Ecological Validity of the Inventory of Problems-29 (IOP-29): an Italian Study of Court-Ordered, Psychological Injury Evaluations Using the Structured Inventory of Malingered Symptomatology (SIMS) as Criterion Variable
TL;DR: In this article, the authors used the Structured Inventory of Malingered Symptomatology (SIMS) as their criterion variable to evaluate the validity of the IOP-29.
Abstract: The Inventory of Problems-29 (IOP-29; Viglione, Giromini, & Landis, Journal of Personality Assessment, 99(5), 534–544, 2017) is a 29-item, recently published, self-administered test aimed at assessing the credibility of various symptom presentations. Although available research strongly supports the use of this symptom validity test in malingering-related contexts, to date, only few studies have analyzed data from real-life forensic evaluations. To fill this gap and explore ecological and convergent validity, the current study analyzed data from 74 court-ordered evaluations aimed at establishing the possible presence of psychological injury. Such evaluations are high-stakes situations in which exaggeration or malingering occur relatively often. We used a research-supported and popular symptom validity test, i.e., the Structured Inventory of Malingered Symptomatology (SIMS; Smith & Burger, Journal of the American Academy on Psychiatry and Law, 25:180–183, 1997), as our criterion variable. The IOP-29 produced excellent area under the curve (AUC) values of .98 with a recommended SIMS total score cutoff (≥ 17) and .99 when eliminating too-close-to-classify cases (Rogers & Bender, 2018) and very large Cohen’s d effect sizes of 2.98 and 3.59, respectively. Crucially, when implementing established cut scores from previous research, the IOP-29 yielded very high specificity and sensitivity rates, and the predictions from the two tests were strikingly similar. Taken together, these findings support the strong convergent validity of the IOP-29 and its utility in applied clinical and forensic settings.
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TL;DR: In this paper , the authors present a review of self-reported symptom validity tests (SVTs) and performance validation tests (PVTs), and make tentative proposals for the field to consider regarding the number of SVTs to be used in an assessment, number of failures required to invalidate test results and the issue of redundancy when selecting multiple SVTs for an assessment.
Abstract: Abstract In psychological injury and related forensic evaluations, two types of tests are commonly used to assess Negative Response Bias (NRB): Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs). SVTs assess the credibility of self-reported symptoms, whereas PVTs assess the credibility of observed performance on cognitive tasks. Compared to the large and ever-growing number of published PVTs, there are still relatively few validated self-report SVTs available to professionals for assessing symptom validity. In addition, while several studies have examined how to combine and integrate the results of multiple independent PVTs, there are few studies to date that have addressed the combination and integration of information obtained from multiple self-report SVTs. The Special Issue of Psychological Injury and Law introduced in this article aims to help fill these gaps in the literature by providing readers with detailed information about the convergent and incremental validity, strengths and weaknesses, and applicability of a number of selected measures of NRB under different conditions and in different assessment contexts. Each of the articles in this Special Issue focuses on a particular self-report SVT or set of SVTs and summarizes their conditions of use, strengths, weaknesses, and possible cut scores and relative hit rates. Here, we review the psychometric properties of the 19 selected SVTs and discuss their advantages and disadvantages. In addition, we make tentative proposals for the field to consider regarding the number of SVTs to be used in an assessment, the number of SVT failures required to invalidate test results, and the issue of redundancy when selecting multiple SVTs for an assessment.
28 citations
TL;DR: In this article , the authors present a review of self-reported symptom validity tests (SVTs) and performance validation tests (PVTs), and make tentative proposals for the field to consider regarding the number of SVTs to be used in an assessment, number of failures required to invalidate test results and the issue of redundancy when selecting multiple SVTs for an assessment.
Abstract: Abstract In psychological injury and related forensic evaluations, two types of tests are commonly used to assess Negative Response Bias (NRB): Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs). SVTs assess the credibility of self-reported symptoms, whereas PVTs assess the credibility of observed performance on cognitive tasks. Compared to the large and ever-growing number of published PVTs, there are still relatively few validated self-report SVTs available to professionals for assessing symptom validity. In addition, while several studies have examined how to combine and integrate the results of multiple independent PVTs, there are few studies to date that have addressed the combination and integration of information obtained from multiple self-report SVTs. The Special Issue of Psychological Injury and Law introduced in this article aims to help fill these gaps in the literature by providing readers with detailed information about the convergent and incremental validity, strengths and weaknesses, and applicability of a number of selected measures of NRB under different conditions and in different assessment contexts. Each of the articles in this Special Issue focuses on a particular self-report SVT or set of SVTs and summarizes their conditions of use, strengths, weaknesses, and possible cut scores and relative hit rates. Here, we review the psychometric properties of the 19 selected SVTs and discuss their advantages and disadvantages. In addition, we make tentative proposals for the field to consider regarding the number of SVTs to be used in an assessment, the number of SVT failures required to invalidate test results, and the issue of redundancy when selecting multiple SVTs for an assessment.
27 citations
TL;DR: In this article, the authors presented the development and initial validation of a PVT module designed to be used in combination with a free-standing SVT Named Inventory of Problems -Memory (IOP-M), which consists of a 34-item, two-alternative, forced-choice, implicit recognition test.
Abstract: A growing literature indicates that to evaluate the credibility of a clinical presentation it would be optimal to rely on multiple sources of information, and use both symptom validity tests (SVTs) and performance validity tests (PVTs) whenever possible In this paper, we present the development and initial validation of a PVT module designed to be used in combination with a free-standing SVT Named Inventory of Problems – Memory (IOP-M), this new PVT module is given to the examinee immediately after completing the Inventory of Problems – 29 (IOP-29) It consists of a 34-item, two-alternative, forced-choice, implicit recognition test Results from 360 nonclinical volunteers – 192 instructed to respond honestly (honest controls) and 168 instructed to feign mental illness (experimental simulators) – suggest that the IOP-M has the potential to yield incremental validity over using the IOP-29 alone In fact, a series of hierarchical logistic regressions using group as criterion variable (0 = honest control; 1 = experimental simulator) and the IOP-29 and IOP-M as predictors showed that the models including both measures significantly improved classification accuracy over those including the IOP-29 only, Δχ2 ≥ 191, p < 01 When considering the optimal cut scores for each measure, only 6 of the 168 simulators (ie, less than 4%) passed both the IOP-29 and IOP-M, and only 3 of the 192 honest responders (ie, less than 2%) failed both A closer examination of false positive classifications, however, revealed that the IOP-M could be prone to false positive errors in examinees with moderate to severe cognitive impairment
26 citations
TL;DR: The results indicated that the SIMS Total Score, Neurologic Impairment and Low Intelligence scales and the MMPI-2-RF Infrequent Responses and Response Bias scales successfully discriminated among symptom accentuators, symptom producers, and consistent participants.
Abstract: In the context of legal damage evaluations, evaluees may exaggerate or simulate symptoms in an attempt to obtain greater economic compensation. To date, practitioners and researchers have focused on detecting malingering behavior as an exclusively unitary construct. However, we argue that there are two types of inconsistent behavior that speak to possible malingering-accentuating (i.e., exaggerating symptoms that are actually experienced) and simulating (i.e., fabricating symptoms entirely)-each with its own unique attributes; thus, it is necessary to distinguish between them. The aim of the present study was to identify objective indicators to differentiate symptom accentuators from symptom producers and consistent participants. We analyzed the Structured Inventory of Malingered Symptomatology scales and the Minnesota Multiphasic Personality Inventory-2 Restructured Form validity scales of 132 individuals with a diagnosed adjustment disorder with mixed anxiety and depressed mood who had undergone assessment for psychiatric/psychological damage. The results indicated that the SIMS Total Score, Neurologic Impairment and Low Intelligence scales and the MMPI-2-RF Infrequent Responses (F-r) and Response Bias (RBS) scales successfully discriminated among symptom accentuators, symptom producers, and consistent participants. Machine learning analysis was used to identify the most efficient parameter for classifying these three groups, recognizing the SIMS Total Score as the best indicator.
26 citations
Cites methods from "Ecological Validity of the Inventor..."
...Studies using this instrument yielded encouraging results in the detection of malingering [23,24] and indicated that it can be used in a multimethod symptom validity assessment along with TOMM [25]....
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TL;DR: A Lithuanian version of the IOP-29 was developed and tested its validity on a sample of 50 depressed patients and 50 healthy volunteers instructed to feign depression, and it discriminated almost perfectly between genuine and experimentally feigned major depression.
Abstract: This article contributes to the growing research on the validity of the recently developed, Inventory of Problems – 29 (IOP-29) in the discrimination of feigned from bona fide mental or cognitive d...
18 citations
Cites background from "Ecological Validity of the Inventor..."
...…of the IOP-29 include simulation samples as opposed to patient samples detected with failed symptom validity from other methods, emerging findings from courtordered forensic evaluations lend strong support to its effectiveness also in real-life, ecologically valid contexts (Roma et al., 2019)....
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11 Jun 2013
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TL;DR: An issue concerning the criteria for tic disorders is highlighted, and how this might affect classification of dyskinesias in psychotic spectrum disorders.
Abstract: Given the recent attention to movement abnormalities in psychosis spectrum disorders (e.g., prodromal/high-risk syndromes, schizophrenia) (Mittal et al., 2008; Pappa and Dazzan, 2009), and an ongoing discussion pertaining to revisions of the Diagnostic and Statistical Manuel of Mental Disorders (DSM) for the upcoming 5th edition, we would like to take this opportunity to highlight an issue concerning the criteria for tic disorders, and how this might affect classification of dyskinesias in psychotic spectrum disorders.
Rapid, non-rhythmic, abnormal movements can appear in psychosis spectrum disorders, as well as in a host of commonly co-occurring conditions, including Tourette’s Syndrome and Transient Tic Disorder (Kerbeshian et al., 2009). Confusion can arise when it becomes necessary to determine whether an observed movement (e.g., a sudden head jerk) represents a spontaneous dyskinesia (i.e., spontaneous transient chorea, athetosis, dystonia, ballismus involving muscle groups of the arms, legs, trunk, face, and/or neck) or a tic (i.e., stereotypic or patterned movements defined by the relationship to voluntary movement, acute and chronic time course, and sensory urges). Indeed, dyskinetic movements such as dystonia (i.e., sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions) closely resemble tics in a patterned appearance, and may only be visually discernable by attending to timing differences (Gilbert, 2006).
When turning to the current DSM-IV TR for clarification, the description reads: “Tic Disorders must be distinguished from other types of abnormal movements that may accompany general medical conditions (e.g., Huntington’s disease, stroke, Lesch-Nyhan syndrome, Wilson’s disease, Sydenham’s chorea, multiple sclerosis, postviral encephalitis, head injury) and from abnormal movements that are due to the direct effects of a substance (e.g., a neuroleptic medication)”. However, as it is written, it is unclear if psychosis falls under one such exclusionary medical disorder. The “direct effects of a substance” criteria, referencing neuroleptic medications, further contributes to the uncertainty around this issue. As a result, ruling-out or differentiating tics in psychosis spectrum disorders is at best, a murky endeavor.
Historically, the advent of antipsychotic medication in the 1950s has contributed to the confusion about movement signs in psychiatric populations. Because neuroleptic medications produce characteristic movement disorder in some patients (i.e. extrapyramidal side effects), drug-induced movement disturbances have been the focus of research attention in psychotic disorders. However, accumulating data have documented that spontaneous dyskinesias, including choreoathetodic movements, can occur in medication naive adults with schizophrenia spectrum disorders (Pappa and Dazzan, 2009), as well as healthy first-degree relatives of chronically ill schizophrenia patients (McCreadie et al., 2003). Taken together, this suggests that movement abnormalities may reflect pathogenic processes underlying some psychotic disorders (Mittal et al., 2008; Pappa and Dazzan, 2009).
More specifically, because spontaneous hyperkinetic movements are believed to reflect abnormal striatal dopamine activity (DeLong and Wichmann, 2007), and dysfunction in this same circuit is also proposed to contribute to psychosis, it is possible that spontaneous dyskinesias serve as an outward manifestation of circuit dysfunction underlying some schizophrenia-spectrum symptoms (Walker, 1994). Further, because these movements precede the clinical onset of psychotic symptoms, sometimes occurring in early childhood (Walker, 1994), and may steadily increase during adolescence among populations at high-risk for schizophrenia (Mittal et al., 2008), observable dyskinesias could reflect a susceptibility that later interacts with environmental and neurodevelopmental factors, in the genesis of psychosis.
In adolescents who meet criteria for a prodromal syndrome (i.e., the period preceding formal onset of psychotic disorders characterized by subtle attenuated positive symptoms coupled with a decline in functioning), there is sometimes a history of childhood conditions which are also characterized by suppressible tics or tic like movements (Niendam et al., 2009). On the other hand, differentiating between tics and dyskinesias has also complicated research on childhood disorders such as Tourette syndrome (Kompoliti and Goetz, 1998; Gilbert, 2006).
We propose consideration of more explicit and operationalized criteria for differentiating tics and dyskinesias, based on empirically derived understanding of neural mechanisms. Further, revisions of the DSM should allow for the possibility that movement abnormalities might reflect neuropathologic processes underlying the etiology of psychosis for a subgroup of patients. Psychotic disorders might also be included among the medical disorders that are considered a rule-out for tics.
Related to this, the reliability of movement assessment needs to be improved, and this may require more training for mental health professionals in movement symptoms. Although standardized assessment of movement and neurological abnormalities is common in research settings, it has been proposed that an examination of neuromotor signs should figure in the assessment of any patient, and be as much a part of the patient assessment as the mental state examination (Picchioni and Dazzan, 2009).
To this end it is important for researchers and clinicians to be aware of differentiating characteristics for these two classes of abnormal movement. For example, tics tend to be more complex than myoclonic twitches, and less flowing than choreoathetodic movements (Kompoliti and Goetz, 1998). Patients with tics often describe a sensory premonition or urge to perform a tic, and the ability to postpone tics at the cost of rising inner tension (Gilbert, 2006). For example, one study showed that patients with tic disorders could accurately distinguish tics from other movement abnormalities based on the subjective experience of some voluntary control of tics (Lang, 1991). Another differentiating factor derives from the relationship of the movement in question to other voluntary movements. Tics in one body area rarely occur during purposeful and voluntary movements in that same body area whereas dyskinesia are often exacerbated by voluntary movement (Gilbert, 2006). Finally, it is noteworthy that tics wax and wane in frequency and intensity and migrate in location over time, often becoming more complex and peaking between the ages of 9 and 14 years (Gilbert, 2006). In the case of dyskinesias among youth at-risk for psychosis, there is evidence that the movements tend to increase in severity and frequency as the individual approaches the mean age of conversion to schizophrenia spectrum disorders (Mittal et al., 2008).
As revisions to the DSM are currently underway in preparation for the new edition (DSM V), we encourage greater attention to the important, though often subtle, distinctions among subtypes of movement abnormalities and their association with psychiatric syndromes.
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