Cross-Cultural Validity in Malingering Assessment: The Dot Counting Test in a Rural Indian Sample

Abstract

With the ever-increasing cultural diversity in the United States, the need for malingering assessment instruments that are valid in diverse cultures and languages has become increasingly apparent. Although language-based tests are obviously problematic when applied to non-English speaking individuals, even nonverbal tests may have subtle (or blatant) biases that render normative data from U.S. samples inaccurate. This study focused on the applicability of a nonverbal malingering test, the Dot Counting Test, in a non-Western population undergoing forensic evaluation for a civil lawsuit. The DCT was administered to 105 Punjabi Sikh litigants, and the distribution of scores and associations with clinical and demographic variables was analyzed. Results demonstrated that a large proportion of seemingly honest respondents (based on clinician ratings) were misclassified as likely malingering based on the DCT. The implications for malingering assessment are discussed.

Keywords:

• forensic assessment
• malingering
• dot counting test
• cross-cultural validity

Acknowledgments

The authors express their appreciation and acknowledge our colleagues who participated in the design and implementation of this project: Allen Keller, M.D., Andrew Rasmussen, Ph.D., Richard Kasner, Iris Bazing, M.D., Kim Reeves, M.A., Jinna Halperin, M.P.H., and Vincent Iacopino, M.D., Ph.D. We are also grateful for the support of the Center for Information and Initiative in Punjab and Physicians for Human Rights.