Factitious Psychological Disorders: The Overlooked Response Style in Forensic Evaluations

ABSTRACT

Forensic psychologists face two formidable challenges in the assessment of feigned mental disorders, not only identifying bogus presentations but also determining their primary motivation. Regarding the type of motivation, factitious presentations are largely overshadowed in forensic assessments by malingering. The study addresses the diagnostic conundrums inherent in distinguishing factitial from malingered presentations. As the first analogue research, it examines two factitious conditions (i.e., dependent and demanding interpersonal styles) and a malingered disability case. Advanced doctoral students in psychology were used because of their sophisticated understanding. They were administered the Personality Assessment Inventory (PAI) and Structured Inventory of Malingered Symptomatology (SIMS) via a simulation design. Contrary to expectations, few differences were found between factitial and malingering conditions on these measures. Of conceptual significance, results indicated that both factitious groups espoused an acute need for treatment. Of clinical relevance, the PAI Defensiveness Index produced moderate to large effect sizes between malingering and factitious presentations. Finally, the SIMS did not differentiate types of feigned condition, although a new index appears promising.

KEYWORDS:

• Factitious disorders
• malingering
• feigning
• response styles
• forensic evaluations