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Self-inflicted dermatoses (SID) are not uncommon in dermatological practice. They can be classified into those associated with hidden or denied underlying behavior and those without hidden or denied underlying behavior. Malingering and factitious disorders are the most common of the first subgroup. Skin picking and related syndromes of compulsive and non-compulsive behavior belong to the second subgroup. Treatment is interdisciplinary, but sometimes frustrating. [ABSTRACT FROM AUTHOR]

Despite poor treatment results, a family-oriented approach and the securing of residency have been deemed essential to recovery from resignation syndrome (RS). In a retrospective cohort study, we evaluated an alternative method involving environmental therapy, with patients separated from their parents, while actively abstaining from involving the asylum process in treatment. We examined medical records, social services acts, and residential care home acts from 13 individuals treated at Solsidan residential care home between 2005 and 2020. Severity and outcome were assessed with Clinical Global Impression, Severity and Improvement subscales. Thirteen participants were included and out of these nine (69%) recovered, i.e. they very much or much improved. Out of the eight that were separated, all recovered, also, one non-separated recovered. The difference in outcome between subjects separated and not was significant (p = 0.007). Moreover, out of the five which received a residency permit during treatment, one recovered whereas four did not. The difference in outcome between subjects granted residency and not was significant (p = 0.007). The data revealed three (23%) cases of simulation where parents were suspected to have instigated symptoms. Our evaluation suggests that separation from parents and abstaining from invoking residency permit could be essential components when treating RS. Relying on a family-oriented approach, and residency could even be detrimental to recovery. The examined intervention was successful also in cases of probable malingering by proxy. [ABSTRACT FROM AUTHOR]

Common antisemitic visual representations are rooted in Ancient Christianity and the Middle Ages, but we have also witnessed new developments after the Holocaust and the condemnation of fascism. Stereotyping and dehumanization through zoomorphism, demonization, exaggeration of certain physical features anchored in the false presumptions of physiognomy and other visual devices have been weaponized across the centuries for racist and antisemitic agendas. This study undergoes a comparative analysis of two corpuses of antisemitic images from the Romanian press and social media at a distance of one century between them. I analyze the persistency, transformations, and new developments of anti - semitic image codes popularized by the Romanian far-right from the start of the 20th century, through to the rise of fascism and the Second World War, up to the present-day social media. This visual qualitative analysis with critical historical insights is carried out on the following corpuses: a) a contemporary subset of 81 memes, digital stickers, and other visuals from 17 Romanian far-right Telegram channels and groups posted over the course of one year (August 2022 - August 2023); and b) 70 archival political cartoons published by 17 far-right ultranationalist newspapers (and one pro-Soviet communist newspaper) between 1911 and 1948. Findings show how persistent certain antisemitic stereotypes have proven across time and different cultural spaces - the hook-nose, zoomorphism, the blood-libel accusations, Judeo-Bolshevism, the satanic representations - and how the visual dimension serves to efficiently implant antisemitic narratives in the collective mind. These (visual) narratives are skillfully recontextualized to fit new (geo-)political realities - the post-Holocaust times, the COVID-19 crisis, the war in Ukraine. [ABSTRACT FROM AUTHOR]

The accuracy of performance validity tests (PVTs) with culturally diverse populations has increasingly been questioned. High false positive rates have been found in some PVTs in culturally and linguistically diverse individuals within the U.S. and internationally. No study to date has investigated the accuracy of PVTs with Chinese-speaking immigrants (CSI) in the U.S. The current study aimed to evaluate two PVTs, the Test of Memory Malingering (TOMM) and Dot Counting Test (DCT), to determine their accuracy in a community sample of CSI with limited English proficiency. These two measures were used in a simulation design, contrasting 52 participants who were instructed to respond honestly to 22 participants instructed to feign incompetency to stand trial. Results demonstrated the scores of TOMM Trial 1 and Trial 2 were effective in classifying honest responders from simulators, whereas the DCT E-score did not differentiate the groups better than chance. However, false positive rates for the TOMM Trial 1, Trial 2, and the DCT E-score were relatively low. Only one honest responder (1.9%) was classified as exerting insufficient effort in TOMM Trial 1 and DCT E-score, and the TOMM Trial 2 did not misclassify any honest responders. Implications and cautionary statements are provided and discussed. [ABSTRACT FROM AUTHOR]

Purpose: Response style evaluation is a fundamental component of forensic examinations. This retrospective study aims to evaluate how measures of feigning performed with individuals with intellectual disabilities (ID) who were undergoing competency to proceed to trial evaluations. Design/methodology/approach: Using a known-groups design (ID vs non-ID) with 145 individuals, 37 individuals met diagnostic criteria for ID. The individuals were administered the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), the Inventory Legal Knowledge (ILK; Musick and Otto, 2010), the Evaluation Competency to Stand Trial-Revised, atypical presentation scale (ATP; Rogers et al., 2004b) and the Competence Assessment for Standing Trial-Mental Retardation (Everington and Luckasson, 1992). Findings: The total ILK demonstrated differences between groups with a large effect size (Cohen's d = 1.02). Six items on the ILK had over a 30% difference as a function of group. However, two revised scales from the ILK, the R-ILK-90 and the R-ILK-95 (Rogers et al., 2017), did not demonstrate differences as a function of group membership with small effect sizes (Cohen's ds = 0.02 and 0.29). The M-FAST total score and ATP scales were not different between groups, although results demonstrated that individuals with ID would be potentially more at risk to for misclassification as feigning on the M-FAST. Research limitations/implications: This study has several limitations. It is a retrospective study with a relatively small sample size so additional research is needed to substantiate the results. However, this study highlights the potential for individuals with intellectual disabilities to be disadvantaged when undergoing competency to stand trial evaluations. Practical implications: This manuscript shows that individuals with ID are at-risk for being mislabeled as feigning when employing standard measures of response style testing if appropriate cautions are not used. However, revised measures that take into account baseline information of legal knowledge offer a way forward that may prevent false positives with individuals with ID. Social implications: The mislabeling of individuals with ID could lead to significant problems, including harsh sentences and unnecessary incarcerations. This manuscript provides real-world data and encourages clinicians to be mindful when evaluation individuals with ID for court-ordered evaluations. Originality/value: This manuscript is critical, as it shows that caution is needed when using instruments of feigning with individuals with ID who are undergoing competency evaluations. This has value for clinicians who are tasked with completing these evaluations for the courts. [ABSTRACT FROM AUTHOR]

Abstract Background In general clinical psychiatric practice, open questions are favored over closed ones because they are considered more therapeutically effective and less likely to make the patients pander to us. However, in forensic psychiatric examinations, suspects may attempt malingering. Case Presentation Using a simple examination based on a forced‐choice technique, the author proved that the level of intelligence of a theft suspect pretending to have an intellectual developmental disorder was not so low. The author prepared two sets consisting of a few coins each and asked the suspect to choose which set had a higher total value. The suspect was questioned repeatedly over multiple trials. He always selected the wrong set over the course of more than 10 trials. Conclusion If the suspect really did not know the correct answer, the probability of getting the answer right or wrong in a binary choice question is 50% for both. The probability of answering the question wrong by chance 10 times in a row is (1/2),10 in other words, about 0.1%. It was evident that the suspect intentionally kept answering incorrectly. When suspects who pretend to have an intellectual developmental disorder answer only “I do not know” to all questions without actively playing out the symptoms, it is difficult to demonstrate that the symptoms are psychiatrically conflicting and prove that they are malingering. Even in such cases, this type of test based on a forced‐choice technique can be used to prove that suspects are behaving falsely.

IntroductionThe false consensus effect consists of an overestimation of how common a subject opinion is among other people. This research demonstrates that individual endorsement of questions may be predicted by estimating peers’ responses to the same question. Moreover, we aim to demonstrate how this prediction can be used to reconstruct the individual’s response to a single item as well as the overall response to all of the items, making the technique suitable and effective for malingering detection.MethodWe have validated the procedure of reconstructing individual responses from peers’ estimation in two separate studies, one addressing anxiety-related questions and the other to the Dark Triad. The questionnaires, adapted to our scopes, were submitted to the groups of participants for a total of 187 subjects across both studies. Machine learning models were used to estimate the results.ResultsAccording to the results, individual responses to a single question requiring a “yes” or “no” response are predicted with 70–80% accuracy. The overall participant-predicted score on all questions (total test score) is predicted with a correlation of 0.7–0.77 with actual results.DiscussionThe application of the false consensus effect format is a promising procedure for reconstructing truthful responses in forensic settings when the respondent is highly likely to alter his true (genuine) response and true responses to the tests are missing.

Epithelial lesions that mimic infectious disease, a reactive lesion, or a neoplastic entity are frequently encountered by dentists, especially specialists in Oral Medicine and Radiology. Improper or incomplete history can complicate clinical differentials even further, leading dentists to prescribe medications that are frequently unnecessary. The histological diagnosis obtained after a biopsy is usually conclusive when representative tissue is incised and sent for diagnosis. This case report presents an intriguing case of a patient with papillary growth along the midline of the palate that was histologically diagnosed as epithelial hyperplasia, which describes the nature of the lesion but masks the clinical symptoms of the underlying inflammatory papillary hyperplasia. [ABSTRACT FROM AUTHOR]

Background: A major problem with the University of Pennsylvania Smell Identification Test (UPSIT) is its poor sensitivity for malingering detection in a group of people familiar with the test mechanism. This study aimed to evaluate the modification of UPSIT to detect anosmia malingering. Methods: This was a pilot experimental study conducted in 2019 in Tehran. The participants were 60 healthy subjects classified into two groups of 30 people. The first group was requested to deliberately feign a negative result on the Iranian version of UPSIT, Iran Smell Identification Test (ISIT) (malingering group). The second group consisted of participants, who did not scratch the odorant part of ISIT during the tests (anosmia group). ISIT was modified in two steps. At each step, one incorrect option was deleted from the available choices. The number of each group’s answers, altered away from the correct choice, was then calculated and compared. Results: The coached malingering group participants were able to feign anosmia in the original ISIT exam. In the modified ISIT, the number of answers changed from correct to wrong during the second stage (from three available choices to two choices) was significantly higher in the anosmia group (P

Abstract Few studies of measures or techniques designed to detect feigning of Attention-Deficit/Hyperactivity Disorder (ADHD) have included groups reporting symptoms of depression and anxiety. Based on the high rate of comorbidity between ADHD and mood disorders, inclusion of such groups is important to mimic clinical referral patterns. The current study evaluated the validity of the ADHD Symptom Infrequency Scale (ASIS), a measure designed to detect malingered symptoms of ADHD, in a four-known groups design that included a group consisting of subjects with symptoms of anxiety and depression. Four groups were included in the current study: (1) control, (2) simulator, (3) ADHD diagnosed, (4) individuals with elevated symptoms of depression/anxiety. The ASIS Infrequency scale showed strong internal consistency (α = .83). Discriminant validity for the Infrequency Scale was established through a low correlation between the ASIS scale assessing feigning and a measure of anxiety and depression (r = −.02). Sensitivity was high for detection of simulation (.71), while specificity was high across comparisons, ranging from .86 to .99. Results support the ASIS as a reliable and valid measure of ADHD that is sensitive to feigning, even when including a sample of individuals reporting symptoms of depression and anxiety. [ABSTRACT FROM AUTHOR]

Objective: This article investigates the accuracy of individual and combined indicators based on different strategies for detecting noncredible performance as part of a new test for the continuous assessment of short-term memory. Method: In two independent studies, we assessed three groups of simulators, cognitively impaired patients, and nonimpaired community members with four tasks separated by a distractor. Results: Pairwise comparisons between receiver operating characteristic (ROC) curves revealed significant differences between two clusters of indicators: mean recognition, inconsistent responses in recognition, and false positives (area under the ROC curves >.800) proved more accurate than delayed recall and false negatives (area under the ROC curves <.800) in discriminating simulators from patients. Likewise, both studies revealed that adding the false positives indicator based on cued recall to mean recognition incrementally improved classification accuracy (including sensitivity, positive predictive value, and negative predictive value) compared with the recognition indicator alone. Conclusions: Our results support the association of two distinct indicators for the assessment of noncredible performance, of which one should be a forced-choice indicator. [ABSTRACT FROM AUTHOR]

On behalf of the editorial team, I would like to thank wholeheartedly all the reviewers who participated in the peer-review process of I Ultrasound in Obstetrics & Gynecology i (UOG) in 2022. This year, UOG achieved its highest ever Impact Factor of 8.678, ranking 4 SP th sp in the category of obstetrics and gynecology. [Extracted from the article]

This article examines the Federal Constitution of Malaysia through the lens of Hans Kelsen's Pure Theory of Law. It first demonstrates the utility of the Grundnorm in explaining the supremacy of the Federal Constitution within the Malaysian legal system. In particular, this article establishes that despite Malaysia's colonial past, the Federal Constitution is the Kelsenian 'historically first constitution' of the present Malaysian legal system because of the Kelsenian 'revolution' that had occurred when the Federation of Malaya attained independence from the British in 1957, as well as the absence of a Kelsenian 'revolution' during the formation of Malaysia in 1963. The Grundnorm of the Malaysian legal system can thus be expressed as 'one ought to obey the prescriptions of the Federal Constitution'. However, this article also argues, using the example of the basic structure doctrine controversy in Malaysia, that while the Pure Theory succeeds in elucidating a measure of legal validity for legal norms, it fails to provide any helpful insight when a constitutional dispute relates to the content of a norm rather than the interaction between hierarchically distinct norms. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to validate the utility of previously established validity indicators derived from MOXO-d-CPT's continuous performance test. Method: Healthy simulators feigned impairment after searching online for relevant information, an ecologically valid coaching condition (n = 39). They were compared to ADHD patients (n = 36) and healthy controls (n = 38). Results: Simulators performed significantly worse than ADHD patients in all MOXO-d-CPT indices, as well as a scale that integrates their contributions (feigned ADHD scale). Three indices (attention, hyperactivity, and impulsivity) and the latter scale exhibited adequate discriminative capacity. Higher education was associated with an exaggerated impairment among simulators, easing their detection. Conclusion: Similarity between the current study and a previous study which examned the utlity of the MOXO-d-CPT validity indicators, increases our confidence in the efficacy of the latters embedded validity indicators. Though the findings provide initial validation of these validity indicators, generalizing beyond highly functioning participants necessitates further research. [ABSTRACT FROM AUTHOR]

The Trauma Symptom Inventory-Second Edition (TSI-2) is garnering research interest as a symptom validity test in the evaluation of trauma-related disorders. However, there has been limited empirical validation of its validity scales in clinical and forensic real-world settings. This study evaluated the ability of the TSI-2 Atypical Response (ATR) scale to discriminate response bias in cognitive performance and symptom reporting in a large sample of disability and compensation-seeking claimants. This retrospective chart review included 296 adults with a known history of trauma exposure or claimed trauma-related psychological injury who underwent neuropsychological and/or comprehensive psychological assessment in a private neuropsychology clinic. The discriminability of the ATR scale to classify credible versus non-credible cognitive profiles and symptom reporting were analyzed by AUC-ROCs. Overall, the ATR scale demonstrated poor discriminability of assessment validity based on the Word Memory Test, Victoria Symptom Validity Test, and Minnesota Multiphasic Personality Inventory-2-Restructured Form. The ATR scale had fair discriminatory ability of only one of the over-reporting scales (F-r), with an ROC area of .73, p = .001. However, the test publisher's proposed ATR cut-offs of ≥8 for screening, research, and normal groups, and ≥15 in forensic and clinical settings revealed significant issues with sensitivity and specificity. These results suggest that the TSI-2 should be paired with other established performance validity and symptom validity tests in clinical assessments and not be used as the primary or sole indicator of assessment validity. [ABSTRACT FROM AUTHOR]

The current study examined characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a sample of 110 patients at an adult neuropsychology clinic. Subjects with especially high or low suspicion of invalid reporting were identified based on clinician-completed questions. SIMS elevation rates were examined at different cutoffs and between these groups and were correlated with other indicators of validity. High rates of SIMS elevations were found at the standard cutoff (>14) for the total sample (45.5%), low suspicion cases (24.4%), and high suspicion cases (95.7%). Other indicators of invalidity were low (secondary gain = 8.5%, clinical suspicion of exaggeration in interview M = 2.37/5, medical records concerning for invalidity = 2.4%, mixed/poor performance validity = 6.1%). Elevations correlated with clinician concern for over-reporting in interview, subject-reported cognitive concern (r = −.610) and psychological measures (BDI-II r = −.602, PROMIS r = −.409) but not with neuropsychological memory tests or performance validity measures (all p >.23). The SIMS should be interpreted with caution, as elevations appeared largely related to cognitive concern and psychiatric distress rather than true malingering. A cutoff of > 16 could be used in neuropsychological populations, although this is still of modest specificity. [ABSTRACT FROM AUTHOR]

Adolescence is a difficult time, both physically and emotionally. Rapid growth coupled with physical changes in the background of high levels of activity can be overwhelming. Meanwhile, unfamiliar life stressors coupled with undeveloped compensatory mechanisms can lead to overwhelming anxiety and emotional distress. Emotional factors can make injuries and overuse syndromes feel more catastrophic. Occasionally, an adolescent's emotional distress can manifest physically, without antecedent injury or physiologic cause. Understanding the psychological milieu is as important as understanding the disease processes that can affect adolescents if one hopes to manage these patients effectively. [ABSTRACT FROM AUTHOR]

It is common for visitors to have rich and varied experiences in the limited space of a classical Chinese garden. This leads to the sense that the garden's scale is much larger than it really is. A main reason for this perceptual bias is the gardener's manipulation of visual information. Most studies have discussed this phenomenon in terms of qualitative description with fragmented perspectives taken from static points, without considering ambient visual information or continuously changing observation points. A general question arises, then, on why depth perception can vary from one observation point to another along a garden path. To better understand the spatial experience in classical Chinese gardens, this study focused on variations in perceived depth among different observation points and aimed to identify influential visual information through psychophysical experimentation. As stimuli for the experiment, panoramic photos of Liu garden were taken from three positions at Lvyin Pavilion. Considering the effects of pictorial visual cues on depth perception, the photos were processed to create 18 kinds of stimuli (six image treatments * three positions). Two tasks were presented to the participants. In Task 1, 71 participants were asked to rate the depth value of the garden using the magnitude estimation method in a cave automatic virtual environment (CAVE). Statistical analysis of Task 1 revealed that depth values differed significantly among different viewpoints. In Task 2, participants were asked to compare 18 stimuli and 3D images presented on three connected monitors and to judge the depth of the garden using the adjustment method. The results of Task 2 again showed that depth values differed significantly among different viewpoints. In both tasks, ambient information (i.e., the perspective of interior space) significantly influenced depth perception. [ABSTRACT FROM AUTHOR]

Abstract Background Method Results Conclusion The availability of information regarding neuropsychological tests threatens their confidentiality. This concern may be particularly relevant to Attention-Deficit/Hyperactivity Disorder (ADHD) considering its widespread online coverage. The present study explored simulators’ online search strategies.Simulators (n = 39) searched for information before undergoing an evaluation which included performing a continuous performance test (CPT). Their search strategies were analyzed, and their performance was compared to that of ADHD patients (n = 36) and healthy controls (n = 38).Most simulators reached high-risk websites that provided written and video-based information regarding the test. Sixty percent, comprised mostly of 3rd-year students, reached Google Scholar. These students were also easier to detect as simulators. Common strategies included performing the CPT in accordance with typical ADHD symptoms and avoiding the endorsement of both unusual and stereotypical symptoms.Simulators can access online information that contains key test data. Higher education may increase the ability to reach academic research while decreasing the ability to convincingly feign impairment. While additional research is needed to examine coaching effects on neuropsychological testing, the risk to test security that many websites pose should be acknowledged and steps, including ones taken by test publishers, should be undertaken to minimize it. [ABSTRACT FROM AUTHOR]

Objective: Performance validity assessment is an important component of concussion baseline testing and Immediate Post-Concussion and Cognitive Testing (ImPACT) is the most commonly used test in this setting. A review of invalid performance on ImPACT was published in 2017, focusing largely on the default embedded validity indicator (Default EVI) provided within the test. There has since been a proliferation in research evaluating the classification accuracy of the Default EVI against independently developed, alternative ImPACT-based EVIs, necessitating an updated review. The purpose of this study was to provide an up-to-date review of the prevalence of invalid performance on ImPACT and to examine the relative effectiveness of ImPACT-based EVIs. Method: Literature related to the prevalence of invalid performance on ImPACT and the effectiveness of ImPACT-based EVIs, published between January 2000 and May 2020, was critically reviewed. Results: A total of 23 studies reported prevalence of invalid performance at baseline testing using ImPACT. Six percent of baseline assessments were found to be invalid by the ImPACT's Default EVI, and between 22.31% and 34.99% were flagged by alternative EVIs. Six studies assessed the effectiveness of ImPACT-based EVIs, with the Default EVI correctly identifying experimental malingerers only 60% of the time. Alternative ImPACT-based EVIs identified between 73% and 100% of experimental malingerers. Conclusions: The ImPACT's Default EVI is not sufficiently sensitive, and clinicians should consider alternative indicators when assessing invalid performance. Accordingly, the base rate of invalid performance in athletes at baseline testing is likely well above the 6% previously reported. [ABSTRACT FROM AUTHOR]

Objective: The addition of Sequencing to WAIS-IV Digit Span (DS) brought about new Reliable Digit Span (RDS) indices and an Age-Corrected Scaled Score that includes Sequencing trials. Reports have indicated that these new performance validity tests (PVTs) are superior to the traditional RDS; however, comparisons in the context of known neurocognitive impairment are sparse. This study compared DS-derived PVT classification accuracies in a design that included adults with verified TBI. Methods: Participants included 64 adults with moderate-to-severe TBI (TBI), 51 healthy adults coached to simulate TBI (SIM), and 78 healthy comparisons (HC). Participants completed the WAIS-IV DS subtest in the context of a larger test battery. Results: Kruskal–Wallis tests indicated that all DS indices differed significantly across groups. Post hoc contrasts revealed that only RDS Forward and the traditional RDS differed significantly between SIM and TBI. ROC analyses indicated that RDS variables were comparable predictors of SIM vs. HC; however, the traditional RDS showed the highest sensitivity when approximating 90% specificity for SIM vs. TBI. A greater percentage of TBI scored RDS Sequencing < 1 compared to SIM and HC. Conclusion: In the context of moderate-to-severe TBI, the DS-derived PVTs showed comparable discriminability. However, the Greiffenstein et al. traditional RDS demonstrated the best classification accuracy with respect to specificity/sensitivity balance. This relative superiority may reflect that individuals with verified TBI are more likely to perseverate on prior instructions during DS Sequencing. Findings highlight the importance of including individuals with verified TBI when evaluating and developing PVTs. [ABSTRACT FROM AUTHOR]

Objective The Test of Memory Malingering (TOMM) Trial 1 (T1) and errors on the first 10 items of T1 (T1-e10) were developed as briefer versions of the TOMM to minimize evaluation time and burden, although the effect of genuine memory impairment on these indices is not well established. This study examined whether increasing material-specific verbal and visual memory impairment affected T1 and T1-e10 performance and accuracy for detecting invalidity. Method: Data from 155 neuropsychiatric patients administered the TOMM, Rey Auditory Verbal Learning Test (RAVLT), and Brief Visuospatial Memory Test-Revised (BVMT-R) during outpatient evaluation were examined. Valid (N = 125) and invalid (N = 30) groups were established by four independent criterion performance validity tests. Verbal/visual memory impairment was classified as ≥37 T (normal memory); 30 T-36T (mild impairment); and ≤29 T (severe impairment). Results: Overall, T1 had outstanding accuracy, with 77% sensitivity/90% specificity. T1-e10 was less accurate but had excellent discriminability, with 60% sensitivity/87% specificity. T1 maintained excellent accuracy regardless of memory impairment severity, with 77% sensitivity/≥88% specificity and a relatively invariant cut-score even among those with severe verbal/visual memory impairment. T1-e10 had excellent classification accuracy among those with normal memory and mild impairment, but accuracy and sensitivity dropped with severe impairment and the optimal cut-score had to be increased to maintain adequate specificity. Conclusion: TOMM T1 is an effective performance validity test with strong psychometric properties regardless of material-specificity and severity of memory impairment. By contrast, T1-e10 functions relatively well in the context of mild memory impairment but has reduced discriminability with severe memory impairment. [ABSTRACT FROM AUTHOR]

To examine the potential of the Five-Variable Psychiatric Screener (V-5) to serve as an embedded symptom validity test (SVT). In Study 1, 43 undergraduate students were randomly assigned to a control or an experimental malingering condition. In Study 2, 150 undergraduate students were recruited to examine the cognitive and emotional sequelae of self-reported trauma history. The classification accuracy of the V-5 was computed against the Inventory of Problems (IOP-29), a free-standing SVT. In Study 1, the V-5 was a poor predictor of experimental malingering status, but produced a high overall classification against the IOP-29. In Study 2, the V-5 was a stronger predictor of IOP-29 than self-reported trauma history. Results provide preliminary support for the utility of the V-5 as an embedded SVT. Given the combination of growing awareness of the need to determine the credibility of subjective symptom report using objective empirical methods and systemic pressures to abbreviate assessment, research on SVTs within rapid assessment instruments can provide practical psychometric solutions to this dilemma. [ABSTRACT FROM AUTHOR]

Objective To avoid misdiagnosing mild cognitive impairment (MCI), knowledge of the multivariate base rates (MVBRs) of low scores on neuropsychological tests is crucial. Base rates have typically been determined from normative population samples, which may differ from clinically referred samples. The current study addresses this limitation by calculating the MVBR of low or high cognitive scores in older adults who presented to a memory clinic experiencing subjective cognitive decline but were not diagnosed with MCI. Method We determined the MVBRs on the Kaplan–Baycrest Neurocognitive Assessment for 107 cognitively healthy older adults (M age = 75.81), by calculating the frequency of patients producing n scores below or above different cut-off values (i.e. 1, 1.5, 2.0, 2.5 SD from the mean), stratifying by education and gender. Results Performing below or above cut-off was common, with more stringent cut-offs leading to lower base rates (≥1 low scores occurred in 84.1% of older adults at −1 SD , 55.1% at −1.5 SD , and 39.3% at −2 SD below the mean; ≥1 high scores occurred in 80.4% of older adults at +1 SD , 35.5% at +1.5 SD , and 16.8% at +2 SD above the mean). Higher education was associated with varying base rates. Overall, the MVBR of obtaining a low cognitive test score was higher in this clinic sample, compared with prior studies of normative samples. Conclusions MVBRs for clinically referred older adults experiencing memory complaints provide a diagnostic benefit, helping to prevent attributing normal variability to cognitive impairment and limiting false positive diagnoses. [ABSTRACT FROM AUTHOR]

Background: 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). Methods: 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. Results: 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. Conclusions: SIMS seems not to be severely impacted by a variety of symptom coaching styles, although test coaching diminished its performance. [ABSTRACT FROM AUTHOR]

Management of mental health illnesses and needs are important in fostering psychosocial support, interprofessional coordination, and greater adherence to treatment protocols in the field of urology. This can be especially true for mental health conditions that may greatly impact the presentation of a patient in the healthcare setting with urologic symptoms. This review describes the history, epidemiology, pathophysiology, clinical presentation, and treatment of somatic symptom disorder, illness anxiety disorder, compulsive sexual behavior/hypersexuality, factitious disorder, malingering symptoms, and conversion disorder in the realm of urology. Given the newly updated psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, there has been a lack of studies reviewing how these illnesses may present in a urology patient encounter. Additionally, as these mental health illnesses may carry a rare incidence compared to other well-known mental health illness such as generalized depression or generalized anxiety disorder, we have found that the lack of provisions and recognition of the diseases can prolong the timeline for diagnosis and lead to an increased cost in both healthcare and quality of life of patients with these mental health illnesses. This review provides awareness on these mental health conditions which may greatly impact patient history and presentation within the field of urology. Additionally, urologic care providers may have an improved understanding of interdisciplinary management of such illnesses and the common symptoms patients may present with such diseases. [ABSTRACT FROM AUTHOR]

In this article, we hypothesized that in order to feign mental illness, one would need to have empathy and be able to understand other's mental states. To test this hypothesis, we asked 432 healthy volunteers to feign depression, PTSD or schizophrenia while completing a self-report test that measures the severity of the feigned condition's symptoms and the Inventory of Problems − 29 (IOP-29). Additionally, all participants were administered a theory of mind (ToM) task and an empathy measure with the request to respond truthfully. Results from a series of linear regression models revealed that higher cognitive empathy is associated with increased symptom endorsement on self-report symptom questionnaires and higher ToM abilities are associated with less credible feigned profiles, especially in the case of feigned depression. [ABSTRACT FROM AUTHOR]

Objective: There is increased concern for malingering in ADHD evaluations due to presence of incentives such as accommodations and medications. Although several validity tests are available to classify malingering in non-ADHD populations, there is no test with proven effectiveness to detect feigned ADHD. This study investigated the ability of the MARS Symptom Validity Index 4 (MARS SV-index 4) and two published validity tests (the Word Memory Test [WMT] and Clinical Assessment of Attention Deficit-Adult [CAT-A] Infrequency scale) to detect malingered ADHD. Method: The participants consisted of 68 young adults, 34 with ADHD. Participants completed the MARS, CAT-A, and WMT validity measures. Results: The MARS SV index-4 demonstrated higher sensitivity rates for simulated malingering (61.8%) at close to optimal specificity (88.2%) compared to two published tests (which had sensitivity <42% at specificity >90%). Conclusion: The MARS shows good ability to detect feigned ADHD and appears to be useful for adult ADHD assessments. [ABSTRACT FROM AUTHOR]

Abstract Background Despite cases of factitious disorder imposed on self being documented in the literature for decades, it appears to remain an under-identified and under-diagnosed problem. The present study aimed to explore factitious disorder imposed on self in a series of French patients. Methods Patients 18 years old and over with factitious disorder imposed on self were retrospectively included by two independent reviewers according to DSM-5 criteria in Rennes University Hospital for the period 1995 to 2019. Patients were identified from a clinical data warehouse. Results 49 patients with factitious disorder imposed on self were included. Among them, 36 (73.5%) were female. The average age at diagnosis was 38.4 years. The 16 patients with a health-related profession were all female. Direct evidence of falsification was found in 20.4% of cases. Falsification was mainly diagnosed on the basis of indirect arguments: history of factitious disorder diagnosed in another hospital (12.2%), extensive use of healthcare services (22.4%), investigations that were normal or inconclusive (69.4%), inconsistent or incomplete anamnesis and/or patient refusal to allow access to outside information sources (20.4%), atypical presentation (59.2%), evocative patient behaviour or comments (32.7%), and/or treatment failure (28.6%). Dermatology and neurology were the most frequently involved specialities (24.5%). Nine patients were hospitalized in intensive care. Some of them received invasive treatments, such as intubations, because of problems that were only reported or feigned. The diagnosis of factitious disorder imposed on self was discussed with the patient in 28 cases (57.1%). None of them admitted to making up the disorder intentionally. Two suicide attempts occurred within 3 months after the discussion of the diagnosis. No deaths were recorded. 44.9% of the patients returned to the same hospital at least once in relation to factitious disorder imposed on self. Conclusions The present study reinforces data in favour of a predominance of females among patients with factitious disorder imposed on self. This diagnosis is difficult and is based on a range of arguments. While induced cases can be of low severity, cases that are only feigned can lead to extreme medical interventions, such as intubation.

Background: Factitious disorder (FD) is an under-recognized and under-diagnosed mental condition. Healthcare professionals often have challenges to diagnose and treating the disorder. As a result, needless and endless medical resources are recommended to assess and evaluate those affected. FD may present as a physical condition, a psychological disorder, or maybe both depending on the prominent symptoms. However, there is a strong correlation between having FD and psychiatric symptoms. Main Text: FD occurs in early adulthood, with a mean age of onset of 25 years in both genders, although with differing demographic features. The lifetime prevalence of FD imposed on oneself in clinical settings is 1.0%, 0.1% in the overall population (ranging between 0.007% and 8.0%) and occurs more in female health care professionals. FD may make up 0.6%–3.0% of psychiatric referrals, and it accounts for 3-5% of doctor-patient contacts. In actuality, 1-2% of hospital admissions and an average of 6-8% of all psychiatric admissions have been underreported. The study aimed to highlight the signs and symptoms of FD identified in a psychiatry department of a multispecialty center and to increase the awareness of health practitioners. A critical review of the literature was done with an emphasis on psychological symptoms. PubMed, Mendeley, and Google Scholar were thoroughly searched and full-text publications of journals from 2010-2021 were included. Conclusion: FD is a diagnostic puzzle that necessitates adequate, prompt medical attention as well as social support because of the potentially fatal consequence. A stronger patient-therapist relationship can strengthen the patient's conscious self-control to minimize the symptoms; therefore the healthcare provider has to be open-minded. For the diagnostic enigma to be removed and for ease of treatment, additional research, increasing awareness among medical professionals and the general public, accurate evaluation, diagnosis, and psychotherapy should be encouraged. These case studies will contribute to the knowledge base of FD and improve the quality of care.

Lastly, individualized neuroscience findings can be used to compare the brain structure and functioning of defendants with juveniles or individuals with intellectual disabilities, which can be relevant at sentencing. The role of neuroscience in criminal liability has been a topic of much debate in recent years. There are five types of neuroscience evidence that can be applicable to criminal law: The first type of admissible evidence includes data showing brain abnormality obtained through scans, which may diagnose the defendant with conditions such as frontal lobe disorder or traumatic brain injury (TBI). [Extracted from the article]

Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives. Although the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) does not list malingering in its diagnostic section and therefore does not identify it as a formal mental disorder, malingering and verified mental illness commonly coexist. Some subtypes of feigning behaviors, such as partial or pure malingering, dissimulation, and false imputation, can be suspected when patients have marked discrepancies between reported stressors and objective findings. The article discusses these three theoretical concepts with their possible clinical aspects, illustrating each phenomenon by clinical case with self-reported and/or observed psychotic symptoms. We summarized relevant findings and provided a review of clinical considerations that physicians can use to aid in the evaluation of psychotic symptoms in the context of those three concepts. [ABSTRACT FROM AUTHOR]

We investigated the classification accuracy of the Inventory of Problems ù 29 (IOP-29), its newly developed memory module (IOP-M) and the Fifteen Item Test (FIT) in an Australian community sample (N = 275). One third of the participants (n = 93) were asked to respond honestly, two thirds were instructed to feign mild TBI. Half of the feigners (n = 90) were coached to avoid detection by not exaggerating, half were not (n = 92). All measures successfully discriminated between honest responders and feigners, with large effect sizes (d ≥ 1.96). The effect size for the IOP-29 (d ≥ 4.90), however, was about two-to-three times larger than those produced by the IOP-M and FIT. Also noteworthy, the IOP-29 and IOP-M showed excellent sensitivity (>90% the former, > 80% the latter), in both the coached and uncoached feigning conditions, at perfect specificity. Instead, the sensitivity of the FIT was 71.7% within the uncoached simulator group and 53.3% within the coached simulator group, at a nearly perfect specificity of 98.9%. These findings suggest that the validity of the IOP-29 and IOP-M should generalize to Australian examinees and that the IOP-29 and IOP-M likely outperform the FIT in the detection of feigned mTBI. [ABSTRACT FROM AUTHOR]

Research shows incarcerated women suffer more chronic and/or preexisting health conditions than their male counterparts. Through the lens of federal court litigation pursuant to Title 42 U.S. Code Section 1983, this article discusses women who brought legal challenges, questioning the adequacy of correctional medical care rendered to their chronic and preexisting health conditions. Case law reveals several trends, including multiple disease comorbidities, malingering, medication administration, free-world specialty care, diagnostic and treatment limitations, and mental illness. The article concludes with policy implications, suggestions for future research, and recommendations for accelerated research on the chronic and/or preexisting health conditions of female prisoners. [ABSTRACT FROM AUTHOR]