Meta-analysis of the MMPI-2 fake bad scale: utility in forensic practice

Some clinical researchers disagree regarding the clinical utility of the MMPI-2 Fake Bad scale (FBS ) within forensic and clinical settings. The present meta-analysis summarizes weighted effect size differences among the FBS and other commonly used validity scales (L, F, K, Fb, Fp, F-K, O-S, Ds2, Dsr2 ) in symptom overreporting and comparison groups. Forty studies that included FBS were identified through exploration of online databases, perusal of published references, and communication with primary authors. Nineteen of the 40 studies met restrictive inclusion criteria, resulting in a pooled sample size of 3664 (1615 overreporting participants and 2049 comparison participants). The largest grand effect sizes were observed for FBS (.96), followed by O-S (.88), Dsr2 (.79), F-K (.69), and the F- scale (.63). Significant within-scale variability was observed for seven validity scales, including FBS (Q = 119.11, p < .001). Several subsequent FBS moderator analyses yielded moderate to large effect sizes and were statistically significant for level of cognitive effort, type of overreporting comparison group, and condition associated with overreporting (e.g., traumatic brain injury, posttraumatic stress, chronic pain). Findings suggest that the FBS performs as well as, if not superior to, other validity scales in discriminating overreporting and comparison groups; the preponderance of the present literature supports the scale's use within forensic settings.     

Comparison of MMPI-2 validity scale scores of personal injury litigants and disability claimants

Five validity scales derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Infrequency Scale (F), Infrequency-Psychopathology Scale (F[p]), Symptom Validity Scale (FBS), Henry-Heilbronner Index (HHI), and Response Bias Scale (RBS) were evaluated in 118 litigation patients (LPs) and 163 clinical patients (CPs). Varied statistical methods, including hierarchical logistic regression analyses, Receiver Operating Characteristic (ROC) curve, Area Under the Curve (AUC) values, and sensitivity/specificity analyses, showed that RBS performed better than the other four scales in identifying LPs. The regression analyses found RBS to be the most significant predictor of LP and CP group membership (p?相似文献   

The MMPI-2 Fake Bad Scale: concordance and specificity of true and estimated scores

A number of recent studies have supported the use of the MMPI-2 Fake Bad Scale (FBS) as a measure of negative response bias, the scale at times demonstrating greater sensitivity to negative response bias than other MMPI-2 validity scales. However, clinicians may not always have access to True FBS (T-FBS) scores, such as when True-False answer sheets are unavailable or published research studies do not report FBS raw scores. Under these conditions, Larrabee (2003a) suggests a linear regression formula that provides estimated FBS (E-FBS) scores derived from weighted validity and clinical T-Scores. The present study intended to validate this regression formula of MMPI-2 E-FBS scores and demonstrate its specificity in a sample of non-litigating, clinically referred, medically intractable epilepsy patients. We predicted that the E-FBS scores would correlate highly (>.70) with the T-FBS scores, that the E-FBS would show comparable correlations with MMPI-2 validity and clinical scales relative to the T-FBS, and that the E-FBS would show an adequate ability to match T-FBS scores using a variety of previously suggested T-FBS raw score cutoffs. Overall, E-FBS scores correlated very highly with T-FBS scores (r = .78, p < .0001), though correlations were especially high for women (r = .85, p < .0001) compared to men (r = .62, p < .001). Thirty-one of 32 (96.9%) comparisons made between E-FBS/T-FBS correlates with other MMPI-2 scales were nonsignificant. When matching to T-FBS "high" and "low" scores, the E-FBS scores demonstrated the highest hit rate (92.5%) through use of Lees-Haley's (1992) revised cutoffs for men and women. These same cutoffs resulted in excellent overall specificity for both the T-FBS scores (92.5%) and E-FBS scores (90.6%). The authors conclude that the E-FBS represents an adequate estimate of T-FBS scores in the current epilepsy sample. Use of E-FBS scores may be especially useful when clinicians conduct the MMPI-2 short form, which does not include all of the 43 FBS items but does include enough items to compute each of the validity and clinical T-Scores. Future studies should examine E-FBS sensitivity in compensation-seekers with incomplete effort.     

An investigation of the validity of the MMPI-2 response bias scale using an analog simulation design

This study evaluated a measure of feigned cognitive symptoms, the MMPI-2 Response Bias Scale (RBS), using an analog simulation design. A total of 81 participants were randomly allocated to one of two conditions: simulation (n?=?40) or control (n?=?41). Simulators were instructed to feign memory impairment. All participants completed an abbreviated form of the MMPI-2, Warrington's Word Recognition Memory test, and the Test of Memory Malingering. MMPI-2 data were used to calculate the RBS, F, K. FBS scores were prorated. Significant group differences were found on all measures. The effect size of group differences was largest for the RBS (d?=?2.52) compared to the prorated FBS (d?=?2.11), F (d?=?1.31), and K (d?=?0.85). Despite strong significant correlations between MMPI-2 scores, the RBS added incrementally to the other validity indicators in the prediction of group membership. The results from this RBS simulation study are consistent with several previous known-groups evaluations, which suggest that this scale is a useful indicator of negative response bias associated with exaggerated memory impairment.     

Differential sensitivity of the Response Bias Scale (RBS) and MMPI-2 validity scales to memory complaints

The MMPI-2 Response Bias Scale (RBS) is designed to detect response bias in forensic neuropsychological and disability assessment settings. Validation studies have demonstrated that the scale is sensitive to cognitive response bias as determined by failure on the Word Memory Test (WMT) and other symptom validity tests. Exaggerated memory complaints are a common feature of cognitive response bias. The present study was undertaken to determine the extent to which the RBS is sensitive to memory complaints and how it compares in this regard to other MMPI-2 validity scales and indices. This archival study used MMPI-2 and Memory Complaints Inventory (MCI) data from 1550 consecutive non-head-injury disability-related referrals to the first author's private practice. ANOVA results indicated significant increases in memory complaints across increasing RBS score ranges with large effect sizes. Regression analyses indicated that the RBS was a better predictor of the mean memory complaints score than the F, F(B), and F(P) validity scales and the FBS. There was no correlation between the RBS and the CVLT, an objective measure of verbal memory. These findings suggest that elevated scores on the RBS are associated with over-reporting of memory problems, which provides further external validation of the RBS as a sensitive measure of cognitive response bias. Interpretive guidelines for the RBS are provided.     

Comparison of MMPI-2 Validity Scale Scores of Personal Injury Litigants and Disability Claimants

Five validity scales derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Infrequency Scale (F), Infrequency-Psychopathology Scale (F[p]), Symptom Validity Scale (FBS), Henry-Heilbronner Index (HHI), and Response Bias Scale (RBS) were evaluated in 118 litigation patients (LPs) and 163 clinical patients (CPs). Varied statistical methods, including hierarchical logistic regression analyses, Receiver Operating Characteristic (ROC) curve, Area Under the Curve (AUC) values, and sensitivity/specificity analyses, showed that RBS performed better than the other four scales in identifying LPs. The regression analyses found RBS to be the most significant predictor of LP and CP group membership (p?<?.001). The effectiveness of RBS in identifying LPs, all of whom reported neuropsychological symptoms, was attributed to its development based on cognitive effort test scores.     

Differential sensitivity of the Response Bias Scale (RBS) and MMPI-2 validity scales to memory complaints

The MMPI-2 Response Bias Scale (RBS) is designed to detect response bias in forensic neuropsychological and disability assessment settings. Validation studies have demonstrated that the scale is sensitive to cognitive response bias as determined by failure on the Word Memory Test (WMT) and other symptom validity tests. Exaggerated memory complaints are a common feature of cognitive response bias. The present study was undertaken to determine the extent to which the RBS is sensitive to memory complaints and how it compares in this regard to other MMPI-2 validity scales and indices. This archival study used MMPI-2 and Memory Complaints Inventory (MCI) data from 1550 consecutive non-head-injury disability-related referrals to the first author's private practice. ANOVA results indicated significant increases in memory complaints across increasing RBS score ranges with large effect sizes. Regression analyses indicated that the RBS was a better predictor of the mean memory complaints score than the F, F_B, and F_P validity scales and the FBS. There was no correlation between the RBS and the CVLT, an objective measure of verbal memory. These findings suggest that elevated scores on the RBS are associated with over-reporting of memory problems, which provides further external validation of the RBS as a sensitive measure of cognitive response bias. Interpretive guidelines for the RBS are provided.     

The validity of the MMPI-2/MMPI-2-RF Symptom Validity Scale (FBS/FBS-r) is established: reply to Nichols (2017)

We reply to Nichols’ (2017) critique of our commentary on the MMPI-2/MMPI-2-RF Symptom Validity Scale (FBS/FBS-r) as a measure of symptom exaggeration versus a measure of litigation response syndrome (LRS). Nichols claims that we misrepresented the thrust of the original paper he co-authored with Gass; namely, that they did not represent that the FBS/FBS-r were measures of LRS but rather, intended to convey that the FBS/RBS-r were indeterminate as to whether the scales measured LRS or measured symptom exaggeration. Our original commentary offered statistical support from published literature that (1) FBS/FBS-r were associated with performance validity test (PVT) failure, establishing the scales as measures of symptom exaggeration, and (2) persons in litigation who passed PVTs did not produce clinically significant elevations on the scales, contradicting that FBS/FBS-r were measures of LRS. In the present commentary, we draw a distinction between the psychometric data we present supporting the validity of FBS/FBS-r, and the conceptual, non-statistical arguments presented by Nichols, who does not refute our original empirically based conclusions.     

Scores on the MMPI-2-RF scales as a function of increasing levels of failure on cognitive symptom validity tests in a military sample

This research examined associations between the full range of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity and substantive scales and increasing levels of cognitive symptom validity test (SVT) failure in a sample of 501 military members who completed a neuropsychological evaluation primarily for mild traumatic brain injury resulting from a closed head injury and blast exposure or heat injury. SVT failure was associated with significant linear increases in all of the over-reporting MMPI-2-RF validity scales and most of the substantive scales. For the validity scales, all over-reporting scales had large effect sizes (ESs) when comparing a group that failed no SVTs with a group that failed three SVTs. A comparison between these two groups for the substantive scales revealed the largest ESs for scales related to somatic/cognitive complaints and emotional dysfunction. RBS (Response Bias Scale) had the largest ES of all scales (d = 1.69), followed by FBS-r (Symptom Validity Scale; d = 1.34), AXY (Anxiety, d = 1.21), and COG (Cognitive Complaints, d = 1.19). The scales related to behavioral dysfunction had the smallest ESs of all of the substantive scales, and there were no significant associations between the vast majority of these scales and SVT failure. With respect to clinically significant elevations, those who did not fail SVTs had clinically significant elevations only on COG and NUC (Neurological Complaints), and MLS (Malaise) approached clinical significance. For those who failed SVTs, RBS was the only over-reporting scale that was elevated across all failure groups. Those who failed any SVT had clinically significant elevations on COG, MLS, NUC, and AXY. Those who failed three SVTs had additional elevations on scales related to emotional dysfunction.     

Utility of the MMPI-2-RF in detecting non-credible somatic complaints

We examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity scales (infrequent responses (F-r), infrequent psychopathology responses (Fp-r), infrequent somatic responses (Fs), symptom validity (FBS-r), and response bias (RBS)) in differentiating individuals who were asked to feign physical health problems from a group of somatoform disorder patients and genuine medical patients with no history of mental health problems. A large group of undergraduate students were instructed to feign physical health problems as if they were participating in a disability evaluation for a work-related injury. Comparison groups were drawn from archival databases and consisted of non-litigating medical patients or individuals carefully diagnosed with somatoform disorder. The Fs and Fp-r scales were associated with the best differentiation between the three groups; the Fs scale was the most sensitive to somatic malingering, whereas the Fp-r scale was the most specific. Both scales were associated with high likelihood ratios in differentiating the somatic malingering group from the somatoform and medical illness groups. Although the FBS-r scale was overall the most sensitive in differentiating non-credible somatic complaints from genuine medical illness, it could not differentiate well between the somatic malingering and somatoform patient conditions. The MMPI-2-RF appears to have considerable promise in detecting individuals who feign physical health problems. Not surprisingly, differentiating somatic malingering from somatoform disorder with the MMPI-2-RF was less accurate than differentiating somatic malingering from bona-fide medical patients.     

Examining the relationship between the reconstructed scales and the fake bad scale of the MMPI-2

This study explores the relationship between the Reconstructed (RC) scales and the Fake Bad Scale (FBS) of the MMPI-2 in the context of a personal injury population to demonstrate which RC scales are susceptible to symptom exaggeration. The sample consisted of 76 compensation-seeking participants who were assessed for neurocognitive dysfunction. A multiple regression analysis was performed to determine the association between the Reconstructed Scale T-scores with the FBS T-scores. Three of the nine RC scales (RC1, RC2, RC3) were significantly (p <. 05) associated with FBS, with RC7 demonstrating a strong trend (p =. 0526). These scale scores accounted for approximately 66% of the variation in the FBS score. The RC1 scale accounted for the most variation (R(2) =. 53). Results suggest that the RC scales are susceptible to exaggeration of somatic concerns and non-psychotic emotional distress.     

The Fake Bad Scale and MMPI-2 F-Family in Detection of Implausible Psychological Trauma Claims

We tested the validity of the Lees-Haley Fake Bad Scale (FBS) and the family of MMPI-2 F scales (F-family; F, F(p), and F-K scales) in predicting improbable psychological trauma claims in an applied setting. Litigants reporting implausible symptoms long after minor scares and nonlitigants clinically referred following severe stressors completed the MMPI-2. Both groups were naturally matched on social class. The FBS demonstrated sensitivity, specificity, and positive predictive power in the detection of atypical problems but the F-family showed poor utility. FBS cutting scores derived from logistic regression were applied to a third group made up of litigants with histories of undeniably severe traumas. A substantial number of this third group scored above cutoffs for exaggeration, but this finding is ambiguous. Reasons for the F-family's insensitivity to real-world exaggeration may include using student simulators for validation and content reflective of psychotic simulation. The superiority of the FBS in applied forensic settings could derive from its development in actual litigants and content reflective of nonpsychotic exaggerations. The FBS appears acceptable for use in applied forensic settings where persons seek compensation for nonpsychotic syndromes.     

Application of the new MMPI-2 Malingered Depression scale to individuals undergoing neuropsychological evaluation: relative lack of relationship to secondary gain and failure on validity indices

The Malingered Depression (Md) scale for the MMPI-2 (Steffan, Clopton, & Morgan, 2003) was recently developed to detect attempts at malingering depressive symptomatology. The Steffan et al. cutoffs for the Md scale were derived through comparisons of undergraduate malingering simulators with depressed undergraduates. In order to explore the potential utility for neuropsychological practice, we examined the Md scale among 160 individuals with and without a context of secondary gain referred for neuropsychological evaluation. Md results were compared to other MMPI-2 validity indices and performance on effort testing. While Md was found to correlate highly with other validity indices from the MMPI-2, it was also correlated significantly with measures of depression, both in individuals with and without a secondary gain context. Md scores were not significantly different between secondary gain and no secondary gain groups, whereas FBS and L were significantly different. The effect of passing or failing validity indicators on rates of Md scores exceeding the Steffan et al. cutoffs was limited. Only among the few individuals exceeding a high threshold on the F scale or combinations of F, FBS, and effort indicators was it common to also surpass the Md cutoff. Overall, Md showed relatively little relationship to either secondary gain status or cognitive malingering in our sample. Given that such factors do not necessarily produce high scores on Md, the utility of the scale to clinical neuropsychologists appears low.     

Scores on the MMPI-2-RF Scales as a Function of Increasing Levels of Failure on Cognitive Symptom Validity Tests in a Military Sample

This research examined associations between the full range of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity and substantive scales and increasing levels of cognitive symptom validity test (SVT) failure in a sample of 501 military members who completed a neuropsychological evaluation primarily for mild traumatic brain injury resulting from a closed head injury and blast exposure or heat injury. SVT failure was associated with significant linear increases in all of the over-reporting MMPI-2-RF validity scales and most of the substantive scales. For the validity scales, all over-reporting scales had large effect sizes (ESs) when comparing a group that failed no SVTs with a group that failed three SVTs. A comparison between these two groups for the substantive scales revealed the largest ESs for scales related to somatic/cognitive complaints and emotional dysfunction. RBS (Response Bias Scale) had the largest ES of all scales (d?=?1.69), followed by FBS-r (Symptom Validity Scale; d?=?1.34), AXY (Anxiety, d?=?1.21), and COG (Cognitive Complaints, d?=?1.19). The scales related to behavioral dysfunction had the smallest ESs of all of the substantive scales, and there were no significant associations between the vast majority of these scales and SVT failure. With respect to clinically significant elevations, those who did not fail SVTs had clinically significant elevations only on COG and NUC (Neurological Complaints), and MLS (Malaise) approached clinical significance. For those who failed SVTs, RBS was the only over-reporting scale that was elevated across all failure groups. Those who failed any SVT had clinically significant elevations on COG, MLS, NUC, and AXY. Those who failed three SVTs had additional elevations on scales related to emotional dysfunction.     

The Fake Bad Scale and MMPI-2 F-family in detection of implausible psychological trauma claims

We tested the validity of the Lees-Haley Fake Bad Scale (FBS) and the family of MMPI-2 F scales (F-family; F, F(p), and F-K scales) in predicting improbable psychological trauma claims in an applied setting. Litigants reporting implausible symptoms long after minor scares and nonlitigants clinically referred following severe stressors completed the MMPI-2. Both groups were naturally matched on social class. The FBS demonstrated sensitivity, specificity, and positive predictive power in the detection of atypical problems but the F-family showed poor utility. FBS cutting scores derived from logistic regression were applied to a third group made up of litigants with histories of undeniably severe traumas. A substantial number of this third group scored above cutoffs for exaggeration, but this finding is ambiguous. Reasons for the F-family's insensitivity to real-world exaggeration may include using student simulators for validation and content reflective of psychotic simulation. The superiority of the FBS in applied forensic settings could derive from its development in actual litigants and content reflective of nonpsychotic exaggerations. The FBS appears acceptable for use in applied forensic settings where persons seek compensation for nonpsychotic syndromes.     

The detection of content-based invalid responding: a meta-analysis of the MMPI-2-Restructured Form’s (MMPI-2-RF) over-reporting validity scales

Objective: This study synthesized research evaluation of the effectiveness of the over-reporting validity scales of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) for detecting intentionally feigned over-endorsements of symptoms using a moderated meta-analysis. Method: After identifying experimental and quasi-experimental studies for inclusion (k = 25) in which the validity scales of the MMPI-2-RF were compared between groups of respondents, moderated meta-analyses were conducted for each of its five over-reporting scales. These meta-analyses explored the general effectiveness of each scale across studies, as well as the impact that several moderators had on scale performance, including comparison group, study type (i.e. real versus simulation), age, education, sex, and diagnosis. Results: The over-reporting scales of the MMPI-2-RF act as effective general measures for the detection of malingering and over endorsement of symptoms with individual scales ranging in effectiveness from an effect size of 1.08 (Symptom Validity; FBS-r) to 1.43 (Infrequent Pathology; Fp-r), each with different patterns of moderating influence. Conclusions: The MMPI-2-RF validity scales effectively discriminate between groups of respondents presenting in either an honest manner or with patterned exaggeration and over-endorsement of symptoms. The magnitude of difference observed between honest and malingering groups was substantially narrower than might be expected using traditional cut-scores for the validity scales, making interpretation within the evaluation context particularly important. While all over-reporting scales are effective, the FBS-r and RBS scales are those least influenced by common and context specific moderating influences, such as respondent or comparison grouping.     

Let's Not Get Hysterical: Comparing the MMPI-2 Validity,Clinical, and RC Scales in TBI Litigants Tested for Effort

The MMPI-2 restructured clinical (RC) scales replace the traditional clinical scales in the MMPI-2 restructured form (MMPI-2-RF). Few studies to date have examined the MMPI-2 RC scales in traumatic brain injury (TBI) litigants. We compared MMPI-2 validity, clinical, and RC scales profiles of 83 mild, complicated mild, and moderate/severe TBI litigants who were tested for effort. Past research shows that patients referred for neuropsychological evaluations with mild TBIs paradoxically have higher MMPI-2 clinical scale elevations than patients with moderate/severe TBIs. Failure on cognitive symptom validity tests (SVTs) has also been associated with elevated validity and clinical scales profiles. The “conversion V” (elevated Hs and Hy, followed by D) is the most frequent elevated profile configuration in mild TBI and/or SVT failure. We sought to determine if these patterns of symptom reporting would replicate on the RC scales profile. Archival data from independent neuropsychological examinations were used to correlate TBI severity, cognitive test effort as indicated by SVTs, and MMPI-2 profiles. Results suggest that the validity, clinical, and RC scales profiles all correlate well with indices of cognitive test effort (namely that failure on SVTs is correlated with elevated symptom reporting). In addition, the validity scales profile, but not the clinical or RC scales profiles, was significantly inversely related to TBI severity. Discriminant function analyses suggest that the MMPI-2 RC scales can aid in the diagnosis of over-reported TBI symptomatology. However, RC3—the RC equivalent of the Hy scale—no longer appears to serve as a marker of somatization and/or malingering.     

Detection of symptom exaggeration with the MMPI-2 in litigants with malingered neurocognitive dysfunction

MMPI-2 scores of 26 persons identified as meeting criteria for definite malingered neurocognitive dysfunction (MND), were contrasted with the MMPI-2 scores of 29 persons who had suffered moderate or severe closed head injury. The Lees-Haley Fake Bad Scale (FBS) was the most sensitive MMPI-2 scale in discriminating the malingerers from the head-injured persons, with additional significant differences obtained on standard MMPI-2 clinical scales including Scales 1 (Hs), 2 (D), 3 (Hy), 7 (Pt), and 8 (Sc). Correlational analyses on a larger sample combining additional subjects with evidence of possible or probable MND, with the original sample and the head injured subjects, demonstrated the concurrent validity of the FBS, which correlated with the Portland Digit Recognition Test (PDRT), and with Scales 1 (Hs), 2 (D), 3 (Hy), and 7 (Pt) of the MMPI-2.