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. 2024 Feb 8:15:1320636.
doi: 10.3389/fpsyg.2024.1320636. eCollection 2024.

Malingering assessment after severe traumatic brain injury in forensic psychology with a potential embedded symptom validity indicator of Symptom Checklist 90

Cong Liu #  1 , Qiuying Lu #  1   2 , Guangxun Rao #  1 , Xiaorui Chen  1 , Man Liang  1 , Zilong Liu  1
Affiliations

Malingering assessment after severe traumatic brain injury in forensic psychology with a potential embedded symptom validity indicator of Symptom Checklist 90

Cong Liu et al. Front Psychol. .

Abstract

Objective: Malingering of neuropsychological damage is common among traumatic brain injury patients pursuing disability compensation in forensic contexts. There is an urgent need to explore differences in neuropsychological assessment outcomes with different levels of cooperation.

Methods: A total of 420 participants with severe traumatic brain injury were classified into malingering group, partial cooperation group, and complete cooperation group according to the Binomial forced-choice digit memory test. The Wechsler Adult Intelligence Scale, event-related potential component, and Symptom Checklist 90 were applied subsequently to assess the psychological status of participants.

Results: Participants in the malingering group presented lower scores in the binomial forced-choice digit memory test and the Wechsler Adult Intelligence Scale, lower P3 amplitude, and simultaneously higher scores in the Symptom Checklist 90 than the other two groups. The actual intelligence quotient of participants with malingering tendencies ranged mostly between normal and marginal damage, and they often reported elevated whole scale scores in the Symptom Checklist 90. The Cooperation Index (defined as the ratio of positive symptom distress index to global severity index, CI) was proposed and validated to function as an embedded validity indicator of the Symptom Checklist 90, and the area under the receiver operating characteristic (ROC) curve was 0.938. When valued at 1.28, CI has the highest classification ability in differentiating malingering from non-malingering. Combined with the CI and P3 amplitude, the area under the ROC curve for malingering diagnosis further reached 0.952.

Conclusion: Any non-optimal effort in a forensic context will lead to unexpected deviation in psychology evaluation results. CI is a potential candidate to act as an embedded validity indicator of the Symptom Checklist 90. The combination of CI and P3 amplitude can help to identify malingering in participants after severe traumatic brain injury.

Keywords: P300 event-related potentials; Symptoms Checklist 90; disability compensation; forensic psychology; intelligence quotient; malingering; traumatic brain injury.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The test procedure for this study.
Figure 2
Figure 2
The receiver operating characteristic (ROC) analysis of N2 latency, N2 amplitude, P3 latency, and P3 amplitude as indicators for malingering assessment.
Figure 3
Figure 3
The nine subscale scores of SCL-90 of patients from five groups (norm, M-G, PC-G, CC-G, and M-G after correction).
Figure 4
Figure 4
The ROC analysis of cooperation index (CI) and positive symptom total (PST) as validity indicators for malingering assessment in the current sample.
Figure 5
Figure 5
ROC analysis using the combination of CI and P3 latency as the index of malingering assessment in the current sample.
See this image and copyright information in PMC

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