Encyclopedia of Psychology and Law

administration time. The M–FAST items were

developed to represent the following response styles/

strategies that have been validated for identifying

malingered psychiatric symptoms: Reported versus

Observed Symptoms, Extreme Symptoms, Rare

Combinations, Unusual Hallucinations, Unusual

Symptom Course, Negative Image, and Suggestibility.

The M–FAST includes items that represent these detec-

tion strategies along with items that reflect actual

symptoms of mental illness.

Since the M–FAST items were developed to oper-

ationally measure several strategies for malingering

detection, the factor structure has been examined. Two

principal component analyses were performed on the

nonclinical and clinical M–FAST development sam-

ples. Examination of the scree plots suggested one

primary “malingering” factor in both samples

accounting for 55% (nonclinical) and 49% (clinical)

of the variance. The factor structure of the M–FAST

has been tested independently from the development

samples by exploratory and confirmatory factor

analysis. Similar to the initial factor findings, the lat-

est analyses indicate that the M–FAST is found best to

represent a single, dominant factor.

Reliability

The M–FAST was developed at a forensic hospital

with patients who were either found NGRI or incom-

petent to stand trial. The initial reliability (or consis-

tency) of the M–FAST was assessed in several ways.

The test-retest reliability, given an average of 2 weeks

apart, and the internal consistency of M–FAST items

were both reported to be high at .92. A third analysis

assessed interrater reliability by comparing scores of

different M–FAST interview raters. An interclass cor-

relation coefficient, using two-way random effects

model with consistency reported, was calculated and

found to be high at 99.6. Several independent studies

since the development of the M–FAST have indicated

that the M–FAST is highly reliability; M–FAST inter-

nal consistency ranging from .90 to .92, scale (or strat-

egy) internal consistency ranging from .53 to .82, and

interrater reliability found to be 1.0.

Validity

The primary goal for M–FAST validation was to

demonstrate criterion, convergent, and discriminant

validity of the instrument. The diagnostic efficacy of

the M–FAST for identifying malingered mental illness

was also examined. Initial validation of the measure

was demonstrated by significant, positive relationships

found between the M–FAST and other validated

instruments and scales designed to assess for response

style and/or malingered mental illness. These initial

studies included forensic patients who were incompe-

tent to stand trial or NGRI and a group of civil outpa-

tients being evaluated for mental illness disability

status. In all the samples the M–FAST effectively dis-

criminated between bona fide psychiatric patients and

those who were found to be faking mental illness for

secondary gain.

Since its development, the M–FAST has been

examined for validity and diagnostic efficacy with

several different samples including civil psychiatric

inpatients, imprisoned offenders being assessed for

psychiatric services, and additional samples of foren-

sic inpatients being assessed for CST. In all these sam-

ples, the M–FAST was found to be valid and to

effectively differentiate those individuals who were

malingering from those who were bona fide psychi-

atric patients. The use of the M–FAST to detect diag-

nostic-specific malingering has also been examined.

In these studies, the M–FAST has been found to be an

effective screen when an individual is attempting to

malinger the specific disorders of posttraumatic stress

disorder, schizophrenia, major depressive disorder,

and bipolar disorder.

Holly A. Miller

See alsoCompetency to Stand Trial; Forensic Assessment;

Malingering

Further Readings

Guy, L. S., & Miller, H. A. (2004). Screening for malingered

psychopathology in a correctional setting: Utility of the

Miller–Forensic of Symptoms Test (M–FAST). Criminal

Justice and Behavior, 31(6), 695–716.

Jackson, R. L., Rogers, R., & Sewell, K. W. (2005). Forensic

applications of the Miller Forensic Assessment of

Symptoms Test (M–FAST): Screening for feigned

disorders in competency to stand trial evaluations. Law

and Human Behavior, 29(2), 199–210.

Miller, H. A. (2001). The Miller Forensic of Symptoms Test

(M–FAST) professional manual.Odessa, FL:

Psychological Assessment Resources.

Miller, H. A. (2005). The Miller Forensic Assessment of

Symptoms Test (M–FAST): Test generalizability and

utility across race, literacy, and clinical opinion. Criminal

Justice and Behavior, 32(6), 591–611.

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