Feigning ≠ Feigning a Memory Deficit: The Medical Symptom Validity Test as an Example

Abstract

The Medical Symptom Validity Test (MSVT) is a widely used memory test with three built-in effort measures that aim to detect feigning. We evaluated the merits of the MSVT as a broad screening tool for symptom validity. In study 1, we interviewed participants (N = 54) about the symptoms that they would and would certainly not feign. Non-specific somatic symptoms and depression were mentioned most frequently. Nearly 10% of the participants stated that they would certainly not feign memory problems. Study 2 contrasted the diagnostic accuracy of the MSVT with that of a broad index of symptom exaggeration (Structured Inventory of Malingered Symptomatology; SIMS) in experimental malingerers (N = 42) who were free to choose which psychological symptoms to feign. Although both tests correctly identified all honest controls (100% specificity), the SIMS surpassed the MSVT in correctly identifying experimental malingerers (91% versus 45%). In study 3, we explored the overlap between MSVT effort parameters and SIMS scores in a psychiatric sample (N = 21). Only one MSVT parameter (Delayed Recognition) was significantly related to SIMS scores (φ = -.52, p < .05). The results indicate that memory-oriented symptom validity tests such as the MSVT may be useful for detecting feigned memory deficits but that such tests perform less well as screening tools for other types of feigned psychopathology.