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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.

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

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

This is a short editorial to the special issue of Psychological Injury and Law. The first of the articles of this issue (Merten et al., Symptom and performance validity assessment in European countries: an update, in this issue) was conceived as the proper introduction. The collection contains eight contributions from authors doing their research in eight different countries (Austria, Belgium, Germany, Great Britain, Italy, the Netherlands, Spain, and Switzerland), using a variety of approaches (review and empirical articles, social security and criminal background, etc.). They describe major research trends and the state-of-the-art of validity assessment across the continent. They also reflect the transition from malingering assessment to validity testing and the extension of this field from forensic applications to clinical and rehabilitation referral contexts.

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

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

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

Some self-report symptom validity tests, such as the Self-Report Symptom Inventory (SRSI), rely on a detection strategy that uses bizarre, extreme, or very rare symptoms. Thus, items are constructed to invite respondents with an invalid response style to affirm pseudosymptoms that are usually not experienced by genuine patients. However, these pseudosymptoms should not be easily recognizable, because otherwise sophisticated over-reporters could strategically avoid them and go undetected. Therefore, we tested how well future psychology professionals were able to differentiate between genuine complaints and pseudosymptoms in terms of their plausibility and prevalence.Psychology students (N = 87) received the items of the SRSI online and were given the task to rate each item as to its plausibility and prevalence in the community.Students evaluated genuine symptoms as significantly more plausible and more prevalent than pseudosymptoms. However, 56% of students rated pseudosymptoms as moderately plausible, whereas 17% rated them as moderately prevalent in the general public.Overall, it appears that psychology students are successful in distinguishing bizarre, unusual, or rare symptoms from genuine complaints. Yet, the majority of students still attributed relatively high prima facie plausibility to pseudosymptoms. We contend that if such a trusting attitude is true for psychology students, it may also be the case for young psychology practitioners, which, consequently, may diminish the probability of employing self-report validity measures in psychological assessments.

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

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

In 2013, a special issue of the Spanish journal Clinica y Salud published a review on symptom and performance validity assessment in European countries (Merten et al. in Clinica y Salud, 24(3), 129-138, 2013). At that time, developments were judged to be in their infancy in many countries, with major publication activities stemming from only four countries: Spain, The Netherlands, Great Britain, and Germany. As an introduction to a special issue of Psychological Injury and Law, this is an updated report of developments during the last 10 years. In that period of time, research activities have reached a level where it is difficult to follow all developments; some validity measures were newly developed, others were adapted for European languages, and validity assessment has found a much stronger place in real-world evaluation contexts. Next to an update from the four nations mentioned above, reports are now given from Austria, Italy, and Switzerland, too.

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

Objective: The Self-Report Symptom Inventory (SRSI) is a new symptom validity test that, unlike other symptom over-reporting measures, contains both genuine symptom and pseudosymptom scales. We tested whether its pseudosymptom scale is sensitive to genuine psychopathology and evaluated its discriminant validity in an instructed feigning experiment that relied on carefully selected forensic inpatients (n = 40). Method: We administered the SRSI twice: we instructed patients to respond honestly to the SRSI (T1) and then to exaggerate their symptoms in a convincing way (T2). Results: On T1, the pseudosymptom scale was insensitive to patients’ actual psychopathology. Two patients (5%) had scores exceeding the liberal cut point (specificity = 0.95) and no patient scored above the more stringent cut point (specificity = 1.0). Also, the SRSI cut scores and ratio index discriminated well between honest (T1) and exaggerated (T2) responses (AUCs were 0.98 and 0.95, respectively). Conclusions: Given the relatively few false positives, our data suggest that the pseudosymptom scale of the SRSI is a useful measure of symptom over-reporting in forensic treatment settings.

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

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

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

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

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

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

Dandachi-FitzGerald, Ponds and Merten (2013) conducted a survey on symptom validity practices and beliefs among neuropsychologists from six European countries. Members of the German Neuropsychological Society constituted the largest group of participants. The results obtained for this subsample (n = 211) were selected for a review. Although research participants acknowledged the importance of a thorough evaluation of symptom validity, unstandardized assessment approaches appeared to prevail. The most common symptom validity tests employed by German neuropsychologists were the Testbatterie zur Forensischen Neuropsychologie, the Word Memory Test, the Rey 15-Item Memory Test, the Amsterdam Short-Term Memory Test and the Aggravations- und Simulationstest. Substantial variation was observed both for prevalence estimates of negative response bias in neuropsychological evaluations and for professionals' familiarity with modern approaches of symptom validation. Moreover, the relevance of symptom validation differed considerably between clinical and forensic referral contexts. Official professional guidelines for symptom validity assessment are still lacking for the German speaking countries.

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

We meta-analytically reviewed studies that used the Structured Inventory of Malingered Symptomatology (SIMS) to detect feigned psychopathology. We present weighted mean diagnostic accuracy and predictive power indices in various populations, based on 31 studies, including 61 subsamples and 4009 SIMS protocols. In addition, we provide normative data of patients, claimants, defendants, nonclinical adults, and various experimental feigners, based on 41 studies, including 125 subsamples and 4810 SIMS protocols. We conclude that the SIMS (1) is able to differentiate well between instructed feigners and honest responders; (2) generates heightened scores in groups that are known to have a raised prevalence of feigning (e.g., offenders who claim crime-related amnesia); (3) may overestimate feigning in patients who suffer from schizophrenia, intellectual disability, or psychogenic non-epileptic seizures; and (4) is fairly robust against coaching. The diagnostic power of the traditional cut scores of the SIMS (i.e., > 14 and > 16) is not so much limited by their sensitivity-which is satisfactory-but rather by their substandard specificity. This, however, can be worked around by combining the SIMS with other symptom validity measures and by raising the cut score, although the latter solution sacrifices sensitivity for specificity.

During the last decades, symptom validity has become an important topic in the neuropsychological and psychiatric literature with respect to how it relates to malingering, factitious disorder, and somatoform complaints. We conducted a survey among neuropsychologists (N = 515) from six European countries (Germany, Italy, Denmark, Finland, Norway, and the Netherlands). We queried the respondents about the tools they used to evaluate symptom credibility in clinical and forensic assessments and other issues related to symptom validity testing (SVT). Although the majority of the respondents demonstrated technical knowledge about symptom validity, a sizeable minority of the respondents relied on outdated notions (e.g., the idea that clinicians can determine symptom credibility based on intuitive judgment). There is little consensus among neuropsychologists on how to instruct patients when they are administered SVTs and how to handle test failure. Our findings indicate that the issues regarding how to administer and communicate the SVT results to patients warrant systematic research.

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

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

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

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

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

Self-report instruments to detect distorted symptom reporting play a crucial role in clinical and forensic psychology. Most of the instruments currently available for this purpose only list implausible symptoms, which makes them easily identifiable as symptom validity tests. We developed the Self-Report Symptom Inventory (SRSI), combining five self-report scales of genuine symptoms with five pseudosymptom scales to screen for distorted symptom reporting in various domains (e.g., depression, post-traumatic stress). With a preliminary questionnaire version, we collected data in a heterogeneous sample (N = 239) and performed an item selection, resulting in the final 107-item version. This version was evaluated in civil forensic patients, inmates of a prison, and a population-based sample; N = 387). Data show that (a) SRSI pseudosymptom scores correlate highly (=. 80) with other instruments tapping distorted symptom endorsement, notably the Structured Inventory of Malingered Symptomatology; (b) High SRSI pseudosymptom scores tend to correlate with underperformance; and (c) The psychometric features of the SRSI are satisfactory, with internal consistency for the total scales >.90 and retest reliability >.85. The instrument appears to be a promising tool for examining symptom exaggeration, but further work is required, in particular cross-validation with other samples and different methods.

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

This paper proposes that malingered symptoms may become internalized due to the self-deceptive power of cognitive dissonance. Studies demonstrating how other-deception may turn into self-deception are briefly discussed, as are clinical notions about the overlap between malingering and medically unexplained symptoms. In our view this literature showcases the relevance of cognitive dissonance for research on malingering. A cognitive dissonance perspective may help to clarify how ambiguous sensations may escalate into subjectively compelling symptoms. This perspective suggests that malingered symptom reports are more than just a complication during psychological evaluation. It may generate new research avenues and may clarify practically relevant issues.

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

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

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

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