How good are inpatients at feigning Miranda abilities?: An investigation of the Miranda Quiz, Inventory of Legal Knowledge, and Structured Inventory of Malingered Symptomatology.

The current study represents the first investigation into feigned Miranda abilities using an inpatient population. We investigated the use of a very generic measure (i.e., the Structured Inventory of Malingered Symptomatology, or SIMS) as well as two specialized forensic feigning measures: the Miranda Quiz (MQ) and Inventory of Legal Knowledge (ILK). With a quasi-random assignment, 82 acute inpatients were evenly distributed to "feigning" and "genuine" groups. The recommended SIMS cut score > 14 performed poorly, misclassifying three-quarters of the genuine group as feigning. In general, sensitivities on the specialized scales were constrained by the general lack of severe decrements for the feigning group. However, specificities were strong to outstanding. In particular, the MQ floor effect showed some promise but was limited by its small number of items. The strongest potential was observed for the revised ILK scales, especially the Revised Clinical ILK (RC-ILK). When using single-point cut scores on two prior correctional samples, the RC-ILK produced excellent sensitivities (0.94 and 0.96) and outstanding specificities (0.98 and 0.99). Methodological issues and professional implications were discussed in the context of feigned Miranda abilities.

Embedded WAIS-IV Detection Strategies and Feigned Cognitive Impairment: An Investigation of Malingered ADHD.

Malingered attention-deficit hyperactivity disorder (ADHD) may be strongly motivated on college campuses by recreational use of ADHD medications and to obtain unwarranted academic accommodations. Rather than rely on face-valid (easily faked) ADHD checklists, the study focused on the more complex Wechsler Adult Intelligence Scale-Fourth edition (WAIS-IV; Wechsler, 2008). However, the current literature has not yet investigated well-defined detection strategies for feigned WAIS-IV presentations. Using aprioristic standards, four different detection strategies from the feigning literature were adapted to certain WAIS-IV subscales. For example, significantly below-chance performance was applied to visual puzzles. Using a between-subjects simulation design, 74 undergraduate simulators were compared with archival data on 73 outpatients diagnosed with ADHD at a university psychology clinic. Very large effect sizes (Cohen's ds from 1.66 to 1.90) differentiated between genuine and feigned ADHD. Two strategies (significantly below-chance performance and floor effect) showed strong promise if cross-validated for other feigning presentations. The study concluded with clinical considerations and future avenues for research.

Differentiating factitious psychological presentations from malingering: Implications for forensic practice.

Practitioners and researchers have long been challenged with identifying deceptive response styles in forensic contexts, particularly when differentiating malingering from factitious presentations. The origins and the development of factitious disorders as a diagnostic classification are discussed, as well as the many challenges and limitations present with the current diagnostic conceptualization. As an alternative to a formal diagnosis, forensic practitioners may choose to consider most factitious psychological presentations (FPPs) as a dimensional construct that are classified like malingering as a V code. Building on Rogers' central motivations for malingering, the current article provides four explanatory models for FPPs; three of these parallel malingering (pathogenic, criminological, and adaptational) but differ in their central features. In addition, the nurturance model stresses how patients with FPPs attempt to use their relationship with treating professionals to fulfill their unmet psychological needs. Relying on these models, practical guidelines are recommended for evaluating FPPs in a forensic context.

Missing out on Miranda: Investigating Miranda comprehension and waiver decisions in adult inpatients.

Internationally, millions of arrests occur each year, but very little is known about how suspects are informed regarding their rights as the accused and whether these rights are accurately understood. Concerns regarding accurate comprehension are further heightened for suspects with severe mental disorders (SMDs). In the United States alone, it is estimated ≥300,000 mentally disordered suspects are arrested annually and Mirandized (i.e., given American warnings regarding the rights of the accused). Despite this widespread prevalence, only two published studies have specifically targeted impaired Miranda comprehension for persons with SMDs, and none has focused directly on Miranda reasoning and waiver decisions. The current study examined both Miranda comprehension and reasoning for 85 adult inpatients recruited from a private psychiatric hospital with three major findings. First, inpatients extremely poor Miranda recall, averaging only 21.3% of the total warning. Second, none appeared to exhibit adequate abilities for Miranda reasoning. Third, an initial waiver of rights always led to a confession within several minutes of questioning. These findings and methodological issues are discussed for the United States as well as other countries.