Assessing Effort and Malingering with the Hispanic Client

  • Lorraine T. Benuto
  • Brian D. Leany


Accurate and early identification of malingering is of utmost importance. The use of Symptom Validity Tests (SVTs) with culturally diverse populations for whom validation data do not exist must be carefully considered. In this chapter, we explore the most commonly used and/or researched measures that strive to assess for malingering and we discuss research with on these measures with Hispanics. Specifically, we review the Test of Memory Malingering, the Word Memory Test and the Medical Symptom Validity Test, the MMPI-II and the MMPI-A, Reliable Digit Span, the Structured Interview of Reported Symptoms, the Sentence Completion Task-75 (SCT-75), the Miller-Forensic Assessment of Symptoms Test (M-FAST), Rey 15 Items, and the Dot Counting Test. Finally, we provide evidence-based recommendations for the assessment of malingering with the Hispanic client.


Antisocial Personality Disorder Psychological Injury Sentence Completion Hispanic Adolescent Symptom Validity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text rev.). Washington, DC: APA.Google Scholar
  2. Angel, R., & Guarnaccia, P. J. (1989). Mind, body, and culture: Somatization among Hispanics. Social Science & Medicine, 28, 1229–1238.CrossRefGoogle Scholar
  3. Archer, R. P., Buffington-Vollum, J. K., Stredny, R. V., & Handel, R. W. (2006). A survey of psychological test use patterns among forensic psychologists. Journal of Personality Assessment, 87(1), 84–94 & 11.Google Scholar
  4. Ardila, A., Monica, R., Feggy, O. S., Jose, M., Gladys, G., & Migue, S. (2000). Syntactic comprehension, verbal memory, and calculation abilities in Spanish-English bilinguals. Applied Neurospychology, 7(1), 3–16 & 14.Google Scholar
  5. Axelrod, B. N., Fichtenberg, N. L., Millis, S. R., & Wertheimer, J. C. (2006). Detecting incomplete effort with digit span from the Wechsler adult intelligence scale—Third edition. The Clinical Neuropsychologist, 20(3), 513–523.PubMedCrossRefGoogle Scholar
  6. Babikian, T., Boone, K., Lu, P., & Arnold, G. (2006). Sensitivity and specificity of various digit span scores in the detection of suspect effort. The Clinical Neuropsychologist, 20(1), 145–159.PubMedCrossRefGoogle Scholar
  7. Bagby, R. M., Nicholson, R. A., Buis, T., & Bacchiochi, J. R. (2000). Can the MMIP-2 validity scales detect depression feigned by experts? Assessment, 7(1), 55–62.PubMedCrossRefGoogle Scholar
  8. Berry, D. T. R., Baer, R. A., & Harris, M. J. (1991). Detection of malingering on the MMPI: A meta-analysis. Clinical Psychology Review, 11(5), 585–598.CrossRefGoogle Scholar
  9. Boone, K. B., Lu, P., & Herzberg, D. (2002). The dot counting test. Los Angeles: Western Psychological Services.Google Scholar
  10. Boone, K. B., Salazar, X., Lu, P., Warner-Chacon, K., & Razani, J. (2002). The Rey 15-item recognition trial: A technique to enhance sensitivity of the Rey 15-item memorization test. Journal of Clinical and Experimental Neuropsychology, 24(5), 561–573.PubMedCrossRefGoogle Scholar
  11. Boone, K. B., Savodnik, I., Ghaffarian, S., Lee, A., Freeman, D., & Berman, N. G. (1995). Key 15-item memorization and dot counting scores in a “stress” claim worker’s compensation population: Relationship to personality (MCMI) scores. Journal of Clinical Psychology, 51(3), 457–463.PubMedCrossRefGoogle Scholar
  12. Boone, K. B., Victor, T. L., Wen, J., Razani, J., & Ponton, M. (2007). The association between neuropsychological scores and ethnicity, language, and acculturation variables in a large patient population. Archives of Clinical Neuropsychology, 22(3), 355–365.PubMedCrossRefGoogle Scholar
  13. Bush, S. S., Ruff, R. M., Troster, A. I., Barth, J. T., Koffler, S. P., Pliskin, N. H., et al. (2005). Symptom validity assessment: Practice issues and medical necessity: NAN Policy & Planning Committee. Archives of Clinical Science, 20(4), 419–426.Google Scholar
  14. Butcher, J. N., & Pope, K. S. (1992). The research base, psychometric properties, and clinical uses of the MMPI-2 and MMPI-A. Canadian Psychology/Psychologie canadienne, 33, 61–78.CrossRefGoogle Scholar
  15. Correa, A. A., Rogers, R., & Hoersting, R. (2010). Validation of the Spanish SIRS with monolingual Hispanic outpatients. Journal of Personality Assessment, 92(5), 458–464.PubMedCrossRefGoogle Scholar
  16. Cramer, K. M. (1995). Comparing three new MMPI-2 randomness indices in a novel procedure for random profile derivation. Journal of Personality Assessment, 63(3), 514.CrossRefGoogle Scholar
  17. Dean, A. C., Boone, K. B., Kim, M. S., Curiel, A. R., Martin, D. J., Victor, T. L., et al. (2008). Examination of the impact of ethnicity on the Minnesota multiple personality inventory-2 (MMPI-2) fake bad scale. The Clinical Neuropsychologist, 22, 1054–1060.PubMedCrossRefGoogle Scholar
  18. Garriga (2007). Malingering in the Clinical Setting. Psychiatric Times, 24(3), 1–4.PubMedCrossRefGoogle Scholar
  19. Gasquoine, P. G., Croyle, K. L., Cavazos-Gonzalez, C., & Sandoval, O. (2007). Language of administration and neuropsychological test performance in neurologically intact Hispanic American bilingual adults. Archives of Clinical Neuropsychology, 22(8), 991–1001.PubMedCrossRefGoogle Scholar
  20. Gouvier, W. D., Lees-Haley, P. R., & Hammer, J. H. (2003). The neuropsychological examination in the detection of malingering in the forensic arena: Costs and benefits. In G. P. Prigatano & N. H. Pliskin (Eds.), Clinical neuropsychology and cost outcome research (pp. 405–424). New York: Taylor and Francis.Google Scholar
  21. Green, P. (2003). Green’s word memory test for windows: User’s manual. Edmonton, Canada: Green’s Publishing.Google Scholar
  22. Green, P. (2004). Green’s medical symptom validity test (MSVT): User’s manual. Edmonton, Canada: Green’s Publishing.Google Scholar
  23. Green, P., & Astner, K. (1995). Manual for the oral word memory test. Edmonton, Canada: Neurobehavioural Associates.Google Scholar
  24. Green, P., Montijo, J., & Brockhaus, R. (2011). High specificity of the word memory test and medical symptoms validity test in groups with severe verbal memory impairment. Applied Neuropsychology: Adult, 18(2), 86–94.CrossRefGoogle Scholar
  25. Greiffenstein, M. F., Baker, W. J., & Gola, T. (1994). Validation of malingered amnesia measures with a large clinical sample. Psychological Assessment, 6(3), 218–224.CrossRefGoogle Scholar
  26. Greiffenstein, M. F., Baker, W. J., Gola, T., Donders, J., & Miller, L. (2002). The fake bad scale in atypical and severe closed head injury litigants. Journal of Clinical Psychology, 58(12), 1591–1600.PubMedCrossRefGoogle Scholar
  27. Greve, K. W., Bianchini, K. J., Etherton, J. L., Meyers, J. E., Curtis, K. L., & Ord, J. S. (2010). The reliable digit span test in chronic pain: Classification accuracy in detecting malingered pain-related disabilities. The Clinical Neuropsychologist, 24(1), 137–152.PubMedCrossRefGoogle Scholar
  28. Greve, K. W., Springer, S., Bianchini, K. J., Black, F. W., Heinly, M. T., Love, J. M., et al. (2007). Malingering in toxic exposure: Classification accuracy of reliable digit span and WAISS-III digit span scaled scores. Assessment, 14(1), 12–21.PubMedCrossRefGoogle Scholar
  29. Guy, L., & Miller, H. (2004). Screening for malingered psychopathology in a correctional setting: Utility of the Miller-forensic assessment of symptoms test (M-FAST). Criminal Justice and Behavior, 31(6), 695–716.CrossRefGoogle Scholar
  30. Haberman, P. W. (1970). Ethnic differences in psychiatric symptoms reported in community surveys. Public Health Reports, 85, 495–502.PubMedCrossRefGoogle Scholar
  31. Haberman, P. W. (1976). Psychiatric symptoms among Puerto Ricans in Puerto Rico and New York City. Ethnicity, 3, 133–144.Google Scholar
  32. Hall, G. C. N., Bansal, A., & Lopez, I. R. (1999). Ethnicity and psychopathology: A meta-analytic review of 31 years of comparative MMPI-MMPI-2 research. Psychological Assessment, 11(2), 186–197.CrossRefGoogle Scholar
  33. Heinly, M. T., Greve, K. W., Bianchini, K. J., Love, J. M., & Brennan, A. (2005). WAIS digit span-based indicators of malingered neurocognitive dysfunction classification accuracy in traumatic brain injury. Assessment, 12(4), 429–442.PubMedCrossRefGoogle Scholar
  34. Iverson, G. L., & Tulsky, D. S. (2003). Detecting ­malingering on the WAIS-III unusual digit span ­performance patterns in the normal population and in clinical groups. Archives of Clinical Neuropsychology, 18(1), 1–9.PubMedGoogle Scholar
  35. Kaufman, A. S. (1990). Assessing adolescent and adult intelligence. Boston: Allyn and Bacon.Google Scholar
  36. Larrabee, G. J. (1998). Somatic malingering on the MMPI and MMPI-2 in personal injury litigants. The Clinical Neuropsychologist, 12(2), 179–188.CrossRefGoogle Scholar
  37. Larrabee, G. (2003). Detection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17(3), 410–425.PubMedCrossRefGoogle Scholar
  38. Lees-Haley, P. R., English, L. T., & Glenn, V. J. (1991). A fake bad scale on the MMPI-2 for personal injury claimants. Psychological Reports, 68, 203–210.PubMedCrossRefGoogle Scholar
  39. Lezak, M. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.Google Scholar
  40. Lim, J., & Butcher, J. N. (1996). Detection of faking on the MMPI-2: Differentiation among faking-bad, denial, and claiming extreme virtue. Journal of Personality Assessment, 67(1), 1 & 25.Google Scholar
  41. Lucio, E., Ampudia, A., Duran, C., Gallegos, L., & Leon, I. (1999). La Nueva version del Inventario Multifasico de la Personalidad de Minnesota para Adolescents: MMPI-A [The new version of the Minnesota multiphasic personality inventory for Mexican adolescents]. Revista Mexicana de Psicología, 16, 217–226.Google Scholar
  42. Lucio, E., Durán, C., Graham, J. R., & Ben-Porath, Y. S. (2002). Identifying faking bad on the Minnesota multiphasic personality inventory-adolescent with Mexican adolescents. Assessment, 9(1), 62–69. doi: 10.1177/1073191102009001008.PubMedCrossRefGoogle Scholar
  43. Lucio, E., & Valencia, M. (1997). Detección del perfil de los sujetos simuladores y de los sujetos honestos por medio de las escalas del MMPI-2. Salud Mental, 20(4), 23–33.Google Scholar
  44. Marshall, P., & Happe, M. (2007). The performance of individuals with mental retardation on cognitive tests assessing effort and motivation. The Clinical Neuropsychologist, 21(5), 826–840.PubMedCrossRefGoogle Scholar
  45. Martens, M., Donders, J., & Millis, S. R. (2001). Evaluation of invalid response sets after traumatic head injury. Journal of Forensic Neuropsychology, 2(1), 1–18.CrossRefGoogle Scholar
  46. Messer, J. M., & Fremouw, W. J. (2007). Detecting malingered posttraumatic stress disorder using the morel emotional numbing test-revised (MENT-R) and the Miller forensic assessment of symptoms test (M-FAST). Journal of Forensic Psychological Practice, 7(3), 33–57.CrossRefGoogle Scholar
  47. Miller, H. A. (2001). MFAST: Miller forensic assessment of symptoms test professional manual. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
  48. Nelson, N. W., Sweet, J. J., & Demakis, G. J. (2006). Meta-analysis of the MMPI-2 fake bad scale: Utility in forensic practice. The Clinical Neuropsychologist, 20, 39–58.PubMedCrossRefGoogle Scholar
  49. Prieto De Estebecorena, M. J. (2007). Evaluating the role of education and acculturation in the performance of Hispanics on a non-verbal test. ProQuest dissertations and theses, Fielding Graduate University, 123 p. Retrieved from
  50. Puente, A. E., & Perez-Garcia, M. (2000). Neuropsychological assessment of ethnic minorities: Clinical issues. In I. Cuéllar & F. A. Paniagua (Eds.), Handbook of multicultural mental health (pp. 419–435). San Diego, CA: Academic. doi: 10.1016/B978-012199370-2/50021-3.CrossRefGoogle Scholar
  51. Rogers, R. (Ed.). (2008). Clinical assessment of malingering and deception. New York: The Guilford Press.Google Scholar
  52. Rogers, R., Bagby, R. M., & Dickens, S. E. (1992). Structured interview of reported symptoms (SIRS) and professional manual. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
  53. Rogers, R., Sewell, K. W., & Gillard, N. (2010a). Structured interview of reported symptoms-2 (SIRS-2) and professional manual. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
  54. Rogers, R., Sewell, K. W., & Gillard, N. D. (2010b). SIRS professional manual (2nd ed.). Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
  55. Rogers, R., Sewell, K. W., & Salekin, R. T. (1994). A meta-analysis of malingering on the MMPI-2. Assessment, 1(3), 227–237.Google Scholar
  56. Ross, S. R., Millis, S. R., Krukowski, R. A., Putnam, S. H., & Adams, K. M. (2004). Detecting incomplete effort on the MMPI-2: An examination of the fake-bad scale in mild head injury. Journal of Clinical & Experimental Neuropsychology, 26(1), 115–124 & 10.Google Scholar
  57. Rubenzer, S. (2010). Review of the structured inventory of reported symptoms-2 (SIRS-2). Open Access Journal of Forensic Psychology, 2, 273–286.Google Scholar
  58. Saavedra, L. T. (1999). The translation and validation of the SCT-75 for assessing malingering among Hispanics involved in personal injury litigation. ProQuest dissertations and theses, Miami Institute of Psychology of the Caribbean Center for Advanced Studies, 99 p. Retrieved from
  59. Salazar, X. D., Lopez, E., Peña, R., & Mitrushina, M. (2003). Datos normativos y validez de tres pruebad para la evaluación de bajo esfuerzo/simulación en personas con educación limitada. [Validation and preliminary normative data for three effort measures within a limited education, Spanish-speaking sample living in the United States]. Poster session presented at the annual international meeting of the Sociedad Lationamericana de Neuropsicología, Montreal, Canada.Google Scholar
  60. Salazar, X. F., Lu, P. H., Wen, J., & Boone, K. (2007). The use of effort tests in ethnic minorities and in non-English-speaking and English as a second language populations. In K. Boone (Ed.), Assessment of feigned cognitive impairment: A neuropsychological perspective (pp. 405–427). New York: Guilford Press.Google Scholar
  61. Srole, L., Langner, T. S., Michael, S. T., Kirkpatrick, P. O., Marvin, K., & Rennie, T. A. C. (1978). Mental health in the metropolis: The midtown Manhattan study. New York: McGraw-Hill.Google Scholar
  62. Stein, L. A. R., Graham, J. R., & Williams, C. L. (1995). Detecting fake-bad MMPI-A profiles. Journal of Personality Assessment, 65(3), 415–427.PubMedCrossRefGoogle Scholar
  63. Strauss, E., Slick, D. J., Levy-Bencheton, J., Hunter, M., MacDonald, S. W., & Hultsch, D. F. (2002). Intraindividual variability as an indicator of malingering in head injury. Archives of Clinical Neuropsychology, 17(5), 423–444.PubMedGoogle Scholar
  64. Suhr, J. A., & Barrash, J. (2007). Performance on standard attention, memory, and psychomotor speed tasks as indicators of malingering. In G. L. Larrabee (Ed.), Assessment of malingered neuropsychological deficits (pp. 131–170). New York: Oxford University Press.Google Scholar
  65. Timmons, L. A., Lanyon, R. I., Almer, E. R., & Curran, P. J. (1993). Development and validation of sentence completion test indices of malingering during examination for disability. American Journal of Forensic Psychology, 11(3), 23–38.Google Scholar
  66. Tombaugh, T. N. (1996). The test of memory malingering (TOMM). Toronto, Canada: Multi-Health Systems.Google Scholar
  67. Veazey, C. H., Wagner, A. L., Hays, J. R., & Miller, H. A. (2005). Validity of the Miller forensic assessment of symptoms test in psychiatric inpatients. Psychological Reports, 96(3), 771–774.PubMedCrossRefGoogle Scholar
  68. Verdejo-García, A., Alcázar-Córcoles, M. A., Gómez-Jarabo-García, G. A., & Pérez-García, M. (2004). Guidelines for the scientific and professional development of forensic neuropsychology. Revista de Neurologia, 39(01), 60–73.Google Scholar
  69. Vilar-Lopez, R., Santiago-ramajo, S., Gomez-Rio, M., Verdejo-Garcia, A., Llamas, J. M., & Perez-Garcia, M. (2007). Detection of malingering in a Spanish population using three specific malingering tests. Archives of Clinical Neuropsychology, 22(3), 379–388.PubMedCrossRefGoogle Scholar
  70. Wheeler, D. K. (2010). Digit span with a linguistically diverse Latina/Latino population: A cross-language study. ProQuest dissertations and theses, Fielding Graduate University. Retrieved from

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Psychology, Victims of Crime Treatment CenterUniversity of Nevada, RenoRenoUSA
  2. 2.California Department of Corrections and Rehabilitation, Adult DivisionCalifornia Correctional Health Care ServicesSusanvilleUSA

Personalised recommendations