Malingering and All That
Full course description
This course will deal with illness fabrication (faking bad) and illness denial (faking good) in forensic contexts. It will look into phenomena of fantasy proneness and related concepts such as pseudologia fantastica and supernormality. Also, attention will be given to defendants or claimants who feign conditions such as Post Traumatic Stress Disorder (PTSD), psychosis, and memory disorders. The psychometric detection of feigning is also relevant and therefore included in this topic.
Experts are not considered to be very skilled at detecting malingered symptoms, although they often think that they are. To fully grasp the problems that surround the issue of detecting faking good and faking bad, one has to understand the whole idea of signal detection and how there exists a tradeoff between sensitivity (fakers) and false positives (classifying honest people as fakers). It’s only when students have become fully familiar with this way of thinking that they are able to critically evaluate techniques and tests used to screen for faking. This psychometric approach is strongly advocated in the current course, and students will gain hands-on experience with a number of detection methods.
At the end of this course, students:
- are able to explain the key concepts of response bias, faking good, faking bad, malingering, feigning, factitious disorder, and supernormality, and how they relate to relevant sections from the DSM;
- are able to explain the rationale behind widely used symptom validity tests, specifically over-reporting tests and task tapping into underperformance;
- are able to apply these tests, score them, and summarize the results;
- are able to present the results in the form of a patient vignette/grand round.