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OtherANALYSIS AND COMMENTARY

Clinical and Conceptual Problems in the Attribution of Malingering in Forensic Evaluations

Sanford L. Drob, Kevin B. Meehan and Shari E. Waxman
Journal of the American Academy of Psychiatry and the Law Online March 2009, 37 (1) 98-106;
Sanford L. Drob
PhD
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Kevin B. Meehan
PhD
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Shari E. Waxman
EdM
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Abstract

The authors review clinical and conceptual errors that contribute to false attributions of malingering in forensic evaluations. Unlike the mental disorders, malingering is not defined by a set of (relatively) enduring symptoms or traits; rather, it is an intentional, externally motivated, and context-specific form of behavior. Despite this general knowledge, attributions of malingering are often made by using assessment tools that may detect feigning but cannot be relied upon to determine incentive and volition or consciousness (defining characteristics of malingering). In addition, forensic evaluators may overlook the possibility that feigning is a function of true pathology, as in Ganser syndrome or the factitious disorders, or that a seemingly malingered presentation is due to symptoms of an underlying disorder, such as dissociative identity disorder (DID). Other factors that set the stage for false positives, such as pressure on forensic specialists to identify malingering at all costs, failure to consider the base rate problem, and cultural variables, are also reviewed.

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Journal of the American Academy of Psychiatry and the Law Online: 37 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 37, Issue 1
March 2009
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Clinical and Conceptual Problems in the Attribution of Malingering in Forensic Evaluations
Sanford L. Drob, Kevin B. Meehan, Shari E. Waxman
Journal of the American Academy of Psychiatry and the Law Online Mar 2009, 37 (1) 98-106;

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Clinical and Conceptual Problems in the Attribution of Malingering in Forensic Evaluations
Sanford L. Drob, Kevin B. Meehan, Shari E. Waxman
Journal of the American Academy of Psychiatry and the Law Online Mar 2009, 37 (1) 98-106;
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  • Article
    • Abstract
    • Malingering as a Diagnosis
    • Assessment of Malingering as Lie Detection
    • Consciousness, Volition, and Intention
    • Hysteria and Dissociation
    • Factitious Disorders and the Ganser Syndrome
    • The Assumption of a Rational, Willing Subject
    • Malingering, Genuine Pathology, Acquiescence, and Cultural Difference
    • Content Validity of the Malingering Construct
    • Malingering and the Base Rate Problem
    • The Ethics of Misclassification
    • Clinician and Interactional Variables in the Assessment of Malingering
    • Conclusion
    • References
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