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MMPI-2 Symptom Validity Scale (FBS)

Statement by Yossef Ben-Porath, Ph.D. and Auke Tellegen, Ph.D. regarding the Symptom Validity Scale (FBS)


Statement by: Yossef S. Ben-Porath, Ph.D., and Auke Tellegen, Ph.D.

The MMPI-2 Symptom Validity Scale (FBS), introduced by Lees-Haley, English, and Glenn (1991), has been the subject of extensive empirical scrutiny. This substantial body of research and indications that the scale, although not included in the standard scoring materials for the MMPI-2, was being used widely in neuropsychological assessments, led the University of Minnesota Press, publisher of the MMPI-2, to seek input from a panel of experts on the advisability of adding the FBS to the standard MMPI-2 test materials. Eight experts were asked to review two recent publications that summarize the FBS research base conceptually (Greiffenstein, Fox, & Lees-Haley, in press), and empirically (Nelson, Sweet, & Demakis, 2006), and to indicate to the Press whether, in their opinion, the FBS should be added to the MMPI-2 materials. They were invited to take into account any other information they cared to in preparing their recommendation.

A strong majority of the experts recommended that the FBS be added to the standard scoring materials for the MMPI-2. These experts concluded that empirical research has established the utility of the scale in identifying potentially exaggerated claims of disability, primarily in the context of forensic neuropsychological evaluations. They agreed that, as is the case with all other MMPI-2 validity scales, scores on the FBS should be considered in the context of scores on the other validity scales, the circumstances of the assessment, and any conditions such as significant physical injury or disease that could artificially elevate scores on the FBS.

With these caveats in mind, the experts supporting addition of the FBS to the standard set of MMPI-2 validity scales recommended that raw scores above 22 should raise concerns about the validity of self-reported symptoms and that raw scores above 28 should raise very significant concerns about the validity of self-reported symptoms, particularly with individuals for whom relevant physical injury or medical problems have been ruled out. More specific recommendations and possible moderators of the interpretation of scores on the FBS, which indicate the need for higher cut-offs, are provided by Greiffenstein, Fox, and Lees-Haley (in press).

Experts who opposed adding the FBS to the standard MMPI-2 validity scales cited concerns about “false positives,” that is, the identification as possibly invalid of protocols from individuals who were reporting genuine health problems. The existing literature indicates that raw scores above 28 on the FBS are associated with a very low false positive rate, which is consistent with the false positive rate of other standard MMPI-2 validity scales.

Following is a list of publications on the FBS that can provide users additional context for interpreting scores on the FBS:


FBS References

Arbisi, P. A., Ben-Porath, Y. S., & McNulty, J. (2006). The ability of the MMPI-2 to detect feigned PTSD within the context of compensation seeking. Psychological Services, 3,  249-261.

Arbisi, P. A., & Butcher, J. N. (2004a). Failure of the FBS to predict malingering of somatic symptoms: Response to critiques by Greve and Bianchini and Lees-Haley and Fox. Archives of Clinical Neuropsychology, 19, 341-345.

Arbisi, P. A., & Butcher, J. N. (2004b). Psychometric perspectives on detection of malingering of pain: Use of the Minnesota Multiphasic Personality Inventory-2. Clinical Journal of Pain, 20, 383-391.

Bagby, R. M., Nicholson, R. A., Buis, T., & Bacchiochi, J. R. (2000). Can the MMPI-2 validity scales detect depression feigned by experts? Assessment, 7, 55-62.

Ben-Porath, Y.S., Tellegen, A., & Graham, J.R. (2008). The MMPI-2 Symptom Validity Scale (FBS). Minneapolis, MN: University of Minnesota press.

Berry, D .T .R., & Schipper, L. J. (2007). Detection of feigned psychiatric symptoms during forensic neuropsychological examinations. In G. J. Larrabee (Ed.). Assessment of malingered neuropsychological deficits. (pp. 226-263).  New York: Oxford University Press.

Bianchini, K. J., Houston, R. J., Greve, K. W., Irvin, T. R., Black, F. W., Swift, D. A., & Tamimie, R. J. (2003). Malingered neurocognitive dysfunction in neurotoxic exposure: An application of the Slick Criteria. Journal of Occupational and Environmental Medicine, 45, 1087-1099.

Binder, L. M., Storzbach, D., & Salinsky, M. C. (2006). MMPI-2 profiles of persons with multiple chemical sensitivity. The Clinical Neuropsychologist, 20, 848-857.

Boone, K. B. (in press).  Fixed belief in cognitive dysfunction despite normal neuropsychological scores:  Neurocognitive hypochondriasis?  The Clinical Neuropsychologist.

Boone, K. B., & Lu, P. H. (1999). Impact of somatoform symptomatology on credibility of cognitive performance. The Clinical Neuropsychologist, 13, 414-419.

Bury, A. S., & Bagby, R. M. (2002). The detection of feigned uncoached and coached posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims. Psychological Assessment, 14, 472-484.

Butcher, J. N., Arbisi, P. A., Atlis, M. M., & McNulty, J. L. (2003). The construct validity of the Lees-Haley Fake Bad Scale: Does this scale measure somatic malingering and feigned emotional distress? Archives of Clinical Neuropsychology, 18, 473-485.

Cramer, K. M. (1995). The effects of description clarity and disorder type on MMPI-2 fake-bad validity indices. Journal of Clinical Psychology, 51, 831-840.

Crawford, E. F., Greene, R. L., & Dupart, T. (2006). MMPI-2 assessment of malingered emotional distress related to a workplace injury: A mixed group validation. Journal of Personality Assessment, 86, 217-221.

Dean, A. C., Boone, K. B., Kim, M. S., Curiel, A. R., Martin, D. J., Victor, T. L., Zeller, M. A., & Lang, Y. K. (2008).  Examination of the impact of ethnicity on the Minnesota Multiphasic Personality Inventory – 2 (MMPI-2) Fake Bad Scale.  The Clinical Neuropsychologist, 22, 1054-1060.

Dearth, C. S., Berry, D. T. R., Vickery, C. D., Vagnini, V. L., Baser, R. E., Orey, S. A., & Cragar, D. E. (2005). Detection of feigned head injury symptoms on the MMPI-2 in head injured patients and community controls. Archives of Clinical Neuropsychology, 20, 95-110.

Demakis, G. J., Gervais, R. O. & Rohling, M. L. (In Press). The effect of failure on cognitive and psychological symptom validity tests in litigants with symptoms of Post Traumatic Stress Disorder.  The Clinical Neuropsychologist.

Downing, S. K., Denney, R. L., Spray, B. J., Houston, C. M., & Halfaker, D. H. (In Press). Examining the relationship between the Restructured Scales and the Fake Bad Scale of the MMPI-2.  The Clinical Neuropsychologist.

Elhai, J. D., Gold, P. B., Frueh, B. C., & Gold, S. N. (2000). Cross-validation of the MMPI-2 in detecting malingered posttraumatic stress disorder. Journal of Personality Assessment, 75, 449-463.

Elhai, J. D., Gold, S. N., Sellers, A. H., & Dorfman, W. I. (2001). The detection of malingered posttraumatic stress disorder with MMPI-2 Fake Bad Indices. Assessment, 8, 221-236.

Eyler, V. A., Diehl, K. W., & Kirkhart, M. (2000). Validation of the Lees-Haley Fake Bad Scale for the MMPI-2 to detect somatic malingering among personal injury litigants. Archives of Clinical Neuropsychology, 15, 834-835.

Fox D. D., Gerson, A., & Lees-Haley P. R. (1995). Interrelationship of MMPI-2 validity scales in personal injury claims. Journal of Clinical Psychology, 51, 42-47.

Frueh, B. C., Gold, P., & de Arellano, M. A. (1997). Symptom overreporting in combat veterans evaluated for PTSD: Differentiation on the basis of compensation status.  Journal of Personality Assessment, 68, 369-384.

Greiffenstein, M. F., & Baker, W. J. (2008).  Validity testing in dually diagnosed post-traumatic stress disorder and mild closed head injury.  The Clinical Neuropsychologist, 22, 565-582.

Greiffenstein, M. F., Baker, W. J., Axelrod, B., Peck, T. A., & Gervais, R. (2004). The Fake Bad Scale and MMPI-2 F-family in detection of implausible psychological trauma claims. The Clinical Neuropsychologist, 18, 573-590.

Greiffenstein, M. F., Baker, W. J., & Gola, T. (1994). Validation of malingered amnesia measures with a large clinical sample. Psychological Assessment, 6, 218-224.

Greiffenstein, M. F., Baker, W. J., & Gola, T. (1996). What kind of faking does the Fake Bad Scale measure? American Psychology-Law Society Newsletter [APA Convention Issue].

Greiffenstein, M. F., Baker, W. J., Gola, T., Donders, J., & Miller, L. J. (2002). The FBS in atypical and severe closed head injury litigants. Journal of Clinical Psychology, 58, 1591-1600.

Greiffenstein, M. F., Fox, D., & Lees-Haley, P. R. (2007). The MMPI-2 Fake Bad Scale in detection of noncredible brain injury claims. In K. Boone (Ed.), Assessment of feigned cognitive impairment: A neuropsychological perspective (pp, 210-235). New York: Guilford Publications.

Greiffenstein, M. F., Gola, T., & Baker, W. J. (1995). The MMPI-2 validity scales versus domain specific measures in the detection of factitious brain injury. The Clinical Neuropsychologist, 9, 230-240.

Greve, K. W., & Bianchini, K. J. (2004). Response to Butcher et al., The construct validity of the Lees-Haley Fake Bad Scale. Archives of Clinical Neuropsychology, 19, 337-339.

Greve, K. W., Bianchini, K. J., Love, J. M., Brennan, A., & Heinley, M. T. (2006). Sensitivity and specificity of MMPI-2 validity scales to malingered neurocognitive dysfunction in traumatic brain injury. The Clinical Neuropsychologist, 20, 491-512.

Grillo, J., Brown, R. S., Hilsabeck, R., Price, J. R., & Lees-Haley, P. R. (1994). Raising doubts about claims of malingering: Implications of relationships between MCMI-II and MMPI-2 performances. Journal of Clinical Psychology, 50, 651-655.

Guez, M., Brannstrom, R., Nyberg, L., Toolanen, G., & Hildingsson, C. (2005). Neuropsychological functioning and MMPI-2 profiles in chronic neck pain: A comparison of whiplash and non-traumatic groups. Journal of Clinical and Experimental Neuropsychology, 27, 151-163.

Henry, G. K., Heilbronner, R. L., Mittenberg, W., & Enders, C. (2006). The Henry-Heilbronner index: A 15-item empirically derived MMPI-2 subscale for identifying probable malingering in personal injury litigants and disability claimants. The Clinical Neuropsychologist, 20, 786-797.

Henry, G. K., Heilbronner, R. L., Mittenberg, W., Enders, C., & Stanczal, S. R. (In Press). Comparison of the Lees-Haley Fake Bad Scale, Henry-Heilbronner Index, and Restructured Clinical Scale 1 in identifying noncredible symptom reporting.  The Clinical Neuropsychologist.

Iverson, G. L., & Binder, L. M. (2000). Detecting exaggeration and malingering in neuropsychological assessment. Journal of Head Trauma Rehabilitation, 15, 829-858.

Iverson, G. L., Henrichs, T. F., Barton, E. A., & Allen, S. (2002). Specificity of the MMPI-2 Fake Bad Scale as a marker for personal injury malingering. Psychological Reports, 90, 131-136.

Iverson, G. L., & Lange, R. T. (2006). Detecting exaggeration and malingering in psychological injury claims. In W. J. Koch, K. S. Douglas, T. L. Nichols, & M. O’Neill (Eds.), Psychological injuries: Forensic assessment, treatment, and law.  New York: Oxford University Press.

Lamberty, G. J. (2008).  Understanding somatization in the practice of clinical neuropsychology.  New York: Oxford University Press.

Larrabee, G. J. (1997). Neuropsychological outcome, post concussion symptoms, and forensic considerations in mild closed head trauma. Seminars in Clinical Neuropsychiatry, 2, 196-206.

Larrabee, G. J. (1998). Somatic malingering on the MMPI and MMPI-2 in personal injury litigants. The Clinical Neuropsychologist, 12, 179-188.

Larrabee, G. J. (2003a). Detection of symptom exaggeration with the MMPI-2 in litigants with malingered neurocognitive dysfunction. The Clinical Neuropsychologist, 17, 54-68.

Larrabee, G. J. (2003b). Exaggerated MMPI-2 symptom report in personal injury litigants with malingered neurocognitive deficit. Archives of Clinical Neuropsychology, 18, 673-686.

Larrabee, G. J. (2003c). Exaggerated pain report in litigants with malingered neurocognitive dysfunction. The Clinical Neuropsychologist, 17, 395-401.

Larrabee, G. J. (2003d). Detection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17, 410-425.

Larrabee, G. J. (2007). Evaluation of exaggerated health and injury symptomatology. In G .J. Larrabee (Ed.), Assessment of malingered neuropsychological deficits. (pp. 264-286).  New York: Oxford University Press.

Lees-Haley P. R. (1992). Efficacy of MMPI-2 validity scales and MCMI-II modifier scales for detecting spurious PTSD claims: F, F-K, Fake Bad Scale, ego strength, subtle-obvious subscales, DIS, and DEB. Journal of Clinical Psychology, 48, 681-689.

Lees-Haley P. R. (1997). MMPI-2 base rates for 492 personal injury plaintiffs: Implications and challenges for forensic assessment. Journal of Clinical Psychology, 53, 745-755.

Lees-Haley P. R., English L.T., & Glenn W. J. (1991). A Fake Bad Scale on the MMPI-2 for personal injury claimants. Psychological Reports, 68, 203-210.

Lees-Haley, P. R., & Fox, D. D. (2004). Commentary on Butcher, Arbisi, Atlis, and McNulty (2003) on the Fake Bad Scale. Archives of Clinical Neuropsychology, 19, 333-336.

Lees-Haley, P. R., Iverson, G. L., Lange, R. T., Fox, D. D., & Allen, L. M. III. (2002). Malingering in forensic neuropsychology: Daubert and the MMPI-2. Journal of Forensic Neuropsychology, 3, 167-203.

Martens, M., Donders, J., & Millis, S. R. (2001). Evaluation of invalid response sets after traumatic head injury. Journal of Forensic Neuropsychology, 2, 1-18.

Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169.

Miller, L. J., & Donders, J. (2001). Subjective symptomatology after traumatic head injury. Brain Injury, 15, 297-304.

Nelson, N. W., Parsons, T. D., Grote, C. L., Smith, C. A., & Sisung, J. R. (2006). The MMPI-2 Fake Bad Scale: Concordance and specificity of true and estimated scores. Journal of Clinical and Experimental Neuropsychology, 28(1), 1-12.

Nelson, N. W., Sweet, J. J., Berry, D. T. R., Bryant, F. B., & Granacher, R. P. (2007). Response validity in forensic neuropsychology: Exploratory factor analytic evidence of distinct cognitive and psychological constructs. Journal of the International Neuropsychological Society, 13, 440-449.

Nelson, N. W., Sweet, J. J., & Demakis, G. J. (2006). Meta-Analysis of the MMPI-2 Fake Bad Scale: Utility in forensic practice. The Clinical Neuropsychologist, 20(1), 39-58.

Nelson, N. W., Sweet, J. J., & Heilbronner, R. L. (2007). Examination of the new MMPI-2 Response Bias Scale (Gervais): Relationship with MMPI-2 validity scales. Journal of Clinical and Experimental Neuropsychology, 29, 67-72.

Posthuma, A. B., & Harper, J. F. (1998). Comparison of MMPI-2 responses of child custody and personal injury litigants. Professional Psychology: Research and Practice, 29, 437-443.

Rogers, R., Sewell, K. W., Martin, M. A., & Vitacco, M. J. (2003). Detection of feigned mental disorders: A meta-analysis of the MMPI-2 and malingering. Assessment, 10, 160-177.

Rogers, R., Sewell, K. W., & Ustad, K. L. (1995). Feigning among chronic outpatients on the MMPI-2: A systematic examination of fake-bad indicators. Assessment, 2, 81-89.

Ross, S. R., Millis, S. R., Krukowski, R. A., Putnam, S. H., & Adams, K. M. (2004). Detecting probable malingering on the MMPI-2: An examination of the Fake Bad Scale in mild head injury. Journal of Clinical and Experimental Neuropsychology, 26, 115-124.

Sharland, M. J., & Gfeller, J. D. (2007).  A survey of neuropsychologists’ beliefs and practices with respect to the assessment of effort.  Archives of Clinical Neuropsychology, 22, 213-223.

Slick, D. J., Hopp, G., Strauss, E., & Spellacy, F. J. (1996). Victoria Symptom Validity Test: Efficiency for detecting feigned memory impairment and relationship to neuropsychological tests and MMPI-2 validity scales. Journal of Clinical and Experimental Neuropsychology, 18, 911-922.

Slick, D. J., Sherman, E. M., & Iverson, G. L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13, 545-561.

Staudenmayer, H., & Phillips, S. (2007). MMPI-2 validity, clinical, and content scales and the Fake Bad Scale for personal injury litigants claiming idiopathic environmental intolerance. Journal of Psychosomatic Research, 62, 61-72.

Stone, D. C., Boone, K. B., Back-Madruga, C., & Lesser, I. M. (2006).  Has the rolling uterus finally gathered moss?  Somatization and malingering of cognitive deficit in six cases of “toxic mold” exposure.  The Clinical Neuropsychologist, 20, 766-785.

Strauss, E., Sherman, M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary.  New York: Oxford University Press.

Sweet, J. J., Malina, A., & Ecklund-Johnson, E. (2006). Application of the new MMPI-2 malingered depression scale to individuals undergoing neuropsychological evaluation: Relative lack of relationship to secondary gain and failure on validity indices. The Clinical Neuropsychologist, 20, 541-551.

Tsushima, W. T., & Tsushima, V. G. (2001). Comparison of the Fake Bad Scale and other MMPI-2 validity scales with personal injury litigants. Assessment, 8(2), 205-212.

Wygant, D. B., Sellbom, M., Ben-Porath, Y. S., Stafford, K. P., Freeman, D. B., & Heilbronner, R. L. (2007). The relation between symptom validity testing and MMPI-2 scores as a function of forensic evaluation context. Archives of Clinical Neuropsychology, 22, 488-489.