Search

En l'absence de documents médicaux, le récit de la cécité de John Howard Griffin et de sa guérison ne repose que sur ses déclarations et celles de ses biographes. Ce récit est généralement accepté, même si une enquête révèle les doutes qu'il suscita chez certains de ses amis et correspondants. Après un examen des sources disponibles, nous concluons qu'il s'agissait d'une pseudo-cécité, mélange d'une simulation volontaire puis d'un trouble « fonctionnel ». La possibilité d'un miracle qui avait été évoquée à l'époque – mais jamais par John Howard Griffin lui-même – est développée en référence à deux mystiques célèbres du XXe siècle. La compréhension psychologique de cette pseudo-cécité s'appuie sur le concept de fonction, c'est-à-dire sur son aspect utilitaire. À cet égard se dégagent une fonction « escapiste » pour se tirer de difficultés et une fonction « promotionnelle » quand il se présenta comme un aveugle de guerre lors du lancement de ses premiers romans. Given the lack of available medical records, any study of John Howard Griffin's blindness must rely on Griffin's own words and that of his biographers. Griffin's account of his blindness has generally been accepted, even though some of his friends privately expressed doubts as to its genuineness. After reviewing various sources, we conclude that Griffin's blindness was a pseudo-blindness that is a combination of "functional disorder" and outright simulation. We will further enquire into the possibility that Griffin experienced a miraculous healing – an explanation that he personally rejected – by briefly examining the well-publicized cases of two 20th Century Catholic holy women. We will then lay the groundwork for a psychological explanation of Griffin's blindness, concluding that it had two functions: an escapist one, which allowed him to avoid embarrassment, and a promotional one, which helped him market his novels. [ABSTRACT FROM AUTHOR]

Our study compared the impact of administering Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs) in in-person versus remote formats and assessed different approaches to combining validity test results. Using the MMPI-2-RF, IOP-29, IOP-M, and FIT, we assessed 164 adults, with half instructed to feign mild traumatic brain injury (mTBI) and half to respond honestly. Within each subgroup, half completed the tests in person, and the other half completed them online via videoconferencing. Results from 2 ×2 analyses of variance showed no significant effects of administration format on SVT and PVT scores. When comparing feigners to controls, the MMPI-2-RF RBS exhibited the largest effect size (d = 3.05) among all examined measures. Accordingly, we conducted a series of two-step hierarchical logistic regression models by entering the MMPI-2-RF RBS first, followed by each other SVT and PVT individually. We found that the IOP-29 and IOP-M were the only measures that yielded incremental validity beyond the effects of the MMPI-2-RF RBS in predicting group membership. Taken together, these findings suggest that administering these SVTs and PVTs in-person or remotely yields similar results, and the combination of MMPI and IOP indexes might be particularly effective in identifying feigned mTBI. [ABSTRACT FROM AUTHOR]

AbstractObjective: Anxiety disorders are the most prevalent psychiatric disorders experienced by individuals in the United States, and anxiety is often assessed with anxiety symptom inventories. At present, though, there are no anxiety symptom inventories that include symptom validity indices. The present study sought to develop a symptom validity index for the most commonly used anxiety symptom inventory in neuropsychological practice, the Beck Anxiety Inventory (BAI). Method: A sample of 244 veterans seeking outpatient neuropsychological assessments were included in the study. Participants were divided into valid and invalid groups based on external criterion symptom validity tests. The valid participants were then divided into clinical subgroups (Current Anxiety, Lifetime Anxiety, and No Anxiety). A validity index derived from the BAI total score was examined for the total sample and all subgroups. Results: A cutoff of ≥ 29 was identified when utilizing the Valid Full Sample, which resulted in a 0.91 specificity rate and 0.54 sensitivity rate. However, cutoffs had to be adjusted when applied to the clinical subgroups. The Valid Current Anxiety subgroup required the largest cutoff increase (i.e. ≥ 36), which resulted in a 0.91 specificity rate and a 0.42 sensitivity rate. Conclusions: This is the first published article to develop a symptom validity index for the BAI. To minimize false positive errors, a BAI total score of ≥ 36 is recommended. [ABSTRACT FROM AUTHOR]

Background: Detecting invalid cognitive performance is an important clinical challenge in neuropsychological assessment. The aim of this study was to explore behavior and eye-fixations responses during the performance of a computerized version of the Test of Memory Malingering (TOMM-C) under standard vs. feigning conditions. Participants and methods: TOMM-C with eye-tracking recording was performed by 60 healthy individuals (31 with standard instruction – SI; and 29 were instructed to feign memory impairment: 21 Naïve Simulators – NS and 8 Coached Simulators – CS) and 14 patients with Multiple Sclerosis (MS) and memory complaints performed. Number of correct responses, response time, number of fixations, and fixation time in old vs. new stimuli were recorded. Nonparametric tests were applied for group comparison. Results: NS produced fewer correct responses and had longer response times in comparison to SI on all three trials. SI showed more fixations and longer fixation time on previously presented stimuli (i.e., familiarity preference) specially on Trial 1, whereas NS had more fixations and longer fixation time on new stimuli (i.e., novelty preference) specially in the Retention trial. MS patients produced longer response time and had a different fixation pattern than SI subjects. No behavioral or oculomotor difference was observed between NS and CS. Conclusion: Healthy simulators have a distinct behavioral and eye-fixation response pattern, reflecting a novelty preference. Oculomotor measures may be useful to detect exaggeration or fabrication of cognitive dysfunction. Though, its application in clinical populations may be limited. [ABSTRACT FROM AUTHOR]

AbstractThis study evaluated the universality of the TOMM 2 and provided a reference sample of cognitively intact adults living in Spain whose native language was Spanish. A total of 203 adults completed the TOMM 2 from June 2019 to January 2020. When using the original TOMM cutoff scores derived from English speakers, all participants scored in a range that would suggest that they passed the TOMM. When using a cut score less than 40 on Trial 1, only one participant in this study would be mistakenly classified as providing an invalid performance. Spanish-speaking adults in Spain from this study achieved a perfect score on Trial 1 at a rate more than double that of English-speaking individuals on the original TOMM. At the item level, all but one item met the minimum standard for performance validity; this item fell only marginally below the standard at 89%. This study found a very low failure rate for the TOMM 2, suggesting that the second edition has at least as high specificity as the original in Spanish adults. [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]

Background: 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. Method: 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). Results: 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. Conclusion: 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]

Assessing the credibility of symptoms is critical to neuropsychological assessment in both clinical and forensic settings. To this end, the Inventory of Problems-29 (IOP-29) and its recently added memory module (Inventory of Problems-Memory; IOP-M) appear to be particularly useful, as they provide a rapid and cost-effective measure of both symptom and performance validity. While numerous studies have already supported the effectiveness of the IOP-29, research on its newly developed module, the IOP-M, is much sparser. To address this gap, we conducted a simulation study with a community sample (N = 307) from the United Kingdom. Participants were asked to either (a) respond honestly or (b) pretend to suffer from mTBI or (c) pretend to suffer from depression. Within each feigning group, half of the participants received a description of the symptoms of the disorder to be feigned, and the other half received both a description of the symptoms of the disorder to be feigned and a warning not to over-exaggerate their responses or their presentation would not be credible. Overall, the results confirmed the effectiveness of the two IOP components, both individually and in combination. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine how malingered PTSD behavior affects the performance of a continuous performance task (CPT). An analog trauma group, two malingering groups (with or without educational intervention), and a control group were organized according to simulation design. During the CPT, the numbers of errors and response time indicators along with post-error slowing (PES) and recovery (PER) process were measured. Results are as follows: First, the analog trauma group showed deficits of response inhibition and a higher level of PES compared to the control group. Second, malingered PTSD caused a significant number of errors, inconsistent performance, and no PES. Third, there was a significantly more impaired and inconsistent performance in the low level of knowledge of disability. Finally, a discriminant accuracy of more than 90% appeared in the discriminant analysis of all group comparison conditions. Taken together, the results of this study show that post-error behavior indicators are affected by malingered PTSD, and differences according to the degree of knowledge of PTSD can also be confirmed. These results are expected to be used as basic data for the development of tasks for the detection of malingerers in clinical scenes in the future. [ABSTRACT FROM AUTHOR]

The study describes the validation of a computerized adaptation of the novel Tri-Choice Naming and Response Bias Measure (N-Tri) developed to detect untruthful responding while being less susceptible to coaching than existing measures. We hypothesized that the N-Tri would have comparable sensitivity and specificity to traditional tests but would have improved accuracy for detecting coached simulators. Four-hundred volunteers were randomly assigned to one of three groups: uncoached simulators' group (n = 118), coached simulators' group (n = 136), or control group (n = 146). Both simulator groups were asked to feign concussion symptoms, but the coached group received a test-taking strategy and a description of concussion symptoms. The participants were administered the computerized version of the new measure in conjunction with computerized adaptations of two well-validated response bias tests commonly used to detect cognitive malingering, the Reliable Digit Span (RDS) and Portland Digit Recognition Test (PDRT). Our data show the new measure correlated highly with other established measures. However, the classification accuracy did not significantly increase when compared to the traditional tests. Our findings support that the N-Tri performs at a comparable level to existing forced choice measures of response bias. Nevertheless, the N-Tri could potentially improve the detection of response bias as existing tests become more recognizable by the public. [ABSTRACT FROM AUTHOR]

AbstractObjective: Although performance validity tests (PVTs) are routinely administered in neuropsychological evaluations, they are employed less frequently in assessments for specific learning disabilities such as dyslexia, likely due, at least in part, to the limited availability of PVTs to evaluate effort on measures of academic achievement. This is troubling, as previous research suggests that up to 24% of postsecondary students undergoing learning disability assessments produce noncredible test scores indicative of symptom exaggeration or low effort. This paper discusses normative data collected for the revised Dyslexia Assessment of Simulation or Honesty- Revised (DASH-R), a PVT developed specifically to identify symptom exaggeration or magnification during dyslexia testing. Method: We administered the DASH-R to three groups of students: honest responding controls (n = 48), students with documented dyslexia (n = 232), and students coached to simulate dyslexia (n = 42). Students were also administered measures of reading and processing speed. Results: DASH-R scores differentiated simulators from both honest responding controls and those with dyslexia. Further, ROC curve analysis showed that a composite feigning index score derived from the DASH-R could be used diagnostically to detect low effort; an optimal cut score of ≥4 on a seven-variable index yielded high specificity (≥98%) and good sensitivity (71%), with positive predictive accuracy of 86%. Creation of a 9-variable index that included errors on an additional reading test produced improved positive predictive accuracy to 96% while retaining excellent specificity (99%). Conclusions: The DASH-R appears to be a promising disability-specific measure for detecting feigned reading problems in young adults undergoing evaluations for dyslexia. [ABSTRACT FROM AUTHOR]

AbstractObjective: This study investigated whether extreme cut-scores on the Barkley Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-Fourth Edition (BAARS-IV) self-report scales could serve as symptom overreporting indicators in adult ADHD evaluations. Method: The sample consisted of 162 adults who underwent a neuropsychological evaluation for ADHD. Patients were classified into valid (n = 115) and invalid (n = 47) groups based on multiple criterion symptom validity tests. Results: Overreporting cut-scores identified for each of the BAARS-IV scales demonstrated acceptable classification accuracy or better. The Current Total scale yielded the highest classification accuracy (area under the curve of .83). An optimal raw cut-score of ≥56 for this scale yielded 47% sensitivity when upholding ≥90% specificity. A cut-score of ≥31 for the Current Inattention scale (90% specificity; 47% sensitivity) and ≥29 for the Current Sluggish Cognitive Tempo scale (88% specificity; 46% sensitivity) were also relatively strong indicators of overreporting. The Current Total and Current Sluggish Cognitive Tempo scales captured nonredundant aspects of symptom validity, and using them together increased sensitivity to 57% while maintaining ≥90% specificity. Conclusions: Findings provide preliminary support for the criterion and construct validity of extreme cut-scores on the BAARS-IV Current Sluggish Cognitive Tempo, Current Inattention, and Current Total scales as indicators of ADHD symptom overreporting. However, employing the cut-scores from the Current Sluggish Cognitive Tempo (≥29) and Current Total (≥56) together may be the most promising way to detect overreporting. Scores above both of these cut-points should, at a minimum, prompt further investigation into the validity of a patient’s reported symptoms. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsPerformance validity test (PVT) misclassification is an important concern for neuropsychologists. The present study determined whether expanding PVT analysis from 4-PVTs to 8-PVTs could lead to elevated rates of false positive performance validity misclassifications.Retrospective analysis of 443 patients who underwent a fixed neuropsychological test battery in a mixed clinical and forensic setting. Rates of failing two PVTs were compared to those predicted by Monte Carlo simulations when PVT analysis extended from 4-PVTs to 8-PVTs. Indeterminate performers (IDT; n = 42; those who failed two PVTs only after PVT analysis extended from 4-PVTs to 8-PVTs) were compared to a PVT-Fail group (n = 148; those who failed two PVTs in the 4-PVT battery or failed >2 PVTs).Rate of failing two PVTs remained stable when PVT analysis extended from 4- to 8-PVTs (12.9 to 11.9%) and was significantly lower than those predicted by Monte Carlo simulations. Compared to PVT-Fail, the IDT group was significantly younger, had stronger neuropsychological test performance, and demonstrated comparable rates of forensic referral and conditions with known neurocognitive sequelae (e.g. stroke, moderate-to-severe TBI).Monte Carlo simulations significantly overestimated rates of individuals failing two PVTs as PVT battery length doubled. IDT did not differ from PVT-Fail across variables with known PVT effects (e.g. age, referral context, neurologic diagnoses), lowering concern that this group is comprised entirely of false-positive PVT classifications. More research is needed to determine the effect of PVT battery length on validity classification accuracy. [ABSTRACT FROM AUTHOR]

The existence or questionability of "repressed memories" can be discussed as being a matter of definition. It seems, however, far‐fetched to consider all "lost" memories as caused by encoding problems, brain damage, forgetfulness, failure to disclose events, and so on. We argue that dissociative amnesia (DA) (or "psychogenic amnesia," or "functional amnesia," or, as we favor to call it, "mnestic block syndrome") is caused by psychic alterations, but ultimately they can be traced to changes in the physiology of the brain, as we are of the opinion that all memory processes—positive or negative—alter brain functions, sometimes more permanently, sometimes transiently. We have proven this idea using functional imaging techniques, in particular fluoro‐deoxy‐d‐glucose positron emission tomography. Having investigated dozens of patients with severe and long‐lasting DA conditions, we believe it to be disrespectful to many (but not to all) of the affected patients to question their disease condition, which can be proven to be not caused by feigning, malingering, or direct brain damage. We argue that "repressed memories" – as found in dissociative or psychogenic amnesia – are caused by major stress and trauma conditions and lead to changes in the brain. These alterations can be proven by functional brain imaging. [ABSTRACT FROM AUTHOR]

Amnesia is a frequent claim in major crimes, and it is estimated that the complete or partial absence of memory following a crime ranges from 25% to 50% of total cases. Although some cases may constitute a genuine form of amnesia, due to organic‐neurological defects or psychological causes, and possibly combined with a dissociative or repressive coping style after an extreme experience, malingering is still fairly common in offenders. Therefore, one of the main goals in medico‐legal proceedings is to find methods to determine the credibility of crime‐related amnesia. At present, a number of lie and memory detection techniques can assist the forensic assessment of the reliability of declarative proof, and have been devised and improved over the past century: for example, modern polygraphs, event‐related potentials, thermal imaging, functional magnetic resonance imaging, kinematic, and facial analysis. Other ad hoc psychological tests, such as the so‐called Symptom Validity Test (SVT) and Performance Validity Test (PVT), as well as the autobiographical Implicit Association Test (aIAT), can also be used. To date, however, there is little evidence or case reports that document their real usefulness in forensic practice. Here, we report two cases of crime‐related amnesia, whereby both defendants, who were found guilty of homicide, appeared to exhibit dissociative amnesia but where the application of SVTs, PVTs, and aIAT detected a malingered amnesia. One of the main goals in the context of crime‐related amnesia is to find methods to distinguish whether it is due to an organic‐neurological origin, psychological factors or malingering. Here, we report two homicide cases in which the application of two memory detection techniques, the forced‐choice test and the autobiographical implicit association test (aIAT), strongly suggested a malingered amnesia. [ABSTRACT FROM AUTHOR]

This study was designed to test the upper limits of the Rey-15's classification accuracy in cognitively intact university students and clinical patients. A brief battery of neuropsychological tests was administered to all participants. Students were randomly assigned to either the control (n = 80) or experimental malingering (n = 59) condition. Invalid performance in patients (n = 52) was psychometrically defined. The classification accuracy of the Rey-15 (original free recall and the combination score including the recognition trial developed by Boone et al., 2002) was computed across a range of cutoffs. A free recall ≤13 and combination score ≤25 produced a good combination of sensitivity (.41–.70) and specificity (.90–.94) among students. The highest cutoff to reach.90 specificity in clinical patients was free recall ≤11 and combination score ≤23, at.38–.56 sensitivity. Results confirmed the previous reports that more liberal alternative cutoffs maintain adequate specificity. Cutoffs can be raised even further in cognitively intact examinees. The introduction of the recognition trial provided a significant boost to the instrument's classification accuracy. The Rey-15 remains a cost-effective and clinically useful test in both clinical and research settings. Public Significance Statement: The Rey-15 is one of the oldest performance validity test often criticized for its limited clinical utility. This study demonstrated that its classification accuracy can be improved through the use of alternative cutoffs. [ABSTRACT FROM AUTHOR]

Le trouble factice imposé à soi-même (TFIS) est un trouble mental caractérisé par un comportement conscient de manipulation de la part de patients ne poursuivant pas un objectif externe clairement identifiable. Il atteint des sujets aux caractéristiques diverses, une partie seulement d'entre eux correspondant au profil stéréotypé de la femme jeune exerçant une profession dans le domaine de la santé. Il se manifeste par des symptômes ou des signes cliniques variés et est susceptible d'impliquer toutes les spécialités. Le syndrome de Munchausen constitue une forme particulière de TFIS, plus répandue chez les hommes et marquée par sa sévérité. Les comorbidités psychiatriques sont fréquentes chez les sujets atteints de TFIS. Les décès sont rares mais possibles, du fait soit de la maladie elle-même, soit de complications des examens ou des traitements prescrits, soit d'un geste suicidaire. La démarche diagnostique doit œuvrer à identifier des arguments positifs en faveur du trouble. Un diagnostic par élimination reste possible quand aucune autre hypothèse ne peut expliquer un tableau clinique évocateur de TFIS. Le pronostic est souvent médiocre, du moins à court et moyen terme. Éviter les prescriptions inutiles est essentielle pour prévenir la iatrogénie. La prise en charge du TFIS est mal codifiée. Dans tous les cas, une attitude non-agressive et empathique doit être adoptée par le praticien. Factitious disorder imposed on self (FDIS) is a mental disorder characterized by conscious manipulative behavior from patients with no clearly identifiable external objective. It affects subjects with a wide range of characteristics, only some of whom fit the stereotypical profile of the young female working in the health sector. It can take the form of a variety of symptoms or clinical signs, and is likely to involve all specialties. Munchausen syndrome is a particular form of FDIS, more prevalent in men and marked by its severity. Psychiatric comorbidities are common in patients with FDIS. Death is rare but possible, either as a result of the disease itself, complications of examinations or treatments, or suicide. The diagnostic approach must seek to identify positive arguments in favor of the disorder. Diagnosis by elimination remains possible when no other hypothesis can explain a clinical picture suggestive of FDIS. The prognosis is often poor, at least in the short and medium term. Avoiding unnecessary prescriptions is essential to prevent iatrogenesis. The management of FDIS is poorly codified. In all cases, the practitioner must adopt a non-aggressive, empathetic attitude. [ABSTRACT FROM AUTHOR]

Sometimes forensic psychologists are asked to determine whether the symptoms of PTSD presented by the plaintiff are genuine or feigned. To this end, they may use both symptom validity tests (SVTs) and performance validity tests (PVTs), but SVTs are used far more frequently in these assessments. Thus, we conducted a natural experiment and administered an SVT (i.e., the IOP-29) and a PVT (i.e., the IOP-M) to 76 individuals instructed to feign PTSD and to 34 controls who self-reported exposure to a devastating flood several months earlier. The results confirm the utility of both measures in detecting feigned PTSD. [ABSTRACT FROM AUTHOR]

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) may be unreliable at its standard recommended cutoff score when used with forensic psychiatric inpatient populations given high rates of genuine cognitive impairment. The present study sought to (a) examine the rate of invalid performance on the RBANS EI using the standard cutoff among incompetent to stand trial (IST) inpatients and (b) investigate the psychometric properties of the RBANS EI at various cutoff scores. This study was conducted using archival assessment data collected at a large forensic psychiatric hospital. Across the entire sample (N = 238, 79% male, Mage = 45 years, 24% primary Spanish-speaking), 79% were diagnosed with a schizophrenia spectrum disorder. Experiment 1 of the study (n = 165) contained IST patients who were classified as having a valid presentation. Experiment 2 contained a valid (n = 46) and invalid (n = 27) presentation group comprised of postadjudication and IST inpatients, respectively. In Experiment 1, over one third (36.4%) of the valid presentation sample scored above the standard recommended EI cutoff. In Experiment 2, applying the standard recommended cutoff score of >3 was associated with a false positive rate of over 20%. Obtaining <10% false positive errors was achieved at a cutoff score of >5. At this cutoff score, the estimated local base rate of invalid responding among IST patients was 28%. Clinical and forensic implications and recommendations for adopting this more conservative RBANS EI cutoff score are discussed. Public Significance Statement: The current research suggests that individuals with schizophrenia spectrum disorders who reside in forensic hospital settings are at risk for being falsely identified as putting forth invalid performance on the Repeatable Battery for the Assessment of Neuropsychological Status Effort Index when using the standard recommended cutoff score, which may be related to high rates of genuine cognitive impairment. As such, an alternative Repeatable Battery for the Assessment of Neuropsychological Status Effort Index cutoff score is recommended when assessing individuals in these and similar settings. [ABSTRACT FROM AUTHOR]

Functional movement disorders (FMD) are frequently encountered in the clinical practice of neurologists. Recently, the interest of specialists in FMD has increased. Based on neuroimaging, neurophysiological and neuropsychological studies, concepts of the pathophysiology of FMD have been proposed. A difficult issue is differentiation of FMD from factitious disorder and malingering. Diagnostic criteria for FMD, factitious disorder, and malingering are currently proposed, including in ICD-11, but they still contain many controversial provisions, the most important of which are discussed in this article.

AbstractDetecting malingered neurocognitive dysfunction is a major issue in forensic context, particularly in legal proceeding/insurance assessment after a traumatic brain injury (TBI), condition frequently associated with persistent cognitive impairments that may potentially be related to malingering. Consequently, research has devoted considerable efforts on developing tools to verify symptoms authenticity. This study compared two freestanding performance validity tests (PVTs) (Amsterdam Short-Term Memory Test—ASTM; Word Completion Memory Test—WCMT) and five embedded PVTs (Rey Complex Figure Test—RCFT—Copy and Recall trials; Reliable Digit Span—RDS; Rey Auditory Verbal Learning Test—RAVLT—Recognition and Total Learning trials) in a sample of 120 participants, including 15 patients with TBI (Mage = 44.40), 52 experimental simulators (Mage = 29.52) and 53 control (Mage = 29.77). Group performance was analyzed to assess tests’ discriminatory power, and Receiver Operating Characteristic (ROC) curves were used to examine tools’ sensitivity and specificity. Results indicated that experimental simulators performance on the ASTM, WCMT, and RAVLT differed significantly from TBI patients and controls. The RDS and RCFT did not discriminate experimental simulators from TBI group. ROC curves analysis reveals that the most accurate tests in this battery for detecting malingering were the ASTM and the RAVLT-Total Learning score. This study offers implications for identifying malingering in medico-legal settings, underscoring the importance of incorporating PVTs into clinical practice. [ABSTRACT FROM AUTHOR]

AbstractThe Self-Report Symptom Inventory (SRSI) is a novel tool designed to detect symptom overreporting and other forms of noncredible responding. Unlike existing scales, the SRSI includes genuine and pseudosymptoms scales covering cognitive, affective, motor, pain, and post-traumatic stress disorder domains. The present study aims to investigate the psychometric properties of the Italian Version of the SRSI (SRSI-It), in particular, its factor structure, reliability, convergent and discriminant validity, and diagnostic accuracy. Data from 1180 healthy participants showed a hierarchical structure with higher-order constructs for genuine symptoms and pseudosymptoms, each comprising five subscales. The SRSI-It showed a strong convergent validity with the Structured Inventory of Malingered Symptomatology and discriminant validity through low correlations with the Psychopathic Personality Inventory-Revised. Receiver operating characteristic analysis determined cut scores of 6 (95% specificity) and 9 (98% specificity) for pseudosymptoms, with a Ratio Index score of 0.289 (82% specificity). In summary, the SRSI-It appears to be a promising tool for identifying symptom exaggeration in clinical and forensic contexts, ultimately enhancing the quality and reliability of evaluations in these contexts. [ABSTRACT FROM AUTHOR]

Professionals are encouraged to include multiple symptom validity tests (SVTs) and multiple performance validity tests (PVTs) to assess the credibility of clinical and forensic presentations. Combining the Inventory of Problems–29 (IOP-29, an SVT) with its Memory module (IOP-M, a PVT), referred to here as ‘IOP-29-M’, may be especially beneficial, as it allows for rapid assessment of both symptom and performance validity. Accordingly, the present study aimed at ‘stress testing’ the IOP-29-M by examining base rates of failure (BRFail) in 109 patients with schizophrenia spectrum psychopathology, both with and without criminal convictions. In the overall sample, BRFail were low: 13.8% and 8.3%, respectively, for the standard (≥ .50) and conservative (≥ .65) cutoffs of the IOP-29, and 12.8% and 9.2%, respectively, for the standard (≤ 29) and conservative (≤ 28) cutoffs of the IOP-M. Importantly, very few individuals, less than 5%, failed both components of the IOP-29-M. [ABSTRACT FROM AUTHOR]

This paper describes the case of a defendant accused of homicide who exhibited amnesia, mental health difficulties and widespread cognitive impairments, casting doubt on his fitness to stand trial. Court-ordered assessments opined that he was unfit to stand trial. This paper describes further assessment, and the creation of a novel forced-choice performance validity test (PVT) specific to the defendant’s autobiographical memory and legal circumstances. Symptom validity tests (SVT) were administered to assess the veracity of observed mental health phenomena. The obtained results indicated statistically below chance performance and the feigning of several phenomena. To aid the Court, cumulative binomial probability values were also presented. The paper describes the findings made by the sentencing and appellate courts. It concludes by recommending, with reference to this case study, the use of recently proposed Multidimensional Malingering Criteria for Neurocognitive, Somatic, and Psychiatric Malingering. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Test of Memory Malingering (TOMM) is a widely used performance validity measure that is available in both English and Spanish. The Spanish version, however, has historically lacked normative data from samples that are representative of the U.S. Hispanic/Spanish speaking population. OBJECTIVE: The aim of the current study was to collect normative data on the update TOMM 2 for Hispanic individuals residing in the U.S. METHODS: Normative data on the TOMM 2 was collected across 9 sites from different regions of the U.S. The total sample consisted of n = 188 cognitively healthy adults aged 18 and over with no current or prior history of neurological or psychiatric disorder. Descriptive analyses were performed on total raw scores. RESULTS: Participants obtained a mean score of 48.15 (SD = 2.81) on trial 1 of the TOMM 2, 49.86 (SD = 0.487) on trial 2, and 49.84 (SD = 0.509) on the recognition trial. Scores are provided for traditional cutoff scores as well as some popular cutoffs reported in the literature. Item level analyses were conducted as well as evaluation of performance based on a variety of demographics. CONCLUSION: When compared to the English-speaking normative sample used for the original TOMM, this sample demonstrated better performance on the TOMM 2 indicating better cultural appropriateness of the items. This is the first study conducted that provides culturally appropriate descriptive norms for use with Spanish speakers living in the U.S. [ABSTRACT FROM AUTHOR]

The document titled "Author index" provides a list of authors and their corresponding articles published in the journal "Ultrasound in Obstetrics & Gynecology." The index includes a wide range of authors and topics, covering various aspects of obstetrics and gynecology. This resource can be useful for library patrons conducting research in these fields, as it provides a comprehensive list of authors and their contributions to the journal. [Extracted from the article]

Individuals with mild traumatic brain injury (mTBI) often complain of executive functioning (EF) difficulties. There is a discrepancy between self-reported EF impairment and EF deficits on neuropsychological tests, with some arguing that self-report EF is more related to real-world functioning than EF tests. However, research suggests that self-reported EF may be related more to emotional distress and is vulnerable to invalid reporting. We examined the vulnerability of the short form Barkley Deficits in Executive Functioning Scale (BDEFS) to invalid reporting, using a simulated mTBI paradigm. We included four groups: individuals simulating mTBI with (N = 24) and without (N = 21) histories of mTBI/other psychological conditions and controls with (N = 21) and without (N = 25) histories of mTBI/other psychological conditions. As hypothesized, simulators performed worse on the BDEFS Total Score and EF Symptom Count relative to controls; however, this effect was larger within those who had no self-reported history of mTBI/other psychological conditions. We identified a preliminary cutoff on the EF Symptom Count that detected 42.8% of simulators, with 95% specificity relative to the controls with histories of mTBI/other psychological conditions. The present study emphasizes the need for validity scales on self-report EF measures such as the BDEFS. [ABSTRACT FROM AUTHOR]

Questionnaire-based symptom validity tests (SVTs) are an indispensable diagnostic tool for evaluating the credibility of patients' claimed symptomatology, both in forensic and in clinical assessment contexts. In 2019, the comprehensive professional manual of a new SVT, the Self-Report Symptom Inventory (SRSI), was published in German. Its English-language version was first tested in the UK. This experimental analogue study investigated 20 adults simulating minor head injury symptoms and 21 honestly responding participants. The effect sizes of differences between the two groups were large, with the simulating group endorsing a higher number of pseudosymptoms, both on the SRSI and the Structured Inventory of Malingered Symptomatology, and scoring lower on the Reliable Digit Span than the control group. The results are similar to those obtained in previous research of different SRSI language versions, supporting the effort to validate the English-language SRSI version. [ABSTRACT FROM AUTHOR]

Dandachi-FitzGerald et al. (2022), published the article "Cry for help as a root cause of poor symptom validity: A critical note," in Applied Neuropsychology: Adult [Advance Online], arguing that the cry for help in forensic disability and related assessments is not a valid interpretation for poor symptom validity test results. This rebuttal contests the criticisms of the use of the cry for help in this context, as presented in Young (2019); "The Cry for help in a psychological injury and law: Concepts and review" that appeared in Psychological Injury and Law, Vol. 12, pp. 225–237. It calls for more programmatic research, for example, based on the cry for help questionnaire suggested by the author. In particular, it indicates, for example, that one SVT test failure in a test battery constitutes an assessment result that could allow for attributing the cry for help, everything else being equal. It suggests that the adaptational theory explains the cry for help as much as malingering. It suggests practice and court recommendations that will allow better rebuttals of unethical assessors who overuse/misuse/abuse the cry for help interpretation of poor symptom validity test results in forensic disability and related assessments. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to investigate the cross-cultural validity of two freestanding performance validity tests (PVTs), the Test of Memory Malingering – Trial 1 (TOMM-1) and the Rey Fifteen Item Test (Rey-15) in Romanian-speaking patients. Methods: The TOMM-1 and Rey-15 free recall (FR) and the combination score incorporating the recognition trial (COMB) were administered to a mixed clinical sample of 61 adults referred for cognitive evaluation, 24 of whom had external incentives to appear impaired. Average scores on PVTs were compared between the two groups. Classification accuracies were computed using one PVT against another. Results: Patients with identifiable external incentives to appear impaired produced significantly lower scores and more errors on validity indicators. The largest effect sizes emerged on TOMM-1 (Cohen's d = 1.00–1.19). TOMM-1 was a significant predictor of the Rey-15 COMB ≤20 (AUC =.80;.38 sensitivity;.89 specificity at a cutoff of ≤39). Similarly, both Rey-15 indicators were significant predictors of TOMM-1 at ≤39 as the criterion (AUCs =.73–.76;.33 sensitivity;.89–.90 specificity). Conclusion: Results offer a proof of concept for the cross-cultural validity of the TOMM-1 and Rey-15 in a Romanian clinical sample. [ABSTRACT FROM AUTHOR]

Some widely agreed-upon, official recommendations for professionals conducting psychological assessments suggest employing multiple symptom validity tests (SVTs) to screen the validity of symptom reports. Yet, SVTs are rarely validated in languages other than English, and no free-standing SVT exists in Serbia. To address this gap and stimulate further research on symptom validity within populations from the Balkans, we developed and tested a Serbian version of the Inventory of Problems – 29 (IOP-29). Following the same procedures used in prior IOP-29 validation studies (e.g., Akca et al., 2023), we administered the Serbian IOP-29 to 110 adult volunteers from Serbia. Participants completed the IOP-29 three times under different conditions: responding honestly, randomly, or by feigning a mental disorder (schizophrenia, depression, or post-traumatic stress disorder). We examined the utility of both the False Disorder Probability Score (FDS), which is the chief feigning index of the IOP-29, and of a new index embedded in the IOP-29, which is aimed at detecting random or careless responding. Overall, our results demonstrated that the FDS effectively differentiated between feigned and honest presentations, achieving a sensitivity of 0.86 and a specificity of 0.96 when using the standard cutoff (FDS ≥ 0.50). In addition, the random responding index also successfully identified random responding, achieving a sensitivity of 0.64 and a specificity greater than 0.90 when using a midrange cutoff of T ≥ 67. These findings closely align with outcomes of Akca et al. (2023) and support meta-analytic literature reviews on the IOP-29. More broadly, this study advances and encourages further exploration of symptom validity testing in culturally diverse populations. [ABSTRACT FROM AUTHOR]

It is possible that a portion of the competency crisis may be due to some defendants being misclassified as incompetent, secondary to evaluations of questionable thoroughness and quality, and perhaps over-reliance on interviews and lesser acquisition of collateral data. Meanwhile, a review of descriptive statistics suggests that, as criminal penalties have become increasingly harsh, requests for competency evaluations have proportionately increased. Thus, there is a risk that lengthy waiting lists, mounting time pressures, and attorney tactics may push evaluators in the direction of expediency, possibly at the expense of higher quality forensic work. Evaluators may therefore consider acquiring and perhaps more significantly relying upon relevant collateral informational sources, including police recorded interviews, jail recorded calls, social media content, and prior court records. While an evaluation of present mental state does not necessarily require significant background data, better use of technologies in an evaluation of competency may provide a more objective representation of competency-relevant, mental health-related history. So doing may help to solve a portion of the competency crisis that may be due to evaluations including inadequate collateral data. Best practice approaches, anecdotes, and limitations are presented. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between age and base rates of failure (BRFail) on various performance validity tests (PVTs) administered in medical–legal settings. Archival data were analyzed from 3,297 adults (Mage = 42.3 years; Meducation = 11.2) referred for psychological or neuropsychological assessments in a medical–legal or forensic civil disability context who passed the Word Memory Test. BRFail on 10 PVTs (three freestanding and seven embedded) were reported at multiple cutoffs across five age groups ranging from 16 years to 69 years. BRFail increased with age on most embedded PVTs, with a couple of notable exceptions. Reliable Digit Span was unrelated to age at ≤6 but produced elevated BRFail among older examinees at ≤7. Within freestanding PVTs, a positive relationship emerged between age and BRFail on most instruments/cutoffs. Older age is associated with an increased risk of false positive errors on many embedded PVTs that rely on raw scores. Although freestanding PVTs tend to be more resistant to the effects of age, several commonly used cutoffs may still produce increased false positive rates in older examinees. Taken together, results suggest that PVT scores should be interpreted in the context of patient characteristics, in an evidence-based manner, rather than by rigidly applying omnibus cutoffs. Public Significance Statement: Older adults are at a higher risk for being misclassified as demonstrating invalid performance on certain instruments designed to detect noncredible responding. However, strategically selecting the tests and cutoffs can effectively mitigate this risk. [ABSTRACT FROM AUTHOR]

AbstractThe assessment of performance validity is an important consideration to the interpretation of neuropsychological data. However, commonly used performance validity tests such as the Test of Memory Malingering (TOMM) and Word Memory Test (WMT) have lengthy administration times (20–30 minutes). Alternatively, utilizing a screener of performance validity (e.g., the TOMM T1 or TOMMe10) has proven to be an effective method of assessing performance validity while conserving time. The present study investigates the use of the WMT Immediate Recognition (IR) Trial scores as a screening measure for performance validity using an archival mTBI polytrauma sample (n = 48). Results show that the WMT IR demonstrates a high degree of accuracy in predicting WMT Delayed Recognition (DR) Trial performance across a range of base rates suggesting that the WMT IR is a useful screening measure for noncredible performance. Clinical implications and selection of optimal cutoff are discussed. [ABSTRACT FROM AUTHOR]

Introduction: The Global Psychotrauma Screen (GPS) is a brief transdiagnostic screener that covers a broad range of trauma-related disorders as well as risk factors known to influence the course of symptoms. Methods: We analyzed data from African war refugees in Australia (n = 70), including the GPS, the Structured Clinical Interview for DSM-5 Disorders (SCID-5), the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and the Brief Resilience Scale (BRS). Results: Using the Youden's J Index to examine the clinical validity of the GPS subscales measuring PTSD, dissociation, depression, and generalized anxiety disorder (GAD), we found that a PTSD subscale score of 3 or higher, and a depression and dissociation subscale score of 1 or higher, was optimally efficient for detecting a probable diagnosis (Youden's J = 0.76, J = 0.72, and J = 0.90, respectively) with high sensitivity and specificity. We were unable to test the GPS clinical validity for GAD due to the low GAD occurrence. The GPS resilience item was not related to the total score (r = 0.02), indicating low convergent validity for resilience. Risk factors, including current stressors and childhood trauma history, were related to more severe GPS symptom scores, while lack of resilience, social support, and history of mental illness were not. Conclusion: We conclude that the GPS may be a useful screening tool for PTSD, depression, and the dissociative subtype in refugees. [ABSTRACT FROM AUTHOR]

This study aimed to validate a novel parent-report measure of ADHD symptom inflation, the Parent-Reported ADHD Symptom Infrequency Scale (PRASIS), in a clinical sample. The PRASIS is composed of an Infrequency subscale and an ADHD subscale. Online participants were assigned to one of three groups: mothers of children with diagnosed ADHD (n = 110), mothers of children with diagnosed ODD and/or anxiety (n = 116), and mothers of children without ADHD, ODD, or anxiety. The third group was then randomized to either receive instructions to complete the questionnaire honestly (controls, n = 164) or to complete the questionnaire as if they were trying to convince a provider that their child has ADHD (simulators, n = 141). Results indicated good to excellent internal consistency (INF α = .83, ADHD Total α = .93); strong convergent validity of the PRASIS ADHD scale with the ADHD Rating Scale-5 (r(529) = .85, p < .001); excellent group discrimination of the PRASIS Infrequency scale and the PRASIS ADHD scale (η2 = 0.38–0.42); and specificity of 86.7, sensitivity of 67.4%, and an AUC of .86 for the Infrequency scale. Overall, these outcomes supported the utility of the PRASIS in samples including mothers of children with psychiatric diagnoses of ODD and/or anxiety. [ABSTRACT FROM AUTHOR]

Background/Objective: The area of malingering has advanced in recent years in Spain. However, a boost is still needed to reach and harness international resources and standards. It is of great importance to have guidelines and reviews that can incorporate and adapt recent evidence to the Spanish context. Our aim is to review the literature on malingering and related concepts, in the Spanish forensic-psychological context. In addition, an updated working guide for professionals in the context will be offered. Method: A bibliographic review of the national and international literature was carried out. Results: A series of limitations in terminology have been identified, for which we propose several suggestions that are coherent with the international literature. Similarly, we propose a complete evaluation system, from hypothesis formulation to components and conclusions, oriented towards forensic professional practice. Conclusions: The current state of Spanish literature in this area shows shortcomings that make it difficult to reach the standards of good practice. It is important to promote the adaptation of new tests and the development of research with those that have already been adapted, in new contexts and populations of interest. [ABSTRACT FROM AUTHOR]

Functional neurological symptom disorders (FNSD) pose a common challenge in clinical practice, particularly in pediatric cases where the clinical phenotypes can be intricate and easily confused with structural disturbances. The frequent coexistence of FNSDs with other medical disorders often results in misdiagnosis. In this review, we highlight the distinctions between FNSD and various psychiatric and neurological conditions. Contrary to the misconception that FNSD is a diagnosis of exclusion, we underscore its nature as a diagnosis of inclusion, contingent upon recognizing specific clinical features. However, our focus is on a critical learning point illustrated by the case of a 14-year-old male initially diagnosed with FNSD, but subsequently found to have a rare primary monogenic movement disorder (paroxysmal kinesigenic dyskinesia, PKD). The crucial takeaway from this case is the importance of avoiding an FNSD diagnosis based solely on psychiatric comorbidity and suppressible symptoms. Instead, clinicians should diligently assess for specific features indicative of FNSD, which were absent in this case. This emphasizes the importance of making a diagnosis of inclusion. Extended follow-up and clinical-oriented genetic testing might help identify comorbidities, prevent misdiagnosis, and guide interventions in complex cases, which cannot be simply classified as "functional" solely because other conditions can be excluded. Plain language summary: Understanding and Avoiding Mistakes in Diagnosing Children with Functional Neurological Symptom Disorders: A Review and Case Report: This article discusses Functional Neurological Symptom Disorders (FNSDs), focusing on misdiagnosis, differential diagnosis, and other diagnostic challenges, particularly in pediatric cases. FNSDs involve motor or sensory symptoms that are inconsistent over time and unexplained by neurological disease, often associated with psychosocial factors. The article highlights the complexity of distinguishing FNSDs from other neurological and psychiatric conditions, emphasizing the importance of careful evaluation. The authors review various conditions that can mimic FNSDs, such as epileptic seizures, syncope, and different motor disorders. They emphasize the need to consider psychiatric conditions in the differential diagnosis, including factitious disorders, and malingering. The article presents a case study of a 14-year-old with involuntary movements, initially diagnosed as having a Functional Movement Disorder. After careful evaluation, the patient was diagnosed with a genetic dystonia (PRRT2 mutation). The case shows the importance of not rely solely on psychological problems, bizarre presentations or suppressible symptoms when diagnosing FNSDs. [ABSTRACT FROM AUTHOR]

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. Conclusion: This method is a safe and efficient alternative to more invasive procedures by minimal to no social downtime and mild to no side effects. [ABSTRACT FROM AUTHOR]

In this pilot and exploratory study, we tested the robustness of three self-report symptom validity tests (SVTs) to symptom coaching for depression, with and without additional information available on the Internet. Specifically, we divided our sample (N = 193) so that each subject received either the Structured Inventory of Malingered Symptomatology (SIMS; n = 64), the Self-Report Symptom Inventory (SRSI; n = 66), or the Inventory of Problems-29 (IOP-29; n = 63). Within each of the three subgroups, approximately one third of participants were instructed to respond honestly (Genuine Condition, nSIMS = 21; nSRSI = 24; nIOP-29 = 26) and approximately two-thirds were instructed to feign depression. One half of the feigners were presented with a vignette to increase their compliance with instructions and were given information about symptoms of depression (Coached Feigning, nSIMS = 25; nSRSI = 18; nIOP-29 = 21), and the other half were given the same vignette and information about symptoms of depression, plus two Internet links to review before completing the test (Internet-Coached Feigning, nSIMS = 18; nSRSI = 24; nIOP-29 = 16). Overall, the results showed that the genuine conditions yielded the lowest total scores on all three measures, while the two feigning conditions did not significantly differ from each other. Looking at the detection rates for all feigning participants, all three measures showed satisfactory results, with IOP-29 performing slightly better than SIMS and SIMS performing slightly better than SRSI. Internet-Coached Feigners scored slightly lower on all three measures than feigners who were coached without the Internet links. Taken together, the results of this preliminary and exploratory study suggest that all three SVTs examined are sensitive to feigned depression even in the presence of symptom coaching, both with and without additional Internet-based information. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Symptom validity tests (SVTs) and performance validity tests (PVTs) are important tools in sociomedical assessments, especially in the psychosomatic context where diagnoses mainly depend on clinical observation and self-report measures. This study examined the relationship between reaction times (RTs) and scores on the Structured Inventory of Malingered Symptomatology (SIMS). It was proposed that slower RTs and larger standard deviations of reaction times (RTSDs) would be observed in participants who scored above the SIMS cut-off (>16). Methods: Direct surface electromyography (EMG) was used to capture RTs during a computer-based RT test in 152 inpatients from a psychosomatic rehabilitation clinic in Germany. Correlation analyses and Mann-Whitney U were used to examine the relationship between RTs and SIMS scores and to assess the potential impact of covariates such as demographics, medical history, and vocational challenges on RTs. Therefore, dichotomized groups based on each potential covariate were compared. Results: Significantly longer RTs and larger RTSDs were found in participants who scored above the SIMS cut-off. Current treatment with psychopharmacological medication, diagnosis of depression, and age had no significant influence on the RT measures. However, work-related problems had a significant impact on RTSDs. Conclusion: There was a significant relationship between longer and more inconsistent RTs and indicators of exaggerated or feigned symptom report on the SIMS in psychosomatic rehabilitation inpatients. Findings from this study provide a basis for future research developing a new RT-based PVT. [ABSTRACT FROM AUTHOR]

We aimed to verify the capacity of the Dimensional Clinical Personality Inventory 2 (IDCP-2) factors to identify people with high levels of dependent personality disorder (DPD) traits in a Brazilian sample extracted from the general population. Participants were 1469 adults who responded to factors from the IDCP-2, the Personality Inventory for DSM-5 (PID-5), and the Structured Clinical Interview for the DSM-IV—Personality Questionnaire (PQ-SCID-II). We found three profiles via Latent Profile Analysis using PID-5 facets. Based on the discrimination capacity of IDCP-2 factors to identify these profiles, we created a DPD score for screening patients showing high levels of DPD traits. The IDCP-2 factors were discriminative of the profiles, showing large effects, except Perseveration. The DPD score presented a cutoff equal to 23 with good discriminative indicators, prioritizing the ability to produce fewer false negatives, and higher than those observed in the PQ-SCID-II. The DPD score can be clinically employed to indicate patients presenting a profile matching the DPD pattern. Moreover, the DPD score can assist the professional in mapping the patient's pathological profile into typical DPD traits, as well as helping to plan more personalized interventions. Studies focusing on clinical samples must be conducted to investigate whether our findings replicate. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) as an ultra-brief screener of depression and anxiety in the Philippines during the COVID-19 outbreak. Data from 4,524 non-clinical community respondents aged 18-73 years old was collected online between March and July 2020. We evaluated the screener's factor structure, measurement invariance, and criterion-related validity using confirmatory factor analysis (CFA), multigroup CFA, and structural equation modeling (SEM), respectively. We also evaluated the accuracy of the PHQ-4 cut-off scores by comparing the them with the screeners' full scales (i.e., PHQ-9 and GAD-7). Using the cutoff scores of the screeners, we also estimated the prevalence rates of depression and anxiety. The PHQ-4 has good internal reliability (Cronbach's α = 0.82). The CFA results show that the two-factor model has an excellent model fit that is superior to the one-factor model. The two-factor model held through increasingly constrained multigroup CFA models across gender, age, and geographical location groups, demonstrating measurement invariance. The SEM model supported the PHQ-4's theoretical association to stress, negative affect, and positive affect, supporting the screener's criterion-related validity. In estimating prevalence rates, among those screened by the PHQ-4 cut-off scores for depression (n = 1,905, 42.11%) and anxiety (n = 1,853, 40.96%), 81.78% and 94.06% were consequently screened by the PHQ-9 and GAD-7, respectively. This study supports the reliability, validity, and measurement invariance of the PHQ-4 as an ultra-brief screener of depression and anxiety in a large community sample in Southeast Asia. The inclusion of ultra-brief screeners in COVID-19-related studies and other human disasters, especially among non-clinical samples in low- and middle-income countries, is relevant for the sustainable evaluation and monitoring of the severity mental health symptoms leading to timely and effective mental health service provision. [ABSTRACT FROM AUTHOR]

Objective Illness intrusiveness refers to the subjective cognitive appraisal of a chronic health condition interfering in daily, valued activities and may be highly relevant for parents of children with atypical genital appearance due to differences of sex development (DSD). However, a measure of illness intrusiveness has not been validated for this population. The current study aimed to evaluate the factor structure of the Illness Intrusiveness Scale for Parents (IIS-P) and examine convergent validity. Methods Participants included 102 parents (M age = 33.39 years, SD  =   6.48; 58% mothers) of 65 children (<2 years old) diagnosed with DSD participating in a larger, longitudinal study. Parents completed the IIS-P as well as self-report measures of stigma, and anxious and depressive symptoms. An exploratory factor analysis (EFA) was conducted. Results EFA results supported a 1-factor intrusiveness solution (α  =  .93), as well as a 2-factor solution measuring intrusiveness on daily living (α  =  .92) and community connectedness (α  =  .85). The 1-factor solution and both factors of the 2-factor solution demonstrated significant convergent validity with stigma as well as anxious and depressive symptoms. Conclusions Support emerged for both 1- and 2-factor solutions of the IIS-P in parents of children with DSD. The decision to evaluate illness intrusiveness as a total score or to examine the subscales of daily living and community connectedness should be tailored to the unique aims of researchers and clinicians. Future research should conduct a confirmatory factor analysis with both 1- and 2-factor models with larger, more diverse samples of caregivers. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose: To develop and validate a trans oral endoscopic thyroidectomy vestibular approach (TOETVA) simulator. Methods: The first phase of the project consisted of designing and developing a transoral thyroid surgery simulator based on real surgeries. The product has the oral cavity for attaching the three trocars and the cervical part containing the thyroid and adjacent structures. In the second phase, the simulator was validated by specialists who performed an endoscopic thyroidectomy procedure. They all filled a questionnaire about the simulator and the simulation based on the Likert scale. Results: The simulator consists of a console similar to a human bust and a high-resolution camera system connected to a 22-inch monitor. The simulator had excellent results in the visual evaluation (face validity), with 100% of responses between good and excellent for the following characteristics: synthetic structures, design, visibility of the surgery field, resistance, resilience, fulcrum effect, ergonomics, surgical material, and practicality. The last three were rated higher, with more votes for excellent. For content validity, the items that received the best ratings were, precisely, the steps relating to the surgical procedure: opening the intermuscular midline, isthmotomy, and thyroidectomy. Conclusions: The thyroidectomy training box showed great ability to simulate a TOETVA, with satisfactory evaluations concerning its visual and content validation.