Biased Symptom Reporting and Antisocial Behaviour in Forensic Samples: A Weak Link

Psychiatr Psychol Law. 2016 Dec 12;24(4):530-548. doi: 10.1080/13218719.2016.1256017. eCollection 2017.

Abstract

In two studies (one with 57 forensic inpatients and one with 45 prisoners) the connection between biased symptom reporting and antisocial behaviour is explored. The findings are as follows: 1) the association between symptom over-reporting and antisocial features is a) present in self-report measures, but not in behavioural measures, and b) stronger in the punitive setting than in the therapeutic setting; and 2) participants who over-report symptoms a) are prone to attribute blame for their offence to mental disorders, and b) tend to report heightened levels of antisocial features, but the reverse is not true. The data provide little support for the inclusion of antisocial behaviour (i.e. antisocial personality disorder) as a signal of symptom over-reporting (i.e. malingering) in the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5). The empirical literature on symptom over-reporting and antisocial/psychopathic behaviour is discussed and it is argued that the utility of antisocial behaviour as an indicator of biased symptom reporting is unacceptably low.

Keywords: antisocial personality disorder; malingering; psychopathy; response bias; symptom validity.