Irena Boskovic

Symptom overreporting and dissociative experiences: A qualitative review

We discuss a phenomenon that has received little attention to date in research on dissociative phenomena, namely that self-reports of these phenomena overlap with the tendency to overendorse eccentric items. We review the literature documenting the dissociation-overreporting link and then briefly discuss various interpretations of this link: (1) overreporting is an artifact of measuring dissociative symptoms; (2) dissociative psychopathology engenders overreporting of eccentric symptoms through fantasy proneness or impairments in internal monitoring; (3) an overreporting response style as is evident in malingerers, for example, promotes reports of dissociative symptoms. These three interpretations are not mutually exclusive. Also, the dissociation-overreporting link may have different origins among different samples. Because overreporting may introduce noise in datasets, we need more research specifically aimed at disentangling the dissociation-overreporting link. We suggest various avenues to accomplish this goal.

The Verifiability Approach to detection of malingered physical symptoms

ABSTRACT Inspired by recent research showing that liars are reluctant to include verifiable details in their accounts, we explored in two studies (N = 125; N = 105) whether participants who report fabricated symptoms (‘malingerers’) present fewer verifiable details than participants who report genuine ill-health symptoms. In Study 1, participants were instructed to describe a typical day on which they had experienced a genuine or malingered symptom. Truth tellers’ statements included significantly higher proportions of verifiable details concerning the reported symptoms than malingerers’ statements. Compared with truth tellers, malingerers generated longer statements with more unverifiable details. In Study 2, we informed participants that their statements may be assessed for verifiable or checkable details. Malingerers often mentioned ‘false’ witnesses to provide checkable information and differences between malingerers and truth tellers in statement length, and checkable and uncheckable details were no longer significant. The utility and implications of the Verifiability Approach to detection of malingering are discussed.

Alexithymia as a potential source of symptom over-reporting: An exploratory study in forensic patients and non-forensic participants

The traditional interpretation of symptom over-reporting is that it indicates malingering. We explored a different perspective, namely that over-reporting of eccentric symptoms is related to deficits in articulating internal experiences (i.e., alexithymia). Given that alexithymia has been linked to sleep problems and that fatigue may fuel inattentive responding to symptom lists, we administered measures of alexithymia (TAS-20) and symptom over-reporting (SIMS), but also sleep quality (SLEEP-50) to forensic psychiatric outpatients (n = 40) and non-forensic participants (n = 40). Forensic patients scored significantly higher on all three indices than non-forensic participants. In the total sample as well as in subsamples, over-reporting correlated positively and significantly with alexithymia, with rs being in the 0.50-0.65 range. Sleep problems were also related to over-reporting, but in the full sample and in the forensic subsample, alexithymia predicted variance in over-reporting over and above sleep problems. Although our study is cross-sectional in nature, its results indicate that alexithymia as a potential source of over-reporting merits systematic research.

Symptom self-reports are susceptible to misinformation.

We examined whether self-reported symptoms are affected by explicit and implicit misinformation. In Experiment 1, undergraduates (N = 60) rated how often they experienced somatic and psychological symptoms. During a subsequent interview, they were exposed to misinformation about 2 of their ratings: One was inflated (upgraded misinformation), whereas another was deflated (downgraded misinformation). Close to 82% of the participants accepted the upward symptom misinformation, whereas 67% accepted the downward manipulation. Also, 27% confabulated reasons for upgraded symptom ratings, whereas 8% confabulated reasons for downgraded ratings. At a follow-up test, some days later, participants (n = 55) tended to escalate their symptom ratings in accordance with the upgraded misinformation. Such internalization was less clear for downgraded misinformation. There was no statistically significant relation between dissociativity and acceptance or internalization of symptom misinformation. In Experiment 2, a more subtle and implicit form of misinformation was employed. Undergraduates (N = 50) completed a checklist of symptoms and were provided with feedback for some symptoms (targets), misleadingly suggesting that a slight majority of their peers experienced these targets on a regular basis. Next, participants rated the checklist again. Overall, symptom ratings went down for control but not for target symptoms. Taken together, our results demonstrate that symptom reports are susceptible to misinformation. The systematic study of symptom misinformation may help to understand iatrogenic effects in psychotherapy.

Verifiability on the run: an experimental study on the verifiability approach to malingered symptoms

Several studies on the verifiability approach found that truth-tellers report more verifiable details than liars. Therefore, we wanted to test whether such a difference would emerge in the context of malingered symptoms. We obtained statements from undergraduates (N = 53) who had been allocated to three different conditions: truth-tellers, coached malingerers and naïve malingerers. Truth-tellers carried out an intensive physical exercise and after a short interval wrote a report about their experience and elicited symptoms. The two malingering groups had to fabricate a story about the physical activity and its symptoms. Truth-tellers did not generate more verifiable details than malingerers. However, malingerers reported more non-verifiable details than truth-tellers. Coached and naïve malingerers did not differ in this respect. Relative to truth-tellers, naïve malingerers reported more symptoms-related non-verifiable details, while coached malingerers reported more exercise-related non-verifiable details. Focusing on non-verifiable details may inform the detection of malingered symptoms.

Posttraumatic Stress Disorder and Diminished Criminal Responsibility as "New Evidence" in Criminal Revision Procedures

Posttraumatic stress disorder (PTSD) may affect victims of crime, but may also be reported by offenders. In the postappeal phase, offenders may claim to suffer from chronic PTSD and argue that this indicates diminished criminal responsibility at the time the index crime was committed. As members of a Dutch criminal cases review commission, we recently encountered two cases in which PTSD was presented as new evidence that would justify a reopening of the case. In this article, we argue that such claims are problematic in that clinical decision making resulting in a PTSD diagnosis adheres to quite different standards than those dictating forensic fact‐finding. The two cases illustrate the difference between criminal and clinical fact‐finding.

The Modified Stroop Task Is Susceptible to Feigning : Stroop Performance and Symptom Over-endorsement in Feigned Test Anxiety

Some researchers argue that the modified Stroop task (MST) can be employed to rule out feigning. According to these authors, modified Stroop interference effects are beyond conscious control and therefore indicative of genuine psychopathology. We examined this assumption using a within-subject design. In the first session, students (N = 22) responded honestly, while in the second session they were asked to read a vignette about test anxiety and then fake this condition. During both sessions, we administered an MST consisting of neutral, anxiety-related, and test anxiety-related words. Participants also completed the Self-Report Symptom Inventory (SRSI; Merten et al., 2016) that focuses on over-reporting of pseudosymptoms. Our feigning instructions were successful in that students succeeded in generating the typical MST effect by providing longer response latencies on anxiety related (r = 0.43) and test anxiety-related (r = 0.31) words, compared with neutral words. Furthermore, students endorsed significantly more pseudosymptoms on the SRSI (r = 0.62) in the feigning session than in the honest control condition. We conclude that the MST effect is not immune to feigning tendencies, while the SRSI provides promising results that require future research.