Assessing patient’s subjective experience of illness is an important component of neuropsychological assessment. This information can be assessed using standardized self-reported complaint (SRC) checklists and may have specific applications in the assessment of malingering. Previous research suggests that subjective complaints can be faked under some circumstances, however, the extent to which this occurs when assessments are made using standardized SRC measures is less well understood. In addition, if complaints can be faked, this raises the question: What might reduce the likelihood of faked symptom reports? In this study, we randomly allocated 60 first-year undergraduate subjects to one of the three conditions: malingering, malinger-with-warning, and control. Using a repeated-measures analogue design, we assessed differences between groups on selected SRC measures. The measures used were the Neuropsychological Symptoms Checklist (NSC), the General Health Questionnaire-30 (GHQ-30), and the Depression, Anxiety, and Stress Scales (DASS). We expected to find that SRC measures would be vulnerable to faking, but also that warning malingerers about the possibility of detection would reduce faking behavior. Further, control group scores on SRC measures were calculated to produce preliminary complaint base rate data for these tests. Our results showed that SRC measures were vulnerable to faking. In addition, contrary to expectations, we found that warnings did not significantly deter malingering, although we observed that a trend in the expected direction and future studies with a larger sample size or a modified warning may be needed to further investigate warning efficacy. Broader implications of these findings are discussed in light of deterrence theory and recent debate over the use of SRC measures in the assessment of malingering.
The extent to which tests of ability such as memory can be faked has been the focus of much research in neuropsychology (Gouvier, Hayes, & Smiroldo, 1998; Haines & Norris, 1995 and Kropp & Rogers, 1993; Rogers, Harrell, & Liff, 1993; Vickery, Berry, Hanlon Inman, Harris, & Orey, 2001). These studies have attempted to assess the vulnerability of various objective measures of ability to malingering or symptom exaggeration (e.g., van Gorp et al., 1999). However, few studies have explored the vulnerability of measures of self-reported complaint (SRC) to malingering, even though these measures may also be used as part of neuropsychological assessment and generate information that may be used for a range of important clinical decisions. For example, information about SRCs may be used to inform decisions about which tests of ability should be administered (Lezak, 1995), and may contribute to the formulation of clinical impressions and diagnoses (Gouvier, Cubic, Jones, Brantley, & Cutlip, 1992; Lees-Haley & Brown, 1993 and Loring, 1995). In addition, SRC data may have a specific role facilitating the detection of malingering, for instance, through identification of inconsistent symptom—injury or complaint—performance relationships. This raises an interesting question about the extent to which measures of subjective complaint can be faked and whether there are ways of reducing faked symptom reports.
