Rissmiller D J, Wayslow A, Madison H, Hogate P, Rissmiller F R, Steer R A
Department of Psychiatry, University of Medicine and Dentistry of New Jersey, USA.
Crisis. 1998;19(2):62-6. doi: 10.1027/0227-5910.19.2.62.
The purpose of the present study was to ascertain the prevalence of malingering by inpatients admitted to an urban hospital for suicidal ideation or attempt. Fifty-eight consecutively hospitalized suicidal patients were asked to participate, and of these 40 (70%) agreed to do so. Each patient was given an anonymous questionnaire asking whether they had lied or purposely exaggerated suicidal ideation to gain admission. A psychiatrist and masters-level psychologist, both blind to the patient responses, then rated each patient for suspicion of malingering. Each patient was also administered the MMPI-2 F, L, and K validity scales. Four patients (10%) indicated they had malingered and indicated that external incentives had motivated them to feign either suicidal ideation or a suicide attempt. None of the MMPI-2 validity scales correlated with self-reported malingering. The clinicians detected malingerers with 100% sensitivity, but the specificity rates were only 58% for the psychiatrist and 32% for the psychologist. The results indicate that some inpatients malinger about the extent of their suicidal intentions. The data demonstrate the difficulty inherent in detecting malingering by clinical interviewing and psychological testing.
本研究的目的是确定因有自杀意念或自杀未遂而入住城市医院的住院患者中诈病的发生率。连续58名住院自杀患者被邀请参与研究，其中40名（70%）同意参与。给每位患者发放一份匿名问卷，询问他们是否曾为了入院而说谎或故意夸大自杀意念。一名精神科医生和一名硕士水平的心理学家在对患者的回答不知情的情况下，对每位患者进行诈病嫌疑评级。每位患者还接受了明尼苏达多相人格调查表第二版（MMPI - 2）的F、L和K效度量表测试。4名患者（10%）表示他们有诈病行为，并指出外部诱因促使他们伪装出自杀意念或自杀未遂。MMPI - 2效度量表中没有一个与自我报告的诈病行为相关。临床医生检测诈病者的敏感度为100%，但精神科医生的特异度仅为58%，心理学家的特异度为32%。结果表明，一些住院患者在自杀意图的程度上存在诈病行为。数据表明通过临床访谈和心理测试来检测诈病存在固有的困难。
