Detection of Malingered MVA Related Posttraumatic Stress Disorder

Abstract

This study investigated the ability of professional actors to fool experienced clinical evaluators with symptoms of posttraumatic stress disorder (PTSD) following a motor vehicle accident. Six trained method actors were coached with criteria for PTSD. Simulators were then entered covertly into an ongoing evaluation and treatment study in which six experienced clinical psychology doctoral students unknowingly evaluated the simulators. Examination of clinical interview material, psychological test measures and psychophysiological measures was then performed in both a case-by-case and group comparison method. Results revealed that none of the simulators were initially detected in the routine evaluations. When the assessors were told that they had, in fact, seen a simulator, results revealed that initial clinical judgment resulted in identifying three of the simulators. When clinical interview material was added with psychological test data and psychophysiological measures, accuracy increased to 91%. Six additional evaluators who had not performed the interview were able to identify 50% of the simulators, but false positives increased to 57%. Psychological test scores showed no significant differences between simulators and true MVA survivors with PTSD. Psychophysiological measures showed some sensitivity and potential for distinguishing malingerers simulating PTSD symptoms. Implications for simulation research and clinical practice are discussed.