Citation

Pierre JM. J. Am. Acad. Psychiatry Law 2019; 47(4): 448-456.

Copyright

(Copyright © 2019, American Academy of Psychiatry and the Law, Publisher American Academy of Psychiatry and the Law)

DOI

10.29158/JAAPL.003867-19

PMID

31519734

Abstract

The gold standard for the detection of malingered psychosis involves expert clinical assessment augmented by standardized psychometric testing. The evaluation of malingered auditory verbal hallucinations is complicated, however, by increasing evidence that voice-hearing is a broadly heterogeneous experience that does not always reflect psychopathology, with atypical features nearly as common as typical characteristics. The detection of malingered auditory verbal hallucinations in clinical settings may be particularly vulnerable to false positives and false negatives due to low suspicion on the part of clinicians, low utilization and poor specificity of psychometric testing, and "iatrogenic malingering" that is less likely to include cartoonish claims and more likely to involve voice-hearing as a sole presenting symptom (i.e., monosymptomatic auditory verbal hallucinations). In both clinical and forensic settings, the detection of malingered auditory verbal hallucinations requires detailed exploration of phenomenologic features along with mediating factors that influence the risk of associated violence or suicide.

Language: en

Keywords

Humans; Clinical Medicine; Surveys and Questionnaires; Psychometrics; Sensitivity and Specificity; Forensic Psychiatry; Psychotic Disorders; Malingering; Hallucinations