Test (MSVT) to examine exaggeration of memory impairment in disability claimants. Methods: The MSVT was administered to patients with soft tissue injuries undergoing an independent medical examination (IME). Their results were compared with those from groups of volunteers who were either trying their best on the test or simulating memory impairment. Results: Non-French-speaking volunteers, who were tested in French, showed near perfect performance on the effort subtests, but 42% of IME patients failed the effort tests in English. Their overall results were very similar to those of simulators. Conclusion: This study suggests that exaggeration of cognitive symptoms is widespread in disability-related evaluations. It would be unwise to accept self-reported memory complaints at face value. Criteria-normed symptom validity testing should be done to rule out symptom exaggeration.

Coaching is a topic of utmost importance for forensic neuropsychological assessment, and symptom validity tests (SVTs) should be resistant against it. Four groups of experimental malingerers (n = 15, each) were given scenarios to feign cognitive symptoms after traumatic brain injury. Group A obtained a basic scenario. For Group B, symptom information was added. Group C received an explicit warning against exaggerating symptom presentation. Group D obtained a specific coaching which contained an introduction into principles of effort measurement. All groups were given a short neuropsychological battery including three SVTs: the Amsterdam Short-Term Memory Test (ASTM), the Medical Symptom Validity Test (MSVT), and the Word Completion Memory Test (WCMT). While a general trend for gradually better results in SVTs from Group A to Group D was observed, only in Group D were pass rates elevated for the MSVT and the WCMT. Not a single participant passed the ASTM test. Coaching appears to be more effective...

Zusammenfassung: Beschwerdenvalidierungstests (BVT) dienen zur Überprüfung der Gültigkeit erhaltener Testprofile. Im Rahmen eines Analogdesigns wurden drei BVT (Medical Symptom Validity Test MSVT, Amsterdamer Kurzzeitgedächtnistest AKGT, One-in-Five Test) sowie eine Reihe von Beschwerdenvaliditätsindikatoren anderer Tests auf ihre Güte überprüft. 24 jüngere Erwachsene mit dem Mindestbildungsabschluss Abitur zeigten in der Untersuchung entweder ihre volle Leistung oder waren instruiert, entsprechend einem detaillierten Szenario überzeugend kognitive Störungen vorzutäuschen. Neben den drei BVT wurden folgende neuropsychologische Tests durchgeführt: der Trail Making Test (TMT), der Rey Complex Figure Test and Recognition Trial (RCFT), der Test d2, der Judgment of Line Orientation Test (JLO) und das Zahlennachsprechen des HAWIE-R, woraus auch die Reliable Digit Span (RDS) bestimmt wurde. Für den MSVT, den AKGT und die RDS konnten durch Testwiederholung nach zwei bis drei Tagen bzw. Einsatz einer Äquivalenzform des MSVT Reliabilitätsangaben erhalten werden. Für den AKGT und den MSVT-Durchgang Verzögerte Wiedererkennung ergaben sich zufrieden stellende Reliabilitätskoeffizienten (mit Phi-Koeffizienten von je 0.92), die für die RDS niedriger ausfielen (0.74). Die Ergebnisse zeigen auch eine gute Klassifikationsgüte für die BVT und die RDS, die zwischen 100 % (AKGT) und 79 % (One-in-Five Test) lag. Andere Validitätsindikatoren, die aus TMT, d2 und JLO ermittelt werden, schnitten schlechter ab. Während BVT gegenwärtig die best entwickelte Methodenklasse zur Diagnostik suboptimalen Leistungsverhaltens darstellen, sollte die Güte von Beschwerdenvaliditätsindikatoren, die aus Standardtests abgeleitet werden, deutlich besser überprüft werden, bevor ihr Einsatz in der Einzelfalldiagnostik in Frage kommt.

Zusammenfassung: Ohne eine Untersuchung der Leistungsmotivation sind neuropsychologische Testergebnisse in einem nicht zu kalkulierenden Maß verzerrt. Die Untersuchung von suboptimalem Leistungsverhalten ist im Rahmen neuropsychologischer Begutachtungen von besonderer Bedeutung. Der Artikel gibt einen umfassenden Überblick zu allen wichtigen Fragen der Diagnostik negativer Antwortverzerrungen bei der Bearbeitung gutachterlicher Fragen. Dazu werden auch international bewährte Symptomvalidierungsverfahren vorgestellt. Besonderes Augenmerk wird auf die Verantwortung des Gutachters gelegt, seinerseits die Voraussetzungen dafür zu schaffen, eine valide Diagnostik zu ermöglichen, gleichzeitig aber zielsicher zu bestimmen, wo dies nicht gelingt. Durch einen verbreiteten Einsatz von ausreichend sensitiven Symptomvalidierungstests können Qualitätsstandards neuropsychologischer Gutachten verbessert werden.

Zusammenfassung: In der neuropsychologischen Diagnostik, mehr noch aber in der Begutachtung gewinnen Symptomvalidierungstests (SVT) zur Untersuchung der Leistungsmotivation zunehmend an Bedeutung. In einer Analogstudie wurde die Güte zweier international bekannter Verfahren (Word Memory Test; Amsterdam Short Term Memory Test) sowie einer Neuentwicklung (Word Completion Memory Test) untersucht. Zusätzlich wurden Leistungstests eingesetzt: der Trail Making Test (TMT), der Complex Figure Test sowie die Standard Progressive Matrices (SPM). Eine Gruppe von 10 experimentellen Simulanten wurde spezifisch auf die Vortäuschung von Gedächtnisstörungen vorbereitet, während eine Kontrollgruppe (n = 10) optimale Testanstrengung zeigen sollte. Alle SVT führten im Gegensatz zu den Simulationsmarkern des TMT und der SPM zu einer ausgezeichneten Klassifikationsgüte (95-100 %). Die neuropsychologischen Leistungsmaße wiesen zwar signifikante Gruppenunterschiede aus, zeigten aber auch eine nicht unbedeutende Überlappung der Verteilungen. Mehr Studien sind notwendig, um den SVT in den deutschsprachigen Ländern den Platz zu sichern, den sie international aktuell in der klinisch-neuropsychologischen Forschung und Praxis einnehmen.

Zusammenfassung: Testprotokolle einer auf der Basis empirischer Analysen entwickelten Kurzform des Hooper Visual Organization Test (VOT) lagen für 292 neurologische Patienten einer Akutklinik vor. Es wurden die neuropsychologischen Untersuchungsergebnisse von jenen 200 Patienten ausgewählt, die vollständige Datensätze in einer Minimalbatterie aufwiesen, sodass eine Hauptachsenanalyse mit schiefwinkliger Rotation durchgeführt werden konnte. Der VOT lädt ebenso wie der Mosaik-Test des HAWIE-R, der Trail Making Test (TMT), die Alertness-Reaktion sowie unspezifische Screening-Instrumente auf einem varianzstarken Faktor, der als “globale” oder “nicht-sprachliche kognitive Fähigkeiten” interpretiert wurde. Zwei weitere Faktoren lassen sich als “verbales Gedächtnis” und “Arbeitsgedächtnis/Gedächtnisspanne” benennen. Die höchsten Rangkorrelationen weist die Kurzform mit dem TMT-B sowie mit dem Mosaik-Test des HAWIE-R auf (jeweils 0.68). Die 7-Tage-Retest-Reliabilität wurde anhand einer Teilstichprobe von 36 Patienten auf 0.93 geschätzt, bei einem Anstieg der Testwerte von der Erst- zur Zweitmessung um 1.1 Punkte. Bei einem Vergleich von Patienten mit lateralisierten zerebralen Läsionen wurde ein signifikant niedrigerer Wert für die Patienten mit rechts- gegenüber denen mit linkshemisphärischer Beeinträchtigung gefunden. Insgesamt korrespondieren diese Ergebnisse gut mit denen, die in der Literatur für die Originalform des VOT dokumentiert sind.

Use of the Word Association Technique for Memory Assessment in Older Patients Summary: A free single-word association test (WAT) was performed with 82 older neurological patients (age range: 60 to 85 years), as part of a comprehensive neuropsychological assessment. A list of 25 items was read to the patients twice. First, free associations were obtained and then, response consistency checked immediately. The number of correct repetitions was demonstrated to correlate substantially with other indicators of verbal memory (up to 0.77), such as Wechsler's Logical Memory, Wechsler's Verbal Paired Associates, and verbal learning scores in a selective reminding procedure, but also with rough estimates of cognitive dysfunction such as the Mini-Mental State score (0.59). Total free association response time yielded similarly high correlations with neuropsychological measures, but this was not the case for traditional WAT variables, such as response commonality. The older patients showed a tendency towards preferring paradigmatic associates, such as superordinate, coordinate or synonym responses, in contrast to syntagmatic reactions.

Seit okonomische, okologische und soziale Herausforderungen und Fehlentwicklungen auf nationaler und internationaler Ebene mit Gesetzen, Strategien und Masnahmenplanen zur nachhaltigen Entwicklung beantwortet und alle gesellschaftlichen Akteure in die Verantwortung genommen werden sollen, stellt sich fur Unternehmen zunehmend die Frage, wie sie diese Herausforderungen vor dem Hintergrund sich wandelnder gesellschaftlicher Realitaten in ihr Handeln integrieren und ausbalancieren sollen. Unternehmen muss es gelingen, Themen einer zukunftsfahigen Organisationsentwicklung mit den Systemzusammenhangen eines umfassenden Nachhaltigkeitsverstandnisses in Einklang zu bringen. Die zunehmende Bedeutung der Nachhaltigkeitskommunikation auf nationaler und internationaler Ebene und das grose Interesse an CSR- und Nachhaltigkeitsmanagement in Unternehmen zeigen, dass langfristiges okonomisches Denken und Handeln, okologisch vertragliches Wirtschaften, soziale Verantwortung im eigenen Unternehmen und in der Lieferkette und die Orientierung an Stakeholderbedurfnissen immer wichtiger werden.

Zusammenfassung: Vor dem Hintergrund von Eysencks (1995a) Kreativitätstheorie wurde eine Reihe von Kreativitätsmaßen in einer Stichprobe von 40 künstlerisch Tätigen (17 Schriftsteller, 23 Schauspieler) untersucht. Neben einem erweiterten Wortassoziationsversuch und dem Eysenck Personality Questionnaire wurden die folgenden Methoden angewandt: 2 Untertests des VKT (Vierwortsätze und Utopische Situationen), mit einem zusätzlichen qualitativen Rating der erzeugten Vierwortsätze, zwei eigene produzierte Geschichten (geschrieben und erzählt), die Standard Progressive Matrices (SPM), der Trail Making Test und der Mehrfachwahl-Wortschatz-Test. In einer ersten Analyse (Merten & Fischer, 1999) konnte bestätigt werden, dass Kreative höhere Werte auf Eysencks Psychotizismus-Dimension erreichten und ungewöhnliche Antworten im Assoziationstest abgaben. In der weiterführenden Datenanalyse wurden aber allgemein niedrige Korrelationen zwischen einzelnen Kreativitätsmaßen ermittelt. Während Kreativitätsratings der produzierten Geschichten und qualitative Ratings der Vierwortsätze trotz aufwändigen Ratertrainings keine befriedigenden Ergebnisse erbrachten, korrelierte die bloße Wortanzahl einer geschriebenen Geschichte mit 0.69 bzw. 0.55 mit den traditionellen Produktivitätsmaßen, wie sie mit dem VKT erfasst werden. Alle drei Mengenmaße korrelieren aber auch mit einem konvergenten Intelligenzmaß (SPM). Durch die Ergebnisse wird die Sackgasse illustriert, in die die Kreativitätsforschung trotz ihrer großen sozialen und bildungspolitischen Bedeutung geraten ist, indem sie sich vorwiegend auf gut quantifizier- und testbare Produktivitätsmaße beschränkt.