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Malingering and the Rorschach: Investigating Systematic Differences in Rorschach Responses from Committed Forensic Patients and Normal Subjects Instructed to Fake Insanity

Kiss, Andrea B, PhD

Abstract Details

2017, Doctor of Philosophy, University of Toledo, Psychology - Clinical.
This study is focused on feigning mental disorder within the legal context in order to evade criminal responsibility. More specifically, the purpose is determining whether the variables derived from the Rorschach task are able to distinguish between individuals who suffer from severe mental illness (e.g., psychotic disorders), and those who attempt to appear insane (i.e., malinger) using the Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). The problem of malingering on psychological tests is particularly important in the forensic context where assessors are trying to determine competency to stand trial and criminal responsibility. No single reliable measure for detecting malingering has been identified to date. Although the literature thus far has been equivocal regarding findings on malingering, the Rorschach variables most often associated with faking psychopathology are the Dramatic Content scores. The Critical Content (CritCont%) scores on R-PAS are almost identical to the Dramatic Content Malingering Index (encompassing the scores Morbid, Aggressive Movement, Blood, Explosion, Sex, and Fire) with the addition of one other score: Anatomy. The purpose of this study was to extend the previous research and investigate if the CritCont% can be used as a marker of malingering on R-PAS. Further, this study investigated whether the prediction improved by adding to the CritCont% composite two variables that are not found in the CS and are part of R-PAS (Aggressive Content [AGC] and Mutuality of Autonomy Pathology [MAP]). Mod-Alive, one of the modified responses proposed by Netter and Viglione (1990, 1994), in an attempt to better distinguish between patients who suffer from schizophrenia and individuals who attempt to malinger on the Rorschach, was investigated as well. Mod-Alive is scored when an individual is relating to the inkblot card as if it was alive (e.g., "this monster will get me"; Netter & Viglione, 1994, p. 46). Lastly, I investigated whether there is a systematic and consistent difference between the three groups studied: control subjects, a malingering group, and a forensic inpatient group, on R-PAS Thought and Perception variables, specifically the Thought and Perception Composite (TP-Comp), Weighted Sum of Cognitive Codes (WSumCog), and proportion of responses with distorted form quality (FQ-%). Results indicated that CritCont% significantly differentiated between the groups and a liner trend was significant showing an increase in scores, with the student malingering group producing a higher number of CritCont% scores than the forensic inpatient group and the student control group. Adding the AGC score to the CritCont% improved the prediction and magnitude of the effect size. Mod-Alive differentiated between the student control group and the malingering group. Although no significant differences were found on Mod-Alive scores between the patient and malingering group, diagnostic efficiency statistics for this variable determined that a cutoff score of 1 or more and 2 or more has an excellent positive predictive power (i.e., PPP = .90 and 1.0, respectively). Specificity was also excellent every time there were two or more Mod-Alive scores. For the R-PAS Thought and Perception variables investigated, results indicated that the forensic patient group and the student malingering group scored higher than the student control group on TP-Comp, but they did not differ significantly from each other. The tendency was for the forensic patients to have higher mean scores on TP-Comp than the malingering patients. The forensic patient and the student malingering groups were significantly different on variables measuring thought disorganization (WSumCog), yet not on the major measure of reality testing that is assessed by form quality variables (FQ-). Malingerers were not able to fake more severe thought disruptions (SevCog) like real patients are prone to display. When Mod-Alive type of responses were subtracted from the WSumCog the differences between the malingering group and the student control group were no longer significant. The results showed meaningful differences between the groups that can help to identify Rorschach parameters that differentiate between individuals who try to feign psychosis and individuals who exhibit true psychosis. A limitation for this study is the researcher not being blind to the group designations, which could have influenced scoring. On the other hand, an investigation of the FQ scores for a subset of blindly coded protocols did not support coding bias on this researcher's part.
Joni Mihura, PhD (Committee Chair)
Gregory Meyer, PhD (Committee Member)
Wesley Bullock, PhD (Committee Member)
Stephen Christman, PhD (Committee Member)
Nicole Kletzka, PhD (Committee Member)
207 p.

Recommended Citations

Citations

  • Kiss, PhD, A. B. (2017). Malingering and the Rorschach: Investigating Systematic Differences in Rorschach Responses from Committed Forensic Patients and Normal Subjects Instructed to Fake Insanity [Doctoral dissertation, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1513368890921424

    APA Style (7th edition)

  • Kiss, PhD, Andrea. Malingering and the Rorschach: Investigating Systematic Differences in Rorschach Responses from Committed Forensic Patients and Normal Subjects Instructed to Fake Insanity . 2017. University of Toledo, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1513368890921424.

    MLA Style (8th edition)

  • Kiss, PhD, Andrea. "Malingering and the Rorschach: Investigating Systematic Differences in Rorschach Responses from Committed Forensic Patients and Normal Subjects Instructed to Fake Insanity ." Doctoral dissertation, University of Toledo, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1513368890921424

    Chicago Manual of Style (17th edition)