Repressed Memories (of Sexual Abuse Against Minors) and Statutes of Limitations in Europe: Status Quo and Possible Alternatives.

One of the most heated debates in psychological science concerns the concept of repressed memory. We discuss how the debate on repressed memories continues to surface in legal settings, sometimes even to suggest avenues of legal reform. In the past years, several European countries have extended or abolished the statute of limitations for the prosecution of sexual crimes. Such statutes force legal actions (e.g., prosecution of sexual abuse) to be applied within a certain period of time. One of the reasons for the changes in statutes of limitations concerns the idea of repressed memory. We argue that from a psychological standpoint, these law reforms can be detrimental, particularly when they are done to endorse unfounded psychological theories. The validity of testimonies is compromised many years after the alleged facts, and abolishing the statute of limitations increases the chance that even more (false) recovered memories of abuse might enter the courtroom. We propose solutions to these changes such as establishing an independent expert committee evaluating claims of sexual abuse.

[Social security disability assessments: validity tests are useful]. / Verzekeringsgeneeskundige oordeelsvorming.

Social security disability assessors are required to objectively quantify disability with regards to potential ability to work. Difficulties arise when assessments need to be performed in the absence of objective medical data relying solely on self-report regarding subjective health complaints. In such cases, validity tests provide a useful tool during an assessment. This case report illustrates this through the outcomes of 3 disability assessments.

The prevalence of feigning and concealment of Covid-19 infections in an international sample.

We asked 463 participants from 21 countries whether they had feigned and/or concealed having a coronavirus infection during the pandemic period. 384 respondents (83%) reported having experienced a coronavirus infection. They were, on average, younger and reported more chronic health issues than participants who said they had never been infected. 65 (14%) admitted to having feigned the infection. Prevalence doubled (28%) when asked if they knew anyone who had feigned a coronavirus infection. Main motives for feigning were to stay at home and to obtain sick leave. As to having concealed a coronavirus infection, 56 (12%) responded affirmatively, but when asked about others, the prevalence reached 51% (n = 210). The most common reasons for concealment were to avoid letting others know and to not miss an event. Thus, both feigning and concealing infections can occur on a nontrivial scale, directly affecting prevalence rates in studies that rely on self-reported data collected from social platforms.

Can false denials turn fact into fiction? The effect of false denials on memory for self-performed actions.

We examined the mnemonic effects of falsely denying a self-performed action. Specifically, participants (N = 30) performed, imagined, or received no instruction about 24 action statements (e.g., "cross your arms"). Next, their memory for whether they had performed, imagined, or did nothing (i.e., received no instructions) with these actions was tested. Subsequently, participants were instructed to repeatedly deny an action they had performed (false denial) and to repeatedly claim to have performed an action they had only imagined (false admission). In a final sorting memory task, 54% (n = 16) of participants erroneously indicated, after false admissions, that they had performed the imagined action. None of the participants indicated that they had only imagined an action after false denials, showing that it might be difficult to forget a performed action, even after repeatedly denying it. The current experiment sets the stage for future research to investigate why it seems to be difficult to forget performed actions.

Experts' Failure to Consider the Negative Predictive Power of Symptom Validity Tests.

Feigning (i.e., grossly exaggerating or fabricating) symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests (SVTs) have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM's stereotypical yet faulty profile of the "antisocial" feigner. Across three studies, we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students (Study 1, N = 55) and clinical experts (Study 2, N = 42; Study 3, N = 93) a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale (i.e., 50) and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants (i.e., psychology students, N = 92) about the shortcomings of the DSM's antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1-3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis.

Cry for help as a root cause of poor symptom validity: A critical note.

When patients fail symptom validity tests (SVTs) and/or performance validity tests (PVTs), their self-reported symptoms and test profiles are unreliable and cannot be taken for granted. There are many well-established causes of poor symptom validity and malingering is only of them. Some authors have proposed that a cry for help may underlie poor symptom validity. In this commentary, we argue that cry for help is a (1) metaphorical concept that is (2) difficult to operationalize and, at present, (3) impossible to falsify. We conclude that clinicians or forensic experts should not invoke cry for help as an explanation for poor symptom validity. To encourage conceptual clarity, we propose a tentative framework for explaining poor symptom validity.

Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework.

For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identifyempirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation.

No self-serving bias in therapists' evaluations of clients' premature treatment termination: An approximate replication of Murdock et al. (2010).

In an often-cited study, Murdock et al. (2010) found that therapists are more likely to attribute premature treatment termination to client characteristics than to themselves, a finding that the authors interpreted in terms of a self-serving bias (SSB). We replicated and extended the study of Murdock et al. (2010, study 2). Psychologists and psychotherapists (N = 91) read two case vignettes about premature treatment terminations of clients that, in a between-subjects set-up, were either described as own clients or other therapists' clients. Next, participants used three attribution subscales (blaming therapist, client and situation) to evaluate potential causes for the premature terminations. This way, we tested whether participants would manifest SSB. We also investigated whether therapists' scores on self-confidence and need for closure were linked to SSB tendencies. Unlike Murdock et al. (2010), we found no overall SSB. However, a stronger need for closure was related to more SSB tendencies (i.e., less endorsement of 'blame therapist' attributions) in the own-client condition (r = -.35, p < .05, r2 = .12), but not in the other-therapist's-client condition (r = .17, p = .27). Our results suggest that SSB is not a ubiquitous phenomenon when therapists evaluate premature termination problems and that their willingness to attend to their own role depends to some extent on their need for closure.

Consistency does not aid detection of feigned symptoms, overreporting does: Two explorative studies on symptom stability among truth tellers and feigners.

Practitioners always want to exclude the possibility that a patient is feigning symptoms. Some experts have suggested that an inconsistent symptom presentation across time (i.e., intraindividual variability) is indicative of feigning. We investigated how individuals with genuine pain-related symptoms (truth tellers; Study 1 n = 32; Study 2 n = 48) and people feigning such complaints (feigners; Study 1 n = 32; Study 2 n = 28) rated the intensity of their symptoms across a 5-day period. In both studies, feigners reported on all 5 days significantly higher symptom intensities than people with genuine complaints, but the two groups did not differ with regard to symptom (in)consistency. Thus, persistently inflated, rather than inconsistent, reports of symptom intensity over time are suggestive of feigning. The implications and limitations of our work are discussed.

Memory and eye movement desensitization and reprocessing therapy: a potentially risky combination in the courtroom.

Does Eye Movement and Desensitization and Reprocessing (EMDR) therapy affect the accuracy of memories? This recurrent issue in recent memory research bears relevance to expert witness work in the courtroom. In this review, we will argue that several crucial aspects of EMDR may be detrimental to memory. First, research has shown that eye movements undermine the quality and quantity of memory. Specifically, eye movements have been shown to decrease the vividness and emotionality of autobiographical experiences and amplify spontaneous false memory levels. Second, a sizeable proportion of EMDR practitioners endorse the controversial idea of repressed memories and discuss the topic of repressed memory in therapy. Third, in the Dutch EMDR protocol, patients are instructed to select the target image by using flawed metaphors of memory (e.g., memory works as a video). Such instructions may create demand characteristics to the effect that people over-interpret imagery during therapy as veridical memories. Collectively, the corpus of research suggests that several components of EMDR therapy (i.e., performing eye movements, therapist beliefs and therapeutic instructions) may undermine the accuracy of memory, which can be risky if patients, later on, serve as witnesses in legal proceedings.

Belief in Unconscious Repressed Memory Persists.

On the basis of converging research, we concluded that the controversial topic of unconscious blockage of psychological trauma (i.e., repressed memory) remains very much alive in clinical, legal, and academic contexts. In his commentary, Brewin (this issue, p. 443) conducted a cocitation analysis and concluded that scholars do not adhere to the concept of unconscious repression. Furthermore, he argued that previous survey research did not specifically assess unconscious repression. Here, we present critical evidence that runs counter to his claims. First, we inspected his cocitation analysis and found that some scholars support notions that are closely related to unconscious repression. Furthermore, we conducted another analysis on the basis of articles' similarity. Again, we found examples of scholars specifically endorsing unconscious repressed memories. Second, as opposed to what Brewin reports, recent survey research now exists that bears directly on people's beliefs regarding unconscious repression. This work reveals that large percentages of people (e.g., students and eye-movement desensitization and reprocessing [EMDR] clinicians) endorse the concept of unconscious repressed memories. The belief in unconscious repressed memory can continue to contribute to harmful consequences in clinical, legal, and academic domains (e.g., false accusations of abuse).

Self-Reported Voluntary Blame-Taking: Kinship Before Friendship and No Effect of Incentives.

Inspired by theories of prosocial behavior, we tested the effect of relationship status and incentives on intended voluntary blame-taking in two experiments (Experiment 2 was pre-registered). Participants (N E1 = 211 and N E2 = 232) imagined a close family member, a close friend, or an acquaintance and read a scenario that described this person committing a minor traffic offense. The person offered either a monetary, social, or no incentive for taking the blame. Participants indicated their willingness to take the blame and reasons for and against blame-taking. Overall, a sizable proportion of participants indicated to be willing to take the blame (E1: 57.8%; E2: 34.9%). Blame-taking rates were higher for family members than close friends or acquaintances in both experiments, as expected. Unexpectedly, there was no difference between a close friend and an acquaintance in Experiment 2. Social incentives did not have an effect on voluntary blame-taking in either experiment. Neither did we find an interaction between relationship status and incentives. The results highlight the importance of kin relationships in the context of voluntary blame-taking.

Associations between supernormality ('faking good'), narcissism and depression: An exploratory study in a clinical sample.

We explored underreporting of mental health symptoms and its correlates in adults receiving psychological treatment. We administered the Supernormality Scale (SS), the Minnesota Multiple Personality Inventory-2 (Restructured Form, MMPI-2-RF), the Narcissistic Personality Inventory (NPI) and the Beck Depression Inventory-II (BDI-2) to 147 patients at the start of their treatment. Supernormality (i.e., denial of common symptoms) was positively associated with MMPI-2(-RF) faking good parameters supporting the construct validity of the SS. Narcissism was negatively related to self-reported depression symptoms, but this association failed to reach significance (r = -.15, p = .07). This suggests that patients high on grandiose/overt narcissism might tend to deny common symptoms. The link between supernormality and depression symptoms as measured by the BDI-2 was substantial and negative (r = -.72). Our data suggest that supernormality is associated with constricted self-reports of depression. Given the clinical relevance of symptom underreporting, our preliminary findings require a large-scale replication.

Belief in unconscious repressed memory is widespread: A comment on Brewin, Li, Ntarantana, Unsworth, and McNeilis (2019).

What does believing in repressed memory mean? In a recent article in this journal, Brewin, Li, Ntarantana, Unsworth, and McNeilis (2019, Study 3) argued that when people are asked to indicate their belief in repressed memory, they might actually think of deliberate memory suppression rather than unconscious repressed memory. They further argued that in contrast to belief in unconscious repressed memory, belief in deliberate memory suppression is not scientifically controversial. In this commentary, we show that they are incorrect on both counts. Although Brewin and colleagues surveyed people to indicate their belief in deliberate memory suppression, they neglected to ask their participants whether they (also) believed in unconscious repressed memory. We asked people from the general population whether they believed that traumatic experiences can be unconsciously repressed for many years and then recovered. In 2 studies of the general population, we found high endorsement rates (Study 1 [N = 230]: 59.2% [n = 45]; Study 2 [N = 79]: 67.1% [n = 53]) of the belief in unconscious repressed memory. These endorsement rates did not statistically differ from endorsement rates to statements on repressed memory and deliberate memory suppression. In contrast to what Brewin et al. argued, belief in unconscious repressed memory among lay people is alive and well. Finally, we contend that Brewin et al. overstated the scientific evidence bearing on deliberate repression (suppression). (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Skirting the issue: What does believing in repression mean?

We show that, in contrast to Brewin, Li, Ntarantana, Unsowrth, and McNeilis (2019), large proportions of laypersons believe in the scientifically controversial phenomenon of unconscious repressed memories. We provide new survey data showing that when participants are asked specific questions about what they mean when they report that traumatic memories can be repressed, most provide answers strongly consistent with unconscious repression. Our findings continue to show that researchers, legal professionals, and clinicians should be wary of invoking unconscious repression in their work. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering.

Clinicians tend to overestimate their ability to recognize feigning behavior in psychiatric patients, especially if it concerns patients who have been admitted for observation. Feigning can be either externally motivated (e.g., for financial compensation, known as malingering) or internally motivated (e.g., to assume the "sick role," known as factitious disorder). Persistent presentation of severe symptoms is usually associated with the factitious disorder. We present two patients with strong external incentives who consistently and convincingly feigned severe psychiatric symptoms during a protracted period of inpatient observation in a specialized center; both were engaged in a procedure for medical asylum. The first case presented with the clinical picture of a psychotic depression with severe motor symptoms, and the second case showed symptoms of a chronic post-traumatic stress disorder with secondary psychotic symptoms. Both cases were thoroughly investigated but feigning was overlooked, and unnecessary and harmful treatment interventions were given. To prevent iatrogenic damage, we recommend a critical attitude that takes malingering as an option into account in settings where patients are often involved in high stake legal procedures. A clinical sign that might indicate feigning is therapy-resistant symptoms. To rule out feigning a comprehensive, multimethod approach is required, but an active stance toward collateral information is essential. Specialized psychological tests may be useful for preliminary screening, but for their use in culturally diverse populations as in refugee mental health more research is needed.

Increases of correct memories and spontaneous false memories due to eye movements when memories are retrieved after a time delay.

Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for post-traumatic stress disorder. However, literature on possible adverse memory effects of EMDR is scarce. Using the Deese/Roediger-McDermott (DRM) false memory paradigm, we examined the susceptibility to spontaneous false memories after performing eye movements, as used in EMDR. In Experiment 1, 72 undergraduates received word lists containing negative and neutral associated words and immediately after this they were given a free recall and recognition test. In Experiment 2, 68 undergraduates underwent the free recall and recognition test 48 h later. During the free recall phase in both experiments, participants either performed eye movements or not (control condition). In Experiment 1, the two conditions did not differ statistically with regard to correct and false recall/recognition. In Experiment 2, correct memory rates were higher in the eye movement than in the control condition and this was accompanied by an increase in spontaneous false memories on both free recall and recognition. Although our experimental approach is far removed from clinical practice, our findings suggest that eye movements as used in EMDR might amplify both correct and false memory rates.

The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma.

Can purely psychological trauma lead to a complete blockage of autobiographical memories? This long-standing question about the existence of repressed memories has been at the heart of one of the most heated debates in modern psychology. These so-called memory wars originated in the 1990s, and many scholars have assumed that they are over. We demonstrate that this assumption is incorrect and that the controversial issue of repressed memories is alive and well and may even be on the rise. We review converging research and data from legal cases indicating that the topic of repressed memories remains active in clinical, legal, and academic settings. We show that the belief in repressed memories occurs on a nontrivial scale (58%) and appears to have increased among clinical psychologists since the 1990s. We also demonstrate that the scientifically controversial concept of dissociative amnesia, which we argue is a substitute term for memory repression, has gained in popularity. Finally, we review work on the adverse side effects of certain psychotherapeutic techniques, some of which may be linked to the recovery of repressed memories. The memory wars have not vanished. They have continued to endure and contribute to potentially damaging consequences in clinical, legal, and academic contexts.

Dissociation and its disorders: Competing models, future directions, and a way forward.

Dissociative experiences and symptoms have sparked intense scrutiny and debate for more than a century. Two perspectives, the trauma model (TM), which postulates a direct and potent causal link between trauma and dissociation, and the sociocognitive model (SCM), which emphasizes social and cognitive variables (e.g., fantasy-proneness, media influences, suggestibility, suggestion, cognitive failures), currently vie for support. The intensive focus on controversies has stymied progress in understanding dissociation as much, if not more, than it has inspired research that transcends a single perspective. We assess strengths and limitations of these two perspectives and contend that neither provides a complete account of dissociation symptoms, which occur in the presence of many disorders. We provide a novel, narrative review of the link between dissociation and dissociative disorders and sleep disruptions, hyperassociativity, set shifts, deficits in meta-consciousness, and impaired self-regulation. We suggest that these transtheoretical variables (a) play a role in disorders that covary extensively with dissociative disorders (i.e., borderline personality disorder, schizophrenia spectrum disorders) and (b) provide the basis for overlapping foci of interests and potential collaborations among proponents of competing theoretical camps. Finally, we discuss limitations in knowledge and unresolved issues for future workers in the field to pursue.

Detecting feigned high impact experiences: A symptom over-report questionnaire outperforms the emotional Stroop task.

BACKGROUND AND OBJECTIVES: The Modified Stroop Task (MST) effect refers to a prolonged reaction time (RT) in color-naming words related to an individual's disorder. Some authors argue that its absence in people who claim symptoms might be an indication of feigning. METHOD: We tested whether the MST effect is robust against feigning attempts and compared its absence as an index of feigning with over-reporting tendencies on a symptom questionnaire (i.e., the Self-Reported Symptom Inventory (SRSI)). We included participants (n = 22) who i) reported current high impact of aversive experiences (High scorers), ii) reported current low impact (Low scorers) of aversive experiences (n = 24), and iii) actors (n = 18) with low impact, but instructed to feign current high psychological impact of aversive life events (Simulators). We administered the MST, including impact-related, neutral, and feigning-related words, and the SRSI. RESULTS: We found no MST effect for impact-related words in the high scorers group, or for feigning-related words in the simulators. Relative to high scorers and low scorers, simulators exhibited significantly longer RTs on all types of words and they also endorsed significantly more bogus symptoms on the SRSI. Thus, the SRSI was a more sensitive measure of feigning than the absence of an MST effect. LIMITATION: Some limitations are related to our reliance on a sub-clinical student sample, whereas others reflect the unresolved issues surrounding the MST. Thus, the generalizability of our results is uncertain. CONCLUSION: Our findings add to the doubts on the idea that the MST can be used to differentiate between genuine and feigned complaints.