Agreement among Clinicians in Evaluations of Vocational Disability
The assessment of malingering is essential in evaluations of vocational disability as the prevalence of symptom fabrication and exaggeration in this context has been well documented. However, past research suggests that there is a great deal of variability in how malingering assessments are conducted. Evaluators must decide which and how many tests to administer, how to reconcile inconsistent findings across different tests, and finally, how to integrate psychological test data with clinical information in order to render final opinions. With multiple opportunities for evaluators to diverge in how they collect and interpret data, it is likely that evaluators may vary in their opinions about the presence of feigned symptoms and vocational disability. The aim of the current study was to examine variables that might impact level of agreement among evaluators regarding feigned symptoms and level of impairment in evaluations of vocational disability. To accomplish this aim, an internet-based survey methodology was used to distribute vignettes describing hypothetical disability claimants to practicing psychologists (primarily forensic and/or neuropsychologists). Key variables in the vignettes, such as information related to the claimant’s mental health history and findings from psychological testing, were systematically manipulated. Participants read the vignettes and were then asked to give their clinical opinions about the hypothetical claimants. Data from 194 participants were included in the final analyses. It was found that the administration of multiple measures of feigning, and greater convergence in the results of these measures increased the level of agreement among participants. Alternatively, a greater number of failures in the test data was associated with less agreement among participants. Although these results illuminate possible explanations for evaluator disagreement, future research is needed in order to better understand and improve the process through which evaluators utilize clinical and test data to inform decision-making in disability evaluations, and to increase the reliability of their decisions.
Disability studies|Psychology|Clinical psychology
Howe, Jacqueline, "Agreement among Clinicians in Evaluations of Vocational Disability" (2018). ETD Collection for Fordham University. AAI10810656.