Assessing Symptom Exaggeration of

Received: 6 May 2022 Revised: 20 September 2022 Accepted: 14 November 2022
DOI: 10.1002/bsl.2603
RESEARCH ARTICLE
Assessing symptom exaggeration of

psychopathology in incarcerated individuals and
mentally ill offenders within forensic contexts
Natthawut Arin1 | Jiraporn Mengchuay2
1
Faculty of Humanities, Department of
Psychology, Chiang Mai University, Suthep, Abstract
Thailand
In forensic contexts, there is a high probability that offend-
2
Department of Corrections, Medical
Correctional Hospital, Ministry of Justice,
ers may exaggerate illness to avoid legal punishment. Since
Bangkok, Thailand very few empirical studies presently exist on this matter in
Thailand, the objectives are to explore the prevalence rate
Correspondence
Natthawut Arin, Faculty of Humanities, of the exaggeration of psychopathological symptoms and
Department of Psychology, Chiang Mai to examine the detection strategy response styles for Thai
University, Suthep, Thailand.
Email: natth3601@gmail.com version of the Symptom validity test (SVT-Th). An analysis of
the factors that influence symptom exaggeration would also
Funding information
be included. Mixed participants included 608 individuals
Chiang Mai University
consisting of 528 Incarcerated individuals and 80 Mentally
Ill Offenders (MIOs). SVT-Th indicated the prevalence rates
of feigned psychopathology among overall offenders were
8.88%, 3.20% for incarcerated individuals, and 46.30%
for MIOs. As expected, the endorsed average scores of
the psychopathological symptoms using the Amplifier and
Unlikely response style were recorded at similar amounts.
Offenders with a history of mental illness exaggerated their
symptoms to a greater degree than those without a history
of mental illness. With regard to the type of crime and the
number of offenses, no discrepancies of statistical signifi-
cance were found. Interestingly, offenders who committed
violent crimes, and with more than four times the number
of offenses, were more likely to exaggerate their symptoms
than the other subjects.
Behav Sci Law. 2022;1–17. wileyonlinelibrary.com/journal/bsl © 2022 John Wiley & Sons Ltd. 1
10990798, 0, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/bsl.2603 by Universidad De Coimbra, Wiley Online Library on [24/04/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
2 ARIN and MENGCHUAY
KEYWORDS
forensic context, incarcerated individuals, mentally ill offenders,
symptom exaggeration
1 | INTRODUCTION
More than 15 years ago, Thailand's Department of Mental Health initiated a campaign called “Dare to Care Project”
to reduce the stigma associated with mental illness and offenders and along with the “Chain Unlace Project” (they had
to be in chains since they were hostile and unable to control themselves). This project brings patients to the hospital
for professional treatment in order for them to have a good quality of life and integrate back into society. Another
benefit of the unique Thai culture is the existence of community-based public health volunteers who assist in caring
for patients as if they were members of their own families.
The media, on the other hand, continues to portray terrible news about mentally ill people who commit crimes,
establishing a scary and dangerous image of the psychiatric patient. Despite the fact that most Thais are compas-
sionate and forgiving, forensic specialists may work hard to dispel the stereotype that violent mentally ill people are
terrible person.
Forensic psychologists often encounter complex and challenging cases, particularly when suspects exaggerated
their disorders (Carr, 2015; Saberi et al., 2011). Individuals who exaggerate psychopathological symptoms are prone
to engage in malingering. Malingering refers to the intentional representation of false or exaggerated illnesses in
either physical or mental instances for certain external incentives (Diagnostic and Statistical Manual of Mental Disor-
ders, Fifth Edition: DSM-5; American Psychiatric Association, 2013). Moreover, DSM-5, malingering allocated a V
code as one of the other conditions that may be a focus of clinical attention and an important aspect of forensic
assessments (McDermott & Scott, 2015).
Exaggerated persons are often motivated by various external incentives depending upon their differing circum-
stances, including acquiring financial compensation, obtaining drugs, avoiding military duty, and avoiding severe
punishments, as well as avoiding legal responsibilities (Duncan, 2005). Incarcerated individuals and Mentally Ill
Offenders (MIOs) in particular, who both fall under a forensic and psycholegal context, may exaggerate or feign
psychopathological symptoms to avoid jail terms (American Psychiatric Association, 1994, 2013; Jelicic et al., 2006).
Individuals choose to manifest symptoms based on the circumstances at hand in situational settings. For instance,
military veterans often feign a psychopathological symptom known as post-traumatic stress disorder in the hope of
receiving post-war financial aid (Freeman et al., 2008). Offenders who have been through various complex circum-
stances during the course of prosecution, such as in the process of waiting for trial or even after being convicted, still
have high hopes of receiving better or reversed circumstances, such as punishment adjustment, provisional release,
or relocation to a more comfortable healthcare facility. Therefore, there is a high probability that offenders, such as
incarcerated individuals and MIOs, feign their illnesses. If successful, they can gain a range of benefits (McDermott
et al., 2013). Consistent with the text above, Rogers (1990a, 1990b) advocates a specific model to explain why
individuals malinger. This model is called the “Adaptational Model” and can forecast the possibility of malingering.
He explained that when a person goes through an unfortunate circumstance, that person may adapt him/herself by
exaggerating an illness to achieve their expectations. For instance, some offenders want to be assessed with insanity
or incompetence when they stand trial in order to avoid legal responsibility for their crimes. McDermott et al. (2013)
found that 17% of offenders feigned to be incompetent throughout their trials. Therefore, it can cause the judicial
process to be delayed.
According to a survey done in 2019, Thai prisons had 367,993 detainees overall, including 57,653 on trial (online
inmate statistics obtained from the Department of Corrections, Ministry of Justice, 2019). These incarcerated individ-
uals need to learn to adapt to survive, especially in dealing with circumstances associated with overcrowding, various
internal pressures, and extreme discomfort. Because the number of psychologists in jails is limited, it is challenging
ARIN and MENGCHUAY 3
to provide comprehensive care for individuals' mental health. Amazingly, every Thai jail has a person in charge of
spreading Buddhism, someone who has been ordained and studied the Dharma. They also promote psychological
well-being via Buddhism in order to keep detainees psychologically strong despite the constraints on their freedom,
as well as to promote morality for the individuals in order to avoid recidivism by highlighting the core of Buddhism.
The principle of karma deters recidivism by asserting that an individual's intentions and deeds (the cause) have an
impact on their future (the consequence).
On the other hand, some of the individuals have attempted to fake an illness. According to interviews conducted
with a clinical psychologist from the Medical Correctional Institution, an excerpt reads as follows:
…several incarcerated persons did not want to sleep in crowded prisons because of concerns over
comfort. Feigning an illness would help them be assigned to a medical institution. Importantly, some
people are genuine mentally ill offenders and would require this sort of placement. When an inmate
is admitted to a medical institution, they find it more comfortable than being in the prison where they
had previously been detained; therefore, they would decide to malinger in the hopes of staying longer
at the medical institution. They made excuses that their psychotic conditions had not improved, and
they kept hearing strange things (auditory hallucinations). In addition to this, inmates demanded and
requested certain types of medicine from doctors and claimed that the requested medicine is better
than the medicine given by the prison doctors. However, the medicines requested by the inmates
would not treat or cure the symptoms that the inmates claimed to have.
Even more surprising information also came from the same interview as follows:
…inmates tended to feigned psychiatric symptoms more often than physical illnesses, which can be
easier to detect. Some inmates were on psychiatric medication and suffered from side effects. Further-
more, some inmates said that they were very stressed and suffered from insomnia for months at a time.
(Mengchu, J., personal communication, 1 February 2018)
The prevalence rate of malingering has arisen in legal and forensic psychiatric contexts, which varied depending upon
the settings in each medical facility. According to one survey, malingering occurs in 15.7% of forensic psychiatric patients
(Rogers et al., 1994). In the context of correctional agencies, where inmates come for mental health services, 20% of
them have been found to feign psychotic disorders (Rogers, Salekin, et al., 1998; Rogers, Sewall, et al., 1998). Another
research study, moreover, suggests that 20%–30% of inmates, who have been referred to have their competence and
insanity assessed, tend to malinger (Frederick et al., 2000; Miller, 2001; Mittenberg et al., 2002; Rogers, 1997).
MIOs may also require mental health services in a mental health-related institution. The Forensic Psychiatric Insti-
tute, Department of Mental Health, Thailand, is an academic institution that is responsible for the diagnosis and treat-
ment of psychiatric patients with a criminal background. Here, the forensic patients will be assessed and investigated
if they deliberately exaggerate their psychological symptoms. Some of these cases can be very challenging, especially
when validating illnesses and determining if the subjects are sincere or malingering. The research results suggest that
the percentage of malingering in a forensic psychiatry context stands at around 15.7%–17.4%, which is higher than
in a non-forensic context (Rogers, 1997; Rogers, Salekin, et al., 1998; Rogers, Sewall, et al., 1998). In certain ASEAN
countries, for example, in Taiwan, the percentage was recorded at 9.1% (Chiang et al., 2006). In contrast, Thailand
has had no official statistics to show the number of malingerers in a forensic psychiatric context. The same is true in
China, where very few research studies on malingering have been conducted (Yang, 2003 cited as in Liu et al., 2013).
Another critical problem associated with validating symptoms of malingering is the actual prediction of a malingerer
(Gillard, 2010) when more verifiable evidence of the act is needed (Rogers, 1990a, 1990b; Wasyliw & Cavanaugh, 1989).
Thus, an assessment of malingering should be conducted in a prudent manner. Moreover, a variety of methods should be
employed to avoid producing a stereotyped conclusion. Psychologists can employ psychometric tools that are academi-
cally and scientifically recognized in order to assist this process. Certain tools have been developed within the “Symptom
Validity Testings” (SVTs) system, which has been created and designed to differentiate between honest responders and
malingerers (van Impelen et al., 2014) by using cutoff criteria and detection strategy response styles based on each
test. Examples of these tools include SIMS (Structured Inventory of Malingered Symptomatology; cutoff > 14; Smith
& Burger, 1997), SIRS (Structured Interview of Reported Symptoms; cutoff > 76; Rogers et al., 1992), and M-FAST
(Miller-Forensic Assessment of Symptoms Test; cutoff > 6; Miller, 2001). SIMS utilizes five detection strategies (Psycho-
sis, Low Intelligence, Neurologic Impairment, Affective Disorders, and Amnestic Disorders). M-FAST employs seven
detection strategies (Reported vs. Observed Symptoms, Extreme Symptomatology, Rare Combinations, Unusual Hallu-
cinations, Unusual Symptom Course, Negative Image, and Suggestibility). SIRS consists of eight detection strategies
(Rare Symptoms, Symptom Combinations, Improbable and Absurd Symptoms, Blatant Symptoms, Subtle Symptoms,
Selectivity of Symptoms, Severity of Symptoms, and Reported vs. Observed Symptoms). However, a confirmatory factor
analysis of all three tests was used to classify the scales into two basic categories (Rogers, 2008; Rogers et al., 2005).
The Thai version of the symptom validity test (SVT-Th; Arin & Khowboonngam, 2019) has been developed under
the Symptom Validity Testings (SVTs) principles. It has been examined to ensure that it is customized to Thai people.
Moreover, SVT-Th was developed based on Rogers' two main detection strategies including Unlikely and Ampli-
fied Detection Strategies (Gillard, 2010; Rogers, 2008, 2018) combined with the sub-detection strategies that were
adapted from three detecting tests, including SIRS, SIMS, and M-FAST (Miller, 2001; Rogers et al., 1992; Smith &
Burger, 1997). The results of the confirmatory factor analysis supported the 2-factorial model as has been proposed
by Rogers. The Unlikely Detection Strategy consists of two sub-detection strategies that include Rare Symptoms
and Symptom Combinations. Moreover, the Amplified Detection Strategy consists of two sub-detection strategies
that include Extreme Psychopathology and Over-report. It was found that the reliability of the SVT-Th was 0.94, for
which the Unlikely Detection Strategy score was 0.91 (Rare Symptoms score was 0.82 and Symptom Combinations
score was 0.88) and Amplified Detection Strategy score was 0.86 (Extreme Psychopathology score was 0.85 and
Over-report score was 0.83). The ROC curve determined that the optimal cutoff was 79 with high sensitivity (0.98)
and specificity (0.87). In the same study, it was found that the SVT-Th scores between the two experimental groups
(feigned and honest) were different at a statistically significant level (Arin & Khowboonngam, 2019).
Since the test had not previously existed in a Thai context, no research or study has determined the prevalence
of malingering that occurs within a Thai forensic context. Therefore, this study can be considered a pioneering study
on this phenomenon through the analysis of relevant statistics. Thus, the first objective of this research is to explore the
prevalence rate of symptom exaggeration of psychopathology and to examine the detection strategy response styles within
a Thai forensic context using SVT-Th.
A literature review determined that intended malingering transpires due to various factors, such as the type of
offense and a history of a higher number of criminal arrests (McDermott et al., 2013). Offenders may assess the severity
of the penalty by looking into offense types and the number of offenses they may have had in the past. For instance,
the offenders who were charged with a serious offense, like homicide, typically receive more severe punishment than
those who were charged with burglary. In relation to this point, more offenders in homicide cases are likely to feign
psychiatric disorders than those with less severe offenses. By malingering, offenders believe they will be assessed as
incompetent to stand trial. In addition to this, some corresponding information has suggested that half of the offenders
in criminal courts claim they are incompetent to stand trial and claim to be insane (McDermott et al., 2013). Malingering
possibly occurs among these offenders. One of the reasons an offender may choose to malinger is that they are fearful
and experience a high degree of anxiety when they hear the trial results from the court. Feigning physical or psychiatric
disorders may lead the court to abstain or adjourn the proceedings. As a result, judicial proceedings have often been
delayed. When offenders continue to feign psychotic disorders, problems can consequently occur; for instance, the
cases end up undecided or judicial personnel cannot carry out the legal proceedings. Another case study has shown
that an inmate who has been assessed as a malingerer will receive an enhanced sentence from the court for their decep-
tive behavior. This will occur as they will be perceived as obstacles to the judicial proceedings (Edens et al., 2007; Knoll
& Resnick, 2006). This incident indicates that the offender did whatever it took to extricate himself from the circum-
stances, for he may receive a punishment adjustment, be acquitted, be relocated to a nursing facility, or be treated in a
psychiatric hospital or other places that are more spacious and have better living conditions. In this regard, this type of
delay in the proceedings can result in an even more lengthy jail term for the offender; and as a result, more correctional
resources will be wasted. Furthermore, malingering inmates may take part in other forms of harmful behavior such as
through the abuse of drugs or by selling drugs to other inmates (Tamburello et al., 2017). An assumption has been made
that inmates who have received prior treatment (those previously on medication) for both physical and psychiatric
illnesses are likely to malinger in the hope of receiving the medicine again. Academic researchers have revealed that
inmates who had been previously diagnosed with schizophrenia often lie to correctional officers and stated that their
symptoms had gotten worse. Consequently, they requested an alteration in their treatment, perhaps by switching from
the exiting medication to other types of medicine. Several of the medicines that are used in prisons are often abused
as narcotics (Caniato et al., 2009). This type of behavior demonstrates the intention and willfulness of the offenders
to obtain “external incentives”, which is considered malingering (American Psychiatric Association, 2013) since malin-
gering transpires at a conscious level (Duncan, 2005). Moreover, the above-mentioned information is also a source of
interest in this study. The relevant factors include a subject's inclination to commit crimes, one who may have a history
of physical disorders, one who may have a history of psychiatric disorders, and the type of offense and the number of
offenses can clearly be associated with the symptom exaggeration of psychopathology. Consequently, the second objec-
tive of this research study is to investigate the factors that influence symptom exaggeration of psychopathology among CIs
and MIOs, including physical illness history, mental illness history, the type of crime, and the number of offenses committed.
2 | METHOD
2.1 | Participants
This study was conducted with participants in two forensic contexts: (1) Incarcerated individuals in prisons or correc-
tional institutions under the supervision of the Medical Correctional Institution, Ministry of Justice, and (2) Mentally
ill offenders from the Institute of Forensic Psychiatric Services at the Department of Mental Health, Ministry of Public
Health. In this study, MIO is defined as a condition that affects an individual's mood, thoughts, and behavior and
diagnosed by psychiatrists using the DSM-5 (American Psychiatric Association, 2013).
Determination of the sample size was accomplished by setting a confidence level at 95% and the margin of error
at 5% in order to establish the precise parameter estimates (Martínez-Mesa et al., 2014). According to relevant calcu-
lations, the sample size was equal to 385. However, Kline (2005), Hair et al. (2006), and Tabachnick and Fidell (2007)
suggested that the appropriate sample size should be 500 or more. For this reason, certain concerns have been raised for
the current study with regard to the population and sample size. These concerns will be detailed in the following section.
2.1.1 | Incarcerated individuals
The participants were incarcerated individuals being held in eight prisons and correctional institutions under the
supervision of the Medical Correctional Institution. The total population of inmates on trial was 57,653 (Statistics of
correctional service nationwide, 2019, Ministry of Justice). Participants were selected following the inclusion criteria
of the prisons and correctional institutions, which were then applied by clinical psychologists on duty who were will-
ing to serve as field research assistants for this study. The data were collected randomly from six of the eight prisons/
correctional institutions with individuals who were willing to participate in this study and in the process in the ruling.
Seven hundred and eleven questionnaires were distributed among the inmates and were returned to the researcher.
Following the screening process, the questionnaires of 528 individuals were deemed to be reliable for research
analysis. Most of the responders were male (78.40%) with degrees of secondary education (52.10%). In addition to
this, most had no background of receiving treatment for psychiatric disorders (94.70%) and never had any physical
health problems (68.56%). However, most had been implicated in some sort of drug-related offense (51.90%) and had
already committed a least one offense (77.70%). The average age of the participants was 35.47 years old (SD = 9.45).
2.1.2 | Mentally Ill Offenders (MIOs)
In this participant group, the data were collected at the Forensic Psychiatric Institute under the Department of Mental
Health. According to the annual report of 2018, 129 forensic psychiatric patients were admitted to the institute. All
participants were selected in accordance with the inclusion criteria. The data were gathered from MIOs who were
referred for assessment after undergoing forensic psychiatric procedures and were in the pre-adjudication stage. The
offenders were willing to participate in the research study. Ninety-nine questionnaires were sent to the researcher.
Finally, following the screening process, 80 participants completed the questionnaire as required. The participating
subjects had experienced a range of history including schizophrenia (65%), psychotic disorders not otherwise spec-
ified (8.75%), mood disorders (17.5%), and substance abuse disorders (8.75%). The participants were primarily male
(80.0%) who had completed a primary level of education (45.00%) and who had never before committed any offenses
(53.80%). This figure was close to the number of those who had previously committed crimes (46.30%). These partic-
ipants had a history of psychiatric treatment (72.50%), but never had a history of prior physical health treatment
(98.80%). They had been charged with drug-related offenses (43.80%), followed by violent crimes (25.00%) and those
who had committed their first offenses (76.32%). The average age of this group was 36.48 years old (SD = 9.37).
Inclusion criteria
Participants were (1) voluntary and willing to sign a consent form to participate in this study according to the procures
of research ethics involving humans; (2) eighteen years of age and above; (3) able to understand, write, and read Thai,
(4) have no severe and/or contagious diseases; (5) behave cooperatively and are not aggressive or show no obvious
signs of violence toward themselves and/or others; (6) are able to concentrate and have not been diagnosed with any
active mental symptoms. Lastly, (7) the subjects had also been granted permission from medical staff to participate
in this research study.
Exclusion criteria
Participants were (1) able to request to be withdrawn in all cases from the research (without providing reasons) and
were allowed to leave if they were unable to continue to participate in the survey and complete the test; (2) Clinical
psychologists had determined that the participant may suffer from severe stress or could not concentrate while trying
to complete the questionnaire.
2.2 | Measures
The research instruments consisted of two parts as follows:
2.2.1 | Part 1. General information questionnaire
This part is composed of information concerning the participants' age, gender, education level, treatment history
(physical illness history and mental illness history), types of crimes committed (based on the research of McDermott
et al., 2013), and the number of offenses (based on the research of Rokach, 2001).
2.2.2 | Part 2. The Thai version of symptom validity test (SVT-Th)
The SVT-Th was developed by Arin and Khowboonngam (2019). This test is a self-report that is composed of 57 items.
The test consists of two main detection strategies: (1) the Unlikely Detection Strategy, which has two sub-detection
strategies, including Rare Symptoms and Symptom Combinations; and (2) the Amplified Detection Strategy, which
has two sub-detection strategies including Extreme Psychopathology and Over-report. Scoring is divided into two
steps that were designed following strategies developed for the detection of malingering.
Step 1 Presentation of symptoms where the “No” response is assigned to a score of “0”, while a “Yes” response is assigned
a “1” point.
Step 2 Presentation of severe and amplified symptoms (Severity & Amplifier) with scores ranging from “1” to “5” in line
with their degree of severity, where 1 represents “less severe” and 5 represents “extremely severe.” Subsequently, all
the calculated scores were gathered. The scores ranged from between 0 and 342 points. Offenders with high scores
indicated a greater tendency for symptom exaggeration of psychopathology than those with low scores. In addition,
those with scores that were greater than the criteria (≥79; Arin & Khowboonngam, 2019) may be interpreted as an
“over-report,” which is highly suggestive of feigned psychopathology.
2.3 | Statistical analyses
The independent t-test was used to determine if there was a significant difference between the mean values of the
two groups. This current study consisted of two variables, physical illness history and mental illness history, both of
which were classified as yes (having received any of those treatments) and no (having never received any of those
treatments).
One-way analysis of variance (ANOVA) was used to determine whether the types of crimes and the number of
offenses differed based on the SVT-Th. In this study, we divided the types of crimes into five independent groups
(e.g., (1) violent crimes, (2) sex crimes, (3) property crimes, (4) drug-related crimes, and (5) other miscellaneous crimes)
and the number of offenses into three independent groups (e.g., (1) first offense, (2) two-three offenses, and (3) four
offenses or more).
3 | RESULTS
A total of 608 offenders included 478 male subjects (78.62%) and 130 female subjects (21.38%). The educational
levels of the subjects were primarily of the secondary level at 310 (50.98%). The mean age of the total sample was
35.98 (SD = 9.41). The group composed of 528 incarcerated individuals was composed of 414 male subjects (78.40%)
and 114 female subjects (21.60%). The mean age was 35.47 years old (SD = 9.45). Educational levels were mostly of
the secondary level at 275 (52.10%). The group composed of 80 MIOs was composed of 64 male subjects (80%) and
16 female subjects (20%) with a mean age of 36.48 (SD = 9.37). Moreover, as shown in Table 1, the average scores
from the SVT-Th test were divided by the relevant factors of incarcerated individuals and MIOs. The average score
was found to be higher than that of the criteria (≥79) as follows. In the group of incarcerated individuals, no factors
with scores higher than the cutoff were found. As for the MIOs, it was found that those without a history of physical
illness (Mean = 82.41, SD = 74.77) scored higher than those with a history of physical illness. Furthermore, it was
found that the participants with a history of mental illness (Mean = 96.43, SD = 76.44) and those who had committed
four or more offenses had average scores that were higher than the cutoff (Mean = 99.73, SD = 84.27).
Table 2 shows the numbers and percentages of incarcerated individuals, MIOs, and the overall group that had
lower and higher scores than the cutoffs. It was found that 511 incarcerated individuals scored lower than the cutoff,
which accounted for 96.80%. Only 17 of these subjects, accounting for 3.20%, scored higher than the cutoff value. As
for the MIOs, they similarly scored either lower or higher than the cutoff value. In this regard, 37 MIOs, which account
for 46.30%, scored lower than the cutoff and 43 MIOs, which account for 53.80%, scored higher than the cutoff.
As for the total samples, it was found that 554 participants scored lower than the cutoff, accounting for 91.12%;
while 54 of them had scores that were higher than the cutoff criteria, accounting for 8.88%.
T A B L E 1 Number and percentage of participant demographics, mean, and SD of the SVT-Th score divided by
each factor of the incarcerated individuals, mentally ill offenders, and total participants
Incarcerated individuals Mentally Ill Offenders

(n = 528) (n = 80) Total (n = 608)
Demographics data n % n % n %
Gender
Male 414 78.40 64 80.00 478 78.62
Female 114 21.60 16 20.00 130 21.38
Educational level
Uneducated 2 0.40 1 1.25 3 0.50
Primary education 142 26.90 36 45.00 178 29.28
Secondary education 275 52.10 35 43.75 310 50.98
Undergraduate and above 109 20.60 8 10.00 117 19.24
Factors n % Mean SD n % Mean SD n % Mean SD

Mental illness history
Yes 28 5.30 44.32 54.94 58 72.50 96.43 76.44 86 14.14 79.00 74.40
No 500 94.70 6.57 21.76 22 27.50 43.05 53.59 522 85.86 8.14 24.95
Physical illness history
Yes 166 31.44 8.01 19.35 1 1.20 30.00 0.00 167 27.47 8.14 19.37
No 362 68.56 8.77 28.46 79 98.80 82.41 74.77 441 72.53 21.96 49.55
Type of crimes
Violent crime 60 11.36 12.37 35.29 20 25.00 102.65 82.39 80 13.16 34.94 64.11
Property crime 112 21.21 7.61 22.68 15 18.80 74.53 75.71 127 20.89 15.51 39.50
Sex crime 24 4.54 8.75 28.89 5 6.30 44.80 37.55 29 4.77 14.97 32.85
Drug-related crime 274 51.90 9.01 26.38 35 43.80 79.63 73.47 309 50.82 17.01 41.41
Others 58 11.00 3.98 14.64 5 6.30 71.60 76.55 63 10.36 17.21 55.67
Number of offenses
1 410 77.70 7.99 25.67 54 67.50 83.91 75.67 464 76.32 16.97 42.87
2–3 84 15.90 7.19 15.35 15 18.75 60.80 62.06 99 16.28 16.69 39.77
4 and more 34 6.40 18.38 43.23 11 13.75 99.73 84.27 45 7.40 33.69 57.94
Age mean (SD) 35.47 (9.45) 36.48 (9.37) 35.98 (9.41)
T A B L E 2 Number and percentage of participants in each group with more and less than the cutoff of total
SVT-Th scores
Incarcerated individuals (n = 528) Mentally Ill Offenders (n = 80) Total (n = 608)
Cutoff score n % n % n %
More than cutoff >79 17 3.20 37 46.30 54 8.88
Less than cutoff <79 511 96.80 43 53.80 554 91.12
Table 3 shows the mean scores and correlation for each response style. Importantly, among the intra-participant
group, it was found that the mean scores for each response style were not different between the Unlikely and
Amplified strategies. Continuously, each response style exhibited a highly statistically significant correlation
(r = 0.825–0.966, p < 0.01).
ARIN and MENGCHUAY
TA B L E 3 Mean, SD, and correlation between each detection strategy response style
Detection Total (n = 608) Incarcerated individuals (n = 528) Mentally Ill Offenders (n = 80)
strategy
response Mean Mean Mean
style (SD) UDS RS SC ADS EP OV (SD) UDS RS SC ADS EP OV (SD) UDS RS SC ADS EP OV
UDS 8.46 1 0.976** 0.970** 0.916** 0.912** 0.855** 4.16 1 0.954** 0.942** 0.886** 0.863** 0.828** 36.83 1 0.975** 0.970** 0.875** 0.895** 0.760**
(19.93) (11.54) (35.03)
RS 4.72 1 0.894** 0.887** 0.885** 0.825** 2.40 1 0.797** 0.803** 0.792** 0.742** 20.08 1 0.892** 0.865** 0.886** 0.751**
(10.85) (6.43) (18.80)
SC 3.74 1 0.897** 0.890** 0.840** 1.77 1 0.881** 0.848** 0.833** 16.75 1 0.835** 0.855** 0.726**
(9.64) (5.74) (17.22)
ADS 9.70 1 0.959** 0.966** 4.37 1 0.949** 0.958** 44.93 1 0.947** 0.946**
(24.82) (15.15) (41.92)
EP 4.11 1 0.855** 1.74 1 0.818** 19.70 1 0.791**

(12.29) (7.58) (22.20)
OVR 5.60 1 2.62 1 25.23 1

(13.49) (8.30) (22.11)
Abbreviations: ADS, amplified detection strategy; EP, extreme psychopathology; OVR, over-report; RS, rare symptoms; SC, symptom combinations; UDS, unlikely detection strategy.
**p < 0.01.
9
T A B L E 4 t-test analysis of comparison of the SVT-Th average score difference by mental illness history and
physical illness history
Factors n Mean SD t p Effect size (d)

Incarcerated individuals
Yes 28 44.32 54.94 −3.62 0.001*** 0.90
No 496 6.57 21.76
Yes 166 8.01 19.35 0.311 0.756 ns 0.03
No 362 8.77 28.46
Mentally Ill Offenders
Yes 58 96.43 76.44 −3.002 0.004** 0.81
No 22 43.05 53.59
Yes 1 30.00 0.01 0.696 0.448 ns 0.99
No 79 82.41 74.77
Abbreviation: ns, not significant.
**p < 0.01, ***p < 0.001.
As is shown in Table 4, it was found that the participants (both incarcerated individuals and MIOs) with a mental
illness history had an average score that was higher than those without prior background of mental illness with a
degree of statistical significance (incarcerated individuals; t = 3.62, p < 0.001, d = 0.90, MIOs; t = 3.002, p < 0.004,
d = 0.81). However, no discrepancies were observed in terms of a history of physical illness (incarcerated individuals;
t = 0.311, p = 0.756, d = 0.03, MIOs; t = 696, p = 0.448, d = 0.99).
A comparison within a group of participants, categorized by the types of crimes and the number of offenses, is
presented in Table 5. No discrepancies were observed for the types of crimes with any statistical significance (incar-
cerated individuals; F = 0.833, p = 0.505, η 2 = 0.08, MIOs; F = 756, p = 0.557, η 2 = 0.19). The types of crimes include
(a) violent crimes, (b) sex crimes, (c) property crimes, (d) drug-related crimes, and (e) other miscellaneous crimes.
However, those who had committed violent crimes had the highest scores as is illustrated in Figure 1. Furthermore,
no discrepancies were observed in terms of the number of offenses with any statistical significance (incarcerated
individuals; F = 2.674, p = 0.070, η 2 = 0.10, MIOs; F = 934, p = 0.398, η 2 = 0.15). These included (a) those who had
committed the first offense, (b) those with 2–3 offenses, and (c) those with four offenses or more. Nevertheless, it
was observed that participants with more than four offenses scored higher than the other participants as illustrated
in Figure 2.
4 | DISCUSSION
A study on the prevalence rate of symptom exaggeration of psychopathology in a forensic setting revealed several
important facts (McDermott & Sokolov, 2009). The diversity of the tests was an important factor although the
psychometric tests were based on the “Symptom Validity Testings” concept. Each type of test employed different strat-
egies, cutoff criteria, questionnaire response methods, number of items, and scoring methods. The SIMS had 75 items
with five sub-strategies, including self-report involving true or false questions (cutoff > 14; Smith & Burger, 1997).
M-FAST involved a 25-item structured interview with seven sub-strategies employing the forced-choice response
TA B L E 5 One-way analysis of variance of SVT-Th scores by the type of crimes and number of offenses
Source of variance SS df MS F p Effect size (η 2)

Incarcerated individuals
Type of crimes
Between groups 2242.42 4 560.60 0.833 0.505 ns
0.08
Within groups 351,959.09 523 672.96
Total 354,201.52 527
Number of offenses
Between groups 3571.59 2 1785.79 2.674 0.070 ns
0.10
Within groups 350,629.92 525 667.87
Total 354,201.52 527
Mentally Ill Offenders
Types of crimes
Between groups 17,016.55 4 4254.136 0.756 0.557 ns 0.19
Within groups 421,808.46 75 5624.113
Total 438,825.00 79
Number of offenses
Between groups 10,389.89 2 5194.941 0.934 0.398 ns 0.15
Within groups 428,435.12 77 5564.092
Total 438,825.00 79
Abbreviation: ns, not significant.
F I G U R E 1 The mean score of SVT-Th among incarcerated individuals and Mentally Ill Offenders (MIOs)
divided by type of crime. When those within a group are compared.
style (cutoff > 6; Miller, 2001). The SIRS involved 172 structured interview items with eight sub-strategies employing
a 3-rating scoring system (cutoff > 76; Rogers et al., 1992). The self-report of SVT-Th included 57 items with four
sub-strategies involving a 2-step scoring method by employing yes/no questions and a 5-rating scoring system
(cutoff > 79; Arin & Khowboonngam, 2019). Another significant factor that can contribute to a wide variety of prev-
alence rates would be the different intentions stated for external incentives, such as to avoid criminal prosecution or
F I G U R E 2 The mean score of SVT-Th among incarcerated individuals and Mentally Ill Offenders (MIOs) is
divided by the number of offenses. When those within a group are compared.
to not be punished, to avoid jail terms due to the congested conditions in the jail, to get admitted to a hospital where
it would be more comfortable, or the desire to be treated with certain medicines due to a pre-existing addiction
(McDermott et al., 2013). Although individuals involved may be the same persons, the response styles may change
when either circumstances or expectations change, or whether they can adapt themselves to the current set of
circumstances at hand. Therefore, the response scores can vary in line with the circumstances, which are in accord-
ance with the theory of the Adaptational Model (Rogers, 1990a, 1990b). This model proposes that the malingerer
performs a sort of cost-benefit analysis to determine their best choice (Rogers, Salekin, et al., 1998; Rogers, Sewall,
et al., 1998).
The results of the current study indicate that the percentage of all samples, according to SVT-Th, exceeded the
cutoff value of 8.88%. Only 3.20% of incarcerated individuals overstated their diseases, according to the findings.
Individuals, as it was assumed, had acclimated to their surroundings. Because the length of time spent in prison
was not specified in this research. Data are gathered after a certain period of time in practice for security reasons.
Whereas 46.30% of MIOs overstated their disease in comparison to their actual symptoms. However not surprisingly,
it has been estimated that nearly 40% of mental disorder offenders feigned psychopathology symptoms (Corrections
Grand Jury, 2016 as cited in Castello, 2018). Similar to the outcomes of a study involving 100 forensic psychiatric
inpatients who were tested by M-FAST and SIRS-2, of the number of patients who elevated the M-FAST score over
the recommended cutoff, 42% met the SIRS-2 criteria for feigning (Glassmire et al., 2016). Many studies have found
that approximately 8%–65% of forensic cases had malingered; for instance, Cornell and Hawk (1989) and Cochrane
et al. (2001) reported prevalence levels of 8% and 4%, respectively. Among the inmates who requested mental health
services, 20% of them had feigned mental disorders (Rogers, Salekin, et al., 1998; Rogers, Sewall, et al., 1998). Simi-
larly, the inmates who were referred to have their competency assessed in order to stand trial (20%), and those
diagnosed with insanity (30%), were likely to malinger (Frederick et al., 2000; Miller, 2001; Mittenberg et al., 2002;
Rogers, 1997). The data obtained from the American Department of Justice in 2004 (Hill, 2009) showed that the
number of malingerers was surprisingly high; that is, approximately 56% of subjects were inmates in state prisons,
44.8% were federal inmates, and 64.2% were inmates in local prisons. These inmates were diagnosed with mental
disorders and had previously received psychiatric treatments.
As noted above, the incidence of malingering varies substantially according to the findings of this and other stud-
ies. This is attributable, in part, to the intrinsic motivations of the individuals (Richey & Doninger, 2020). As a common
form, some people actively pretend to be bad. On the other hand, it has been discovered that people with faked
good intentions really exist. Cima-Knijff (2003) created the term “supernormality,” which refers to the intentional
fabrication or extreme exaggeration of healthy characteristics or individuals who seek to appear better than they
actually are (Brodsky, 2013). This allows an individual to respond to questions in a fake positive manner (fake good;
Cima-Knijff, 2003). According to Brodsky (2013), the reasons for the fake good include judgments concerning release
from involuntary commitment, evaluations done before parole hearings, and forthcoming presentence reviews, which
are external incentives and meet the DSM's malingering criterion (American Psychiatric Association, 2013).
Many strategies employed for the detection of feigned psychopathology have been validated (Rogers &
Bender, 2003; Rogers et al., 2005). Most popular of these is the response style of the Amplified and Unlikely Detec-
tion Strategies, which has been confirmed in those who have attempted to feign psychopathology. Our current study
found that among the Thais offenders in a forensic context, they were found to have exaggerated their psycho-
pathological symptoms on the Amplified Detection Strategy, which was close to the results of the Unlikely Detection
Strategy. This indicated that they intentionally exaggerated all aspects of the test. An amplifier response style would
help detect whether symptoms are grossly exaggerated or over-endorsed to such an extent that they are recognized
as endorsed symptoms. The Unlikely Detection Strategy emphasizes the presence of impossible, odd, rare, or unusual
symptoms. As expected, both the Amplified and Unlikely response styles are strong indicators of malingering. The
rare symptom scale for the SIMS items endorsed more than 25% of feigners (Rogers et al., 2014). The popular tests,
such as SIRS, M-FAST, and SIMS, are based on the concept of two strategies employed in the formulation of the ques-
tionnaires. However, misidentification from these tests can occur, such as when 51% of malingerers were identified
as honest responders (Green & Rosenfeld, 2011). The SIRS, which is also an SVT, can identify honest responders at
up to 88%. According to a study conducted by Hill (2009), the M-FAST meanwhile could only detect 7% of honest
responders, while SIRS could detect 12% of them. Misidentification can occur due to various factors. Clinical issues
may be caused by low-intelligence samples wherein participants responded “positively to all questions” without
understanding the content of those questions (Gudjonsson, 2003). Moreover, other research studies have suggested
that the offenders with comorbid disorders, such as schizophrenia (Peters et al., 2013) or psychogenic non-epileptic
seizures (Benge et al., 2012), as well as intellectual disability patients (Graue et al., 2007), could also be a source of
errors in the research results.
Again, Young (2015) had extensively reviewed various pieces of literature to seek a conclusion concerning the
estimation of the prevalence rate of malingering. He suggests that it can be extremely difficult to identify what the
percentage or what the range of percentage of malingering can be. Young, however, concludes that, for the time
being, 15% is probably the most appropriate estimate of ±15% (±15%). In this regard, Young (2015) also adds that it
might depend upon the condition of the problems and other factors. Thus, this research has further studied whether
a history of mental illness, a history of physical illness, types of offenses, and the number of crimes associated with
the response styles could lead to symptom exaggeration of psychopathology. However, some factors were not found
to have resulted in statistically significant differences. As expected, the results within a Thai forensic context for
both groups indicated that offenders with a mental illness history have average scores of symptom exaggeration of
psychopathology that were higher than those without a history of mental illness. The offenders may have previously
been on medication or had regularly used drugs. Such experiences lead the offenders to hope for further opportu-
nities to gain access to drugs. Consistent with Cunningham (2006), it was suggested that inmates with a history of
being on medication for psychiatric disorders often abuse those medicines, which also may be traded in prison. The
medicines that are found and commonly used in prisons are Quetiapine, Olanzapine, Gabapentin, Bupropion, and
Trihexyphenidyl (Tamburello et al., 2017). Quetiapine is currently neither a controlled medicine nor categorized as a
narcotic. Quetiapine has frequently been abused as an addictive substance in prisons (Caniato et al., 2009). Several
reported studies have confirmed the findings of this study, wherein inmates malinger as a way of gaining access to
certain medicines (Waters & Joshi, 2007). A faulty malingering diagnosis, therefore, can lead to a prescription for
antipsychotic medication as well as to the selection of either wrong or dangerous treatments. Diagnoses in question
may also be the cause of budget waste (Pierre et al., 2004).
No statistically significant differences were found for the types of crimes and the number of offenses with
the feigning psychopathology. However, according to Figures 1 and 2, it was determined that both incarcerated
individuals and MIOs who committed violent crimes, such as homicides, attempted murders or who had committed
physical assaults tended to malinger. This was particularly true when compared with those who had committed other
types of offenses, such as property theft, or sex and drug-related crimes, and those with fewer numbers of criminal
cases in their history. In this regard, the offenders may assess the severity of the penalty by the type of offense they
have committed, which may affect their competency to stand trial (McDermott et al., 2013). It is possible that the
offenders are worried and have anxiety about hearing the results of the court's deliberation. Claiming an illness will
then cause a delay in the trial process and could obstruct the proceedings indefinitely. However, a detrimental effect
can occur with malingering offenders. This is often the case because they can also be perceived as obstacles to the
judicial process, which may result in increased penalties (Edens et al., 2007; Knoll & Resnick, 2006).
In terms of competency to stand trial, according to Section 14 of Thailand's Criminal Procedure Code, if a patient is
suffering from active psychosis, medical treatment will be provided to reduce psychotic symptoms and abnormal mood
until the patient is able to retain acceptable behavioral control and interact effectively with others. After that, the patient
will be sent to a group session called the “Competency to Stand Trial Preparedness Group” for rehearsing. This will assist
the patient in establishing a fundamental grasp of the legal system, learning how to behave maturely in court, and prac-
ticing reporting the events of their own cases. Patients are offered a 45-day stay, which may be extended if their mental
health does not improve. The medical staff will regularly report to the court on the patients' progress every 180 days.
5 | LIMITATIONS AND FUTURE DIRECTIONS
This study examined the exaggerated response styles of persons who committed a crime without following through
on the evaluation outcomes using a self-assessment.
The follow-up to the legal system is interesting in clinical practice and future studies, such as assessing the
performance consequences of the SVT-Th in pre-adjudication samples. The study did not identify the criterion for the
length of time the convicts spent in jail for the incarcerated individuals' sample. As a result of a person's adaptability
to jail settings, responding styles may vary.
The sample size in some subgroup was small due to the higher percentage of schizophrenia cases compared to
other groups, which is similar to the limitations of Copeland et al. (2016) and Richey & Doninger (2020). The accuracy
of the study's findings may improve with the analysis of each subgroup. As a result, Richey and Doninger (2020)
suggest implementing it as necessary for each patient's circumstances.
6 | CONCLUSION
The prevalence rate of feigned psychopathology in a Thai forensic context is consistent and similar across other stud-
ies. Forensic offenders have endorsed their psychopathological symptoms on the Amplified response style, which
was close to the Unlikely response style. Each of the offenders' stressful situations will influence any potential malin-
gering. These circumstances may include certain other factors, such as having a previous history of mental illness.
Consequently, it may be possible for the offenders to use their illness experiences to take advantage of the justice
system. Interestingly, the offenders who have committed violent crimes or who have committed many offenses are
even more likely to feign psychopathology symptoms.
ACKNOWLE DG ME NTS
This project was done on vulnerability and complicatedness of participants and also including the difficulty for access-
ing those sample group. Therefore, the researchers would like to thank individuals, teams, and various departments.
The authors thank all participants, clinical psychologists. We would also like to thank the Ministry of Justice, Galya
Rajanagarindra Institute, Department of Mental Health, Ministry of Public Health, and Faculty of Humanities,
Chiang Mai University. This research was supported by a research grant from the Faculty of Humanities, Chiang Mai
University.
CO N FLI CT OF I NTE RE ST
No potential conflict of interest was reported by the authors.
R EF ERE NCE S
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM). American Psychiatric
Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.
org/10.1176/appi.books.9780890425596
Arin, N., & Khowboonngam, S. (2019). Detection strategies for feigned psychopathology: Test development and effects of
criminal charge simulation design on response styles. Journal of Forensic Psychiatry and Psychology, 30(1), 127–151.
https://doi.org/10.1080/14789949.2018.1523946
Benge, J. F., Wisdom, N. M., Collins, R. L., Franks, R., Lemaire, A., & Chen, D. K. (2012). Diagnostic utility of the Structured
Inventory of Malingered Symptomatology for identifying psychogenic non-epileptic events. Epilepsy and Behavior, 24(4),
439–444. https://doi.org/10.1016/j.yebeh.2012.05.007
Brodsky, S. L. (2013). Malingering and faking good. In S. L. Brodsky (Ed.), Testifying in court: Guidelines and maxims for the expert
witness (pp. 123–127). American Psychological Association. https://doi.org/10.1037/14037-029
Caniato, R. N., Gundabawady, A., Baune, B. T., & Alvarenga, M. E. (2009). Malingered psychotic symptoms and quet-
iapine abuse in a forensic setting. Journal of Forensic Psychiatry and Psychology, 20(6), 928–935. https://doi.
org/10.1080/14789940903174196
Carr, C. M. K. (2015). The assessment of malingering within forensic populations [Doctor's thesis, Loma Linda University]. Loma
Linda University Libraries. https://scholarsrepository.llu.edu/etd/227
Castello, M. (2018). The “M” word: Management of malingering in corrections mental healthcare DNP quality improvement project
final report. Oregon Health & Science University OHSU Digital Commons. https://digitalcommons.ohsu.edu/etd/4035
Chiang, Y. C., Tseng, D. S., Chow, P. C. K., Chang, C., Pan, C. C., & Lu, T. (2006). Characteristics of the draftees with suspected
malingering. Taiwanese Journal of Psychiatry, 20(2), 145–154.
Cima - Knijff, M. J. (2003). Faking good, bad, and ugly: Malingering in forensic psychiatric inpatients [Doctoral thesis, Maastricht
University]. Universiteit Maastricht. https://doi.org/10.26481/dis.20030528mc
Cochrane, R. E., Grisso, T., & Frederick, R. I. (2001). The relationship between criminal charges, diagnoses and psycholegal
opinions among federal pretrial defendants. Behavioral Sciences and the Law, 19(4), 565–582. https://doi.org/10.1002/
bsl.454
Copeland, C. T., Mahoney, J. J., Block, C. K., Linck, J. F., Pastorek, N. J., Miller, B. I., Romesser, J. M., & Sim, A. H. (2016). Rela-
tive utility of performance and symptom validity tests. Archives of Clinical Neuropsychology, 31(1), 18–22. https://doi.
org/10.1093/arclin/acv065
Cornell, D. G., & Hawk, G. L. (1989). Clinical presentation of malingerers diagnosed by experienced forensic psychologists.
Law and Human Behavior, 13(4), 375–383. https://doi.org/10.1007/BF01056409
Cunningham, M. D. (2006). Dangerousness and death: A nexus in search of science and reason. American Psychologist, 61(8),
828–839. https://doi.org/10.1037/0003-066X.61.8.828
Duncan, A. (2005). The impact of cognitive and psychiatric impairment of psychotic disorders on the test of memory malin-
gering (TOMM). Assessment, 12(2), 123–129. https://doi.org/10.1177/1073191105275512
Edens, J. F., Poythress, N. G., & Watkins-Clay, M. M. (2007). Detection of malingering in psychiatric unit and general popula-
tion prison inmates: A comparison of the PAI, SIMS, and SIRS. Journal of Personality Assessment, 88(1), 33–42. https://
doi.org/10.1080/00223890709336832
Frederick, R. I., Crosby, R. D., & Wynkoop, T. F. (2000). Performance curve classification of invalid responding on the Validity
Index Profile. Archives of Clinical Neuropsychology, 15(4), 281–300. https://doi.org/10.1093/arclin/15.4.281
Freeman, T., Powell, M., & Kimbrell, T. (2008). Measuring symptom exaggeration in veterans with chronic posttraumatic stress
disorder. Psychiatry Research, 158(3), 374–388. https://doi.org/10.1016/j.psychres.2007.04.002
Gillard, N. D. (2010). Methodological issues in malingering research: The use of simulation designs [Master's thesis, University
of North Texas]. https://digital.library.unt.edu/ark:/67531/metadc33153/m2/1/high_res_d/thesis.pdf
Glassmire, D. M., Tarescavage, A. M., & Gottfried, E. D. (2016). Likelihood of obtaining Structured Interview of Reported
Symptoms (SIRS) and SIRS-2 elevations among forensic psychiatric inpatients with screening elevations on the Miller
Forensic Assessment of Symptoms Test. Psychological Assessment, 28(12), 1586–1596. https://doi.org/10.1037/
pas0000289
Graue, L. O., Berry, D. T. R., Clark, J. A., Sollman, M. J., Cardi, M., Hopkins, J., & Werline, D. (2007). Identification of feigned
mental retardation using the new generation of malingered detection instruments: Preliminary findings. Clinical
Neuropsychologist, 21(6), 929–942. https://doi.org/10.1080/13854040600932137
Green, D., & Rosenfeld, B. (2011). Evaluating the gold standard: A review and meta-analysis of the structured interview of
reported symptoms. Psychological Assessment, 23(1), 95–107. https://doi.org/10.1037/a0021149
Gudjonsson, G. H. (2003). The psychology of interrogations and confessions. Wiley Online Library.
Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis (6th ed.). Prentice-Hall.
Hill, D. (2009). Detecting malingering in correctional settings: A comparison of several psychological tests. Doctoral dissertation.
Pacific University. https://core.ac.uk/download/pdf/48843566.pdf
Jelicic, M., Hessels, A., & Merckelbach, H. (2006). Detection of feigned psychosis with the Structured Inventory of Malin-
gered Symptomatology (SIMS): A study of coached and uncoached simulators. Journal of Psychopathology and Behavioral
Assessment, 28(1), 19–22. https://doi.org/10.1007/s10862-006-4535-0
Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). The Guilford Press.
Knoll, J., & Resnick, P. J. (2006). The detection of malingered post-traumatic stress disorder. Psychiatric Clinics of North Amer-
ica, 29(3), 629–647. https://doi.org/10.1016/j.psc.2006.04.001
Liu, C., Liu, Z., Chiu, H. F., Carl, T. W., Zhang, H., Wang, P., Wu, G., Mwansisya, T. E., Cao, L., Hu, A., Wang, Y., & Xue, Z. (2013).
Detection of malingering: Psychometric evaluation of the Chinese version of the structured interview of reported
symptoms-2. BMC Psychiatry, 13(1), 254. https://doi.org/10.1186/1471-244X-13-254
Martínez-Mesa, J., González-Chica, D. A., Bastos, J. L., Bonamigo, R. R., & Duquia, R. P. (2014). Sample size: How many
participants do I need in my research? Anais Brasileiros de Dermatologia, 89(4), 609–615. https://doi.org/10.1590/
abd1806-4841.20143705
McDermott, B., & Scott, C. (2015). DSM-5 and malingering. In C. Scott (Ed.), DSM-5® and the law: Changes and challenges
(pp. 242–267). Oxford University Press.
McDermott, B. E., Dualan, I. V., & Scott, C. L. (2013). Malingering in the correctional system: Does incentive affect preva-
lence? International Journal of Law and Psychiatry, 36(3–4), 287–292. https://doi.org/10.1016/j.ijlp.2013.04.013.).
McDermott, B. E., & Sokolov, G. (2009). Malingering in a correctional setting: The use of the Structured Interview of Reported
Symptoms in a jail sample. Behavioral Sciences & the Law, 27(5), 753–765. https://doi.org/10.1002/bsl.892
Miller, H. A. (2001). Miller forensic assessment of symptoms test professional manual. PAR Psychological Assessment Resources.
Mittenberg, W., Patton, C., Canyock, E. M., & Condit, D. C. (2002). Base rates of malingering and symptom exaggeration.
Journal of Clinical and Experimental Neuropsychology, 24(8), 1094–1102. https://doi.org/10.1076/jcen.24.8.1094.8379
Peters, M. J. V., Jelicic, M., Moritz, S., Hausschildt, M., & Jelinek, L. (2013). Assessing the boundaries of symptom
over-reporting using the Structured Inventory of Malingered Symptomatology in a clinical schizophrenia sample: Its
relation to symptomatology and neurocognitive dysfunctions. Journal of Experimental Psychopathology, 4(1), 64–77.
https://doi.org/10.5127/jep.023811
Pierre, J. M., Shnayder, I., Wirshing, D. A., & Wirshing, W. C. (2004). Intranasal quetiapine abuse. American Journal of Psychia-
try, 161(9), 1718. https://doi.org/10.1176/appi.ajp.161.9.1718
Richey, L. N., & Doninger, N. A. (2020). A comparison of performance validity measures in predicting MMPI-2 lie scale results.
The Clinical Neuropsychologist, 34(2), 353–367. https://doi.org/10.1080/13854046.2019.1643922
Rogers, R. (1990a). Development of a new classificatory model of malingering. Bulletin of the American Academy of Psychiatry
and the Law, 18(3), 323–333. http://jaapl.org/content/jaapl/18/3/323.full.pdf
Rogers, R. (1990b). Models of feigned mental illness. Professional Psychology: Research and Practice, 21(3), 182–188. https://
doi.org/10.1037/0735-7028.21.3.182
Rogers, R. (1997). Researching dissimulation. In R. Rogers (Ed.), Clinical assessment of malingering and deception (2nd
ed., pp. 398–426). Guilford Press.
Rogers, R. (2008). Clinical assessment of malingering and deception (3rd ed.). Guilford Press.
Rogers, R. (2018). Clinical assessment of malingering and deception (4th ed.). Guilford Press.
Rogers, R., Bagby, R. M., & Dickens, S. E. (1992). Structured interview of reported symptoms professional manual. Psychological
Assessment Resources.
Rogers, R., & Bender, S. D. (2003). Evaluation of malingering and deception. In A. M. Goldstein (Ed.), Handbook of psychology:
Forensic psychology (Vol. 11, pp. 109–129). John Wiley & Sons Inc.
Rogers, R., Jackson, R. L., & Kaminski, P. L. (2005). Factitious psychological disorders: The overlooked response style in foren-
sic evaluations. Journal of Forensic Psychology Practice, 5(1), 21–41. https://doi.org/10.1300/J158v05n01_02
Rogers, R., Robinson, E. V., & Gillard, N. D. (2014). The SIMS screen for feigned mental disorders: The development of
detection-based scales. Behavioral Sciences and the Law, 32(4), 455–466. https://doi.org/10.1002/bsl.2132
Rogers, R., Salekin, R. T., Sewell, K. W., Goldstein, A., & Leonard, K. (1998). A comparison of forensic and nonforensic
malingerers: A prototypical analysis of explanatory models. Law and Human Behavior, 22(4), 353–367. https://doi.
org/10.1023/A:1025714808591
Rogers, R., Sewall, K. W., Cruise, K. R., Wang, E. W., & Ustad, K. L. (1998). The PAI and feigning: A cautionary note on its use
in forensic-correctional settings. Assessment, 5(4), 399–405. https://doi.org/10.1177/107319119800500409
Rogers, R., Sewell, K. W., & Goldstein, A. M. (1994). Explanatory models of malingering: A prototypical analysis. Law and
Human Behavior, 18(5), 543–552. https://doi.org/10.1007/BF01499173
Rokach, A. (2001). Criminal offense type and the causes of loneliness. Journal of Psychology, 135(3), 277–291. https://doi.
org/10.1080/00223980109603698
Saberi, S. M., Karimi, M. R., Sheikhazadi, A., Ghorbani, M., Meysamie, A. P., Nasrabadi, Z. N., & Marashi, S. M. (2011). Malinger-
ing in forensic psychiatry assessment. Journal of Forensic Research, s2(01). https://doi.org/10.4172/2157-7145.S2-006
Smith, G. P., & Burger, G. K. (1997). Detection of malingering: Validation of the SIMS. Bulletin of the American Academy of
Psychiatry and the Law, 25(2), 183–189. http://jaapl.org/content/jaapl/25/2/183.full.pdf
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Pearson Education.
Tamburello, A. C., Kathpal, A., & Reeves, R. (2017). Characteristics of inmates who misuse prescription medication. Journal of
Correctional Health Care, 23(4), 1–10. https://doi.org/10.1177/1078345817727730
van Impelen, A., Merckelbach, H., Jelicic, M., & Merten, T. (2014). The Structured Inventory of Malingered Symptomatology
(SIMS): A systematic review and meta-analysis. Clinical Neuropsychologist, 28(8), 1336–1365. https://doi.org/10.1080/
13854046.2014.984763
Wasyliw, O. E., & Cavanaugh, J. L., Jr. (1989). Simulation of brain damage: Assessment and decision rules. Bulletin of the Amer-
ican Academy of Psychiatry and the Law, 17(4), 373–386. http://jaapl.org/content/jaapl/17/4/373.full.pdf
Waters, B. M., & Joshi, K. G. (2007). Intravenous quetiapine-cocaine use (‘Q-ball’). American Journal of Psychiatry, 164(1),
173–174. https://doi.org/10.1176/ajp.2007.164.1.173a
Young, G. (2015). Malingering in forensic disability-related assessments: Prevalence 15 ± 15%. Psychological Injury and Law,
8(3), 188–199. https://doi.org/10.1007/s12207-015-9232-4
How to cite this article: Arin, N., & Mengchuay, J. (2022). Assessing symptom exaggeration of
psychopathology in incarcerated individuals and mentally ill offenders within forensic contexts. Behavioral
Sciences & the Law, 1–17. https://doi.org/10.1002/bsl.2603

Assessing Symptom Exaggeration of

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Assessing Symptom Exaggeration of

Uploaded by

Copyright:

Available Formats

Received: 6 May 2022 Revised: 20 September 2022 Accepted: 14 November 2022

Assessing symptom exaggeration of

Natthawut Arin1 | Jiraporn Mengchuay2

2.1.1 | Incarcerated individuals

2.1.2 | Mentally Ill Offenders (MIOs)

The research instruments consisted of two parts as follows:

2.2.1 | Part 1. General information questionnaire

2.2.2 | Part 2. The Thai version of symptom validity test (SVT-Th)

2.3 | Statistical analyses

Incarcerated individuals Mentally Ill Offenders

Factors n % Mean SD n % Mean SD n % Mean SD

Incarcerated individuals (n = 528) Mentally Ill Offenders (n = 80) Total (n = 608)

EP 4.11 1 0.855 1.74 1 0.818 19.70 1 0.791**

OVR 5.60 1 2.62 1 25.23 1

Factors n Mean SD t p Effect size (d)

Source of variance SS df MS F p Effect size (η 2)

5 | LIMITATIONS AND FUTURE DIRECTIONS

You might also like