An Examination of Resnick's Model of Malingering: a Pai Study of Feigned Ptsd

Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge in personal injury and disability cases because of the apparent ease in feigning PTSD and the supposed link (proximate cause) to the claimed damages. The effective assessment of feigned PTSD is particularly challenging because this diagnosis is both easier to fake than other Axis I disorders and more difficult to detect. As an additional confound, some patients with genuine PTSD produce highly variable, elevated profiles on multiscale inventories that are difficult to distinguish from feigned PTSD. The current study examined whether the Personality Assessment Inventory (PAI) can effectively differentiate between genuine and feigned PTSD in 109 inpatients from a trauma unit. The two most effective scales were the MAL and the NDS scales. As a primary focus, the current study was the first empirical investigation of Resnick's model of malingered PTSD that is comprised of three subtypes: pure malingering (pure-M), partial malingering (partial-M), and false imputation (false-I). The primary goal was to evaluate whether each feigning group was able to (a) effectively simulate PTSD symptoms and diagnoses and (b) avoid being classified as feigning. The partial-M group proved to be the best feigning group in achieving these two goals. Furthermore, the use of well-defined groups, including an indeterminate band (i.e., unclassified) around each cut score, was explored. Overall, the use of well-defined groups improved accuracy in classification and reduced the number of false-positives