Kucharski L Thomas, Duncan Scott, Egan Shannon S, Falkenbach Diana M
Department of Psychology, John Jay College of Criminal Justice, The City University of New York, 445 West 59th Street, New York, NY 10019, USA.
Behav Sci Law. 2006;24(5):633-44. doi: 10.1002/bsl.661.
Because the use of deception is an important clinical characteristic of psychopathy, there is intuitive appeal to the idea that psychopathy and malingering are associated. There is, however, very little research showing that psychopaths are more likely to malinger. We classified a sample of criminal defendants as high, moderate, or low in psychopathy, based on PCL-R scores, and compared their scores on indices typically used to detect malingering on the MMPI-2, the PAI and the SIRS. The high psychopathy group scored significantly higher on the MMPI-2 F and F-K; the PAI NIM, and the SIRS, but not the MMPI-2 Fb, F(p), or the PAI RDF or Mal, lending some support for the DSM-IV recommendation that malingering should be considered whenever there is a diagnosis of antisocial personality disorder. Logistic regression analysis (LGA) revealed that Factor I but not Factor II of the PCL-R significantly discriminated malingerers from nonmalingerers with 75% correct classification. However, receiver operating characteristic (ROC) analysis revealed that psychopathy ratings had poor sensitivity and specificity in the detection of malingering. Calculation of the percentages of those exceeding accepted cut-offs on each of the malingering measures revealed that a high percentage of severe psychopaths did not attempt to feign psychiatric disorder. The results suggest that psychopathy is not a clinically useful indictor of malingering. The results are discussed in terms of confirmatory bias and the impact such a bias could have on the evaluation of criminal defendants.
由于欺骗行为的运用是精神病态的一个重要临床特征,因此认为精神病态与诈病有关这一观点具有直观的吸引力。然而,很少有研究表明精神病态者更有可能诈病。我们根据PCL-R评分将一组刑事被告样本分为高、中、低精神病态水平,并比较了他们在MMPI-2、PAI和SIRS等通常用于检测诈病的指标上的得分。高精神病态组在MMPI-2的F和F-K、PAI的NIM以及SIRS上的得分显著更高,但在MMPI-2的Fb、F(p),或PAI的RDF或Mal上得分并非如此,这为《精神疾病诊断与统计手册》第四版(DSM-IV)中关于只要诊断为反社会人格障碍就应考虑诈病的建议提供了一些支持。逻辑回归分析(LGA)显示,PCL-R的因素I而非因素II能显著区分诈病者和非诈病者,正确分类率为75%。然而,受试者工作特征(ROC)分析显示,精神病态评分在检测诈病方面的敏感性和特异性较差。计算在每项诈病测量指标上超过公认临界值的人数百分比发现,很大比例的重度精神病态者并未试图伪装精神障碍。结果表明,精神病态并非诈病的一个临床上有用的指标。我们从证实性偏差以及这种偏差可能对刑事被告评估产生的影响方面对结果进行了讨论。