Assessment of malingered depression and pain with the MMPI -2 and Rorschach Inkblot Method

This study investigated the use of the MMPI-2 and Rorschach Inkblot Method (RIM) to identify performance patterns of simulators malingering depression and pain. Assessing for malingered pain and depression has held clinical and forensic implications for matters such as Workers Compensation and personal injury claims. Numerous studies have identified ways these two measures may detect general feigned distress or over reporting, yet few previous investigations have examined depression and pain specifically. Moreover, research addressing these topics have rarely employed both of these measures in their inquiry. This study compared thirty-five patients with a primary diagnosis of Major Depressive Disorder and eight patients diagnosed with Pain Disorder. Two groups of doctoral graduate students were used to represent the experimental malingerer condition in this study. Thirty-five students simulated symptoms of depression and twenty-one students simulated symptoms of chronic pain. The findings indicated that there is a relationship of RIM perceptual accuracy variables (Lambda, X+%, & F+%) that are within normal limits to RIM Dramatic Content scores for detecting malingering irrespective of the condition that is being feigned. The commonly used MMPI-2 validity indexes were not predictive of malingering in this study, yet there was positive relationship between elevated MMPI-2 F scale scores and the production of Dramatic Content on the RIM which further supports the notion that using both measures enhances incremental validity to identify dissimulation. The salient limitations of this study included a small sample size, not controlling for the likelihood of malingering within the patient sample and the disparity in incentive to malinger between the simulators and those involved in real life litigations. Directions for future research recommended assessing for malingering for other conditions such as amnesia and PTSD along with employing other measures designed to assess for malingering specifically for the purposes of incremental and external validity. The possible clinical implications of this study included using both measures together along with the inability of MMPI-2 validity scales to detect malingered conditions other than psychosis.