Encyclopedia of Psychology and Law

questionable validity. In addition to other tests

designed to detect poor effort only, it can be detected

on cognitive tests for which built-in validity detectors

have been developed. Poor effort or malingering is also

suspect when a patient does not cooperate with testing,

performs inconsistently across similar tests (e.g., ver-

bal memory), endorses symptoms inconsistent with the

alleged injury, and presents during the interview in a

manner inconsistent with testing (e.g., demonstrates

good recall when queried about recent personal events,

but poor performance on memory testing).

In addition to cognitive testing, psychological test-

ing is also recommended in mTBI to evaluate the

nature and severity of psychological involvement.

Commonly used tests include the Minnesota Multiphasic

Personality Inventory–2 and the PersonalityAssessment

Inventory. These lengthy self-report tests evaluate a

range of clinical complaints, such as mood, personality,

and behavioral disturbance, as well as patient response

variables. These latter variables evaluate whether a

patient responded honestly and consistently to the items

or whether he overreported symptoms (i.e., presented

himself negatively) or underreported symptoms (i.e.,

presented himself positively). Within the forensic

evaluation, overreporting symptoms are much more

common in mTBI, as patients seek to emphasize expe-

rienced symptoms. It is thus important that whatever

measure of personality is used, it includes a measure of

patient response style. Unfortunately, the existing mea-

sures of postconcussive symptoms, which might be

ideal for evaluation of an mTBI patient, typically do not

include such measures.

George J. Demakis

See alsoMalingering; Minnesota Multiphasic Personality

Inventory–2 (MMPI–2); Minnesota Multiphasic

Personality Inventory–2 (MMPI–2) Validity Scales

Further Readings

Binder, L. M., Rohling, M. R., & Larrabee, G. J. (1997). A

review of mild head trauma. Part 1: Meta-analytic review

of neuropsychological studies. Journal of Clinical and

Experimental Neuropsychology, 19,421–431.

Iverson, G. L. (2005). Outcome from mild traumatic brain

injury. Current Opinion in Psychiatry, 18,301–317.

Putnam, S. H., Millis, S. R., & Adams, K. M. (1996). Mild

traumatic brain injury: Beyond cognitive assessment. In

I. Grant & K. M. Adams (Eds.),Neuropsychological

assessment of neuropsychiatric disorders(pp. 529–551).

New York: Oxford University Press.

Ruff, R. M., & Richardson, A. M. (1999). Mild traumatic brain

injury. In J. J. Sweet (Ed.),Forensic neuropsychology:

Fundamentals and practice (pp. 313–338).Lisse, The

Netherlands: Swets & Zeitlinger.

MILLER FORENSICASSESSMENT

OFSYMPTOMSTEST(M–FAST)

The Miller Forensic Assessment of Symptoms Test

(M–FAST) is a screening measure for the detection of

feigned, or malingered, mental illness. The M–FAST

may be used in psychological evaluations of an adult

who might be attempting to fake a psychiatric disor-

der. Because of the reported prevalence of malinger-

ing and difficulty of accurate detection through

clinical judgment, many researchers and clinicians

have suggested routine formal assessment of malin-

gering in most evaluations. Although there are other,

more lengthy, assessment measures for malingering

detection, the M–FAST was developed to provide the

evaluator with a brief screening tool.

Psychologists are often asked to provide an eval-

uation of criminal defendants to determine if they are

competent to stand trial (CST) or to evaluate defen-

dants pleading not guilty by reason of insanity

(NGRI). Although most individuals who are found

not CST or NGRI do have a severe mental illness, a

percentage will attempt to fake mental illness for

trial postponement or to be sent to a hospital rather

than prison. There are other evaluations, such as dis-

ability assessments or psychological evaluations

with correctional inmates, where malingering is rou-

tinely assessed. In these types of evaluations, malin-

gering is often formally assessed with an instrument

developed specifically to detect the faking of mental

illness. The M–FAST is often used in these evalua-

tions to screen the individual being evaluated for

malingering. If malingering is suggested by the

M–FAST results, further evaluation of feigning is

carried out.

Description and Structure

The M–FAST is a 25-item structured interview that can

be administered in approximately 5 to 10 minutes. The

measure may be more viable than other instruments in

several situations because of its interview format (e.g.,

reading level of the test taker is irrelevant) and its brief

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