Exaggerating Psychopathology Produces Residual Effects That Are Resistant to Corrective Feedback: An Experimental Demonstration

Abstract

We explored the effects of feedback on symptom reporting. Two experimental groups (n = 15 each) were given a scenario with the option to exaggerate symptoms. Compared with a control condition (n = 15), both groups scored significantly higher on the Structured Inventory of Malingered Symptomatology. Next, one group was confronted in a sympathetic way about their symptom validity test failure, whereas the other group was confronted in a neutral manner. Both groups subsequently completed the Brief Symptom Inventory (BSI). BSI scores of both feedback groups remained significantly higher than those of control participants. Participants who had been provided with sympathetic feedback or neutral feedback did not differ in their BSI scores. Even participants who indicated during the exit interview that they had given up symptom exaggeration attained significantly higher BSI scores than those of controls, indicating that exaggeration has residual effects that are resistant to corrective feedback. We discuss cognitive dissonance as a model for understanding the residual effects of symptom exaggeration.

Key words:

• cognitive dissonance
• feedback
• psychopathology
• residual effects
• symptom validity

ACKNOWLEDGEMENTS

This research was funded in part by a grant from the Netherlands Organisation for Scientific Research (NWO; Grant 4006-11-001).

Notes

¹Translations of the case vignette and the feedback instructions are available upon request and can be obtained from the first author.

Note. Data from the exit interview are also shown. Pairwise comparisons significant at the .01 level are designated as:

^a control differs from neutral feedback;

^b control differs from sympathetic feedback; and

^c feedback conditions differ from each other.

²One participant in the control group and one participant in the neutral feedback group had missing data for the BSI.