OBJECTIVE:Symptom overreporting is often considered to be moderated by external incentives, such as financial or legal advantages, although other factors may also play a role. Preliminary studies have suggested a connection between symptom overreporting and alexithymia, that is, trait-like difficulties in recognizing and describing internal sensations. This study aimed to further clarify the relationships among external gain expectations, alexithymia, and symptom overreporting. Specifically, we examined whether alexithymia is related to overreporting in patients without self-reported external gain expectations. METHOD:Using a cross-sectional design, patients referred for psychological assessments in a hospital setting completed a questionnaire about external gain expectations (e.g., regarding work, housing, legal issues). We differentiated between those with self-reports of external gain expectations (n = 73) and those without (n = 84). Both subsamples were administered the Toronto Alexithymia Scale-20 (TAS-20), the Structured Inventory of Malingered Symptomatology (SIMS), and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). RESULTS:Across the full sample, alexithymia showed a positive and statistically significant association with symptom overreporting on the SIMS and the Infrequent somatic responses scale (Fs) of the MMPI-2-RF: r = 0.44 and r = 0.31, respectively. These positive associations were also evident in the subgroup without self-reported external gain expectations (i.e., r = 0.35, 95% CI [0.14, 0.52] and r = 0.35, 95% CI [0.15, 0.53], respectively). Regression analysis indicated that self-reported external gain expectations did not account for the relationship between symptom overreporting and alexithymia. CONCLUSION:These findings suggest that alexithymia is associated with symptom overreporting independently of self-reported external gain expectations. More broadly, the results raise the possibility that alexithymic traits may compromise the accuracy of symptom reporting itself. If so, this has implications not only for the interpretation of symptom validity tests, but also for the broader use of self-report measures in clinical assessment.

Leonhard and Leonhard (2025) argue that Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs) constitute a form of junk science. This qualification stands in sharp contrast to the breadth and depth of the scientific work on validity tests. Leonhard and Leonhard treat these tests as if they were equivalent to polygraph evidence, a move that betrays a fundamental misunderstanding of the conceptual and empirical foundations of these instruments. More than a year ago, we invited Leonhard and Leonhard to provide case law examples —if only a few— demonstrating that SVTs and/or PVTs contributed to risky legal decisions. So far, they have not been willing or able to cite a single instance. We therefore reiterate our invitation: show us the cases.

Validity tests are widely used to detect distorted symptom presentation but offer little guidance on why such distortions occur. In an explorative qualitative study, we examined how forensic inpatients (n = 36) described antecedents of their response patterns during a collaborative feedback interview. Patients were classified as inattentive responders (n = 8), overreporters (n = 7), underreporters (n = 14), or comparison patients (n = 7) based on stand-alone validity measures administered during routine assessment. Transcripts were primarily coded on 11 literature-derived antecedent themes. Inattentive responders emphasized comprehension/scale-use problems, attention lapses, and disengagement. Overreporters described emotion-processing difficulties, needs for social attention, external incentives, and comprehension issues. Underreporters referred to self-presentational concerns, stigma, reactance-related disengagement, forensic stakes, autonomy/control motives, and mistrust/fear of disclosure. Accounts often highlighted modifiable treatment targets (e.g., interoception, stigma, mistrust, reactance). Overall, collaborative discussion of poor validity may inform case formulation and treatment planning in high-stakes forensic settings.

Steven J. Lynn (1946-2024) was a prolific researcher who explored a wide array of topics in clinical psychology. He and his co-authors emphasized the importance of researching the side effects of psychological interventions. In the current studies (Study 1, N = 58; Study 2, N = 64), we examined clinicians' perspectives on side effects. A slight majority of clinicians in both studies reported familiarity with the topic (Study 1: n = 30, 51%; Study 2: n = 39, 61%). Those who claimed familiarity were more likely to discuss side effects with their patients compared with those who acknowledged a lack of knowledge. In Study 2, we found significant variation among clinicians regarding what constitutes avoidable, unavoidable or nonexistent side effects, and their views did not align with those of patients. This divergence may explain why a considerable number of clinicians refrain from discussing side effects with patients, despite patients' right to be fully informed about the potential benefits and risks of their treatment. Our findings underscore the need for clear guidelines that define the full spectrum of side effects and offer strategies for effective communication with patients. The first step in developing such guidelines is to raise awareness among professionals about the topic, which can be effectively achieved by engaging in the work of Steven J. Lynn and his co-authors, whose insights remain highly relevant.

People are most likely to confess to a crime that they did not commit if they are highly suggestible. People are somewhat likely to confess to a crime that they did not commit if they are highly compliant. Suggestive questions should be avoided in police interviews with suspects as they can lead to false confessions and miscarriages of justice.

The 16-item Maladaptive Daydreaming Scale is a self-report measure translated into 37 languages, designed to capture the experience of compulsive and excessive daydreaming. In an online study comprised of monolingual and bilingual participants (N = 201), we examined the psychometric properties of the German and Dutch versions of the scale. We also explored associations of maladaptive daydreaming with fantasy proneness (i.e., characteristics associated with intensive immersion in fantasy) and counterfactual thinking (i.e., the ability to conceptualize alternative scenarios to reality). We found no differences between both language versions, suggesting equivalence. Also, reliabilities were adequate, and the four-factor structure was replicated. We confirmed previous findings of a positive correlation between fantasy proneness and maladaptive daydreaming (rho = .58, p < .01) but found no evidence that maladaptive daydreaming is associated with an increased capacity to generate counterfactuals, although our measure of this capacity was far from optimal. Other study limitations and further research approaches are discussed.

Unwanted events in psychotherapy can hinder treatment, yet clinicians overlook them and tend to attribute treatment stagnation mainly to patient-related factors. The unwanted events-adverse treatment reaction (UE-ATR) checklist was developed to encourage a more balanced reflection on treatment difficulties, but its effectiveness remains unclear. This study investigated whether the UE-ATR checklist enables clinicians to allocate treatment difficulties in a more nuanced way across various contributing factors. Clinicians and psychology students (N = 104) were randomly assigned to either use the UE-ATR (n = 59) or not (n = 45) while reviewing a case vignette of a patient who experienced unwanted events during therapy and treatment stagnation. They allocated responsibility for suboptimal treatment outcome across five factors: the patient, the therapist, the treatment method, the patient's pathology or other circumstances. Attribution was analysed using the Herfindahl-Hirschman index (HHI), where higher scores indicate a monocausal and lower scores reflect a multicausal view. No significant differences were found between the conditions. Although most users found the checklist clinically useful, this positive perception did not lead to a more balanced perspective on the causes of unwanted events. Although the UE-ATR checklist can support clinical reflection, additional training is necessary to maximize its effectiveness.

Validity tests are used in both forensic and clinical settings, but their application in clinical practice is often hindered by misconceptions. These include the assumptions that validity tests imply a medico-legal dimension, primarily detect feigning or malingering, and provide minimal actionable information to clinicians. The authors critically discuss these misconceptions and argue that validity tests may offer significant value in clinical practice by assessing whether patients can describe their symptoms, complaints and impairments with reasonable accuracy, which has important implications for diagnosis and treatment planning. Importantly, in clinical practice, when interpreting validity tests, neutral terminology such as ‘over-reporting’ and ‘underperformance’ is often preferable to – and better to substantiate than – terms like ‘feigning’ and ‘malingering’, which can evoke moral judgements, creating an unnecessary barrier to using these valuable clinical tools.

This review examines the effects of patients overreporting symptoms, which can be identified through validity tests. Such overreporting may reflect concerns about being denied care, difficulty describing experiences, or pursuit of external incentives. Regardless of the reason, it has meaningful clinical implications. Research shows links between overreporting and lower treatment adherence, higher dropout rates, and challenges in building strong therapeutic relationships. When clinicians cannot fully understand the nature or severity of symptoms, misdiagnosis and reduced trust may result. To reduce these risks, it is important to view validity test results as informative and use them to support thoughtful, collaborative conversations with patients and their support networks, ultimately enhancing treatment planning and outcomes.

Social security disability assessors are required to objectively quantify disability with regards to potential ability to work. Difficulties arise when assessments need to be performed in the absence of objective medical data relying solely on self-report regarding subjective health complaints. In such cases, validity tests provide a useful tool during an assessment. This case report illustrates this through the outcomes of 3 disability assessments.

This archival study sought to determine whether psychological reports adequately communicate the results of Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs). We collected reports from a pool of 469 clinical psychological and neuropsychological assessments conducted across five Dutch hospitals. To be included, the administered SVT (i.e., Structured Inventory of Malingered Symptomatology; SIMS) and/or PVT (Amsterdam Short-Term Memory test, ASTM) needed to be either passed or failed. Additionally, we selected reports from psychologists who, prior to conducting the assessments, anticipated either problematic or unproblematic validity. A total of 146 reports (57 clinical psychological and 89 neuropsychological reports), authored by 36 psychologists from five different hospitals, were analyzed. Invalid range scores on SIMS and/or ASTM occurred in 48% of the sample. Two researchers independently reviewed and coded reports, resolving mismatches through consensus and crosschecking with original test data. The majority of clinical psychological reports (89.5%) did not reference the SIMS or accurately describe the SIMS results, despite its use. In contrast, most neuropsychological reports mentioned the SIMS and ASTM, and adequately described their results (77.5%). Approximately half of the reports with invalid range scores on these instruments included interpretative statements, often suggesting overreporting and/or underperformance. In about one-third of cases, a fail on the validity test was attributed to factors such as anxiety, fatigue, depression, or pain. Other cognitive tests and psychological questionnaires were frequently interpreted without considering these invalid scores. Treatment recommendations seldom took SVT/PVT fails into account. The findings indicate that a non-negligible number of reports do not accurately report and discuss SVT/PVT results, underscoring the need for enhancing the quality and precision of psychological reports concerning validity testing.

One of the most heated debates in psychological science concerns the concept of repressed memory. We discuss how the debate on repressed memories continues to surface in legal settings, sometimes even to suggest avenues of legal reform. In the past years, several European countries have extended or abolished the statute of limitations for the prosecution of sexual crimes. Such statutes force legal actions (e.g., prosecution of sexual abuse) to be applied within a certain period of time. One of the reasons for the changes in statutes of limitations concerns the idea of repressed memory. We argue that from a psychological standpoint, these law reforms can be detrimental, particularly when they are done to endorse unfounded psychological theories. The validity of testimonies is compromised many years after the alleged facts, and abolishing the statute of limitations increases the chance that even more (false) recovered memories of abuse might enter the courtroom. We propose solutions to these changes such as establishing an independent expert committee evaluating claims of sexual abuse.

Typically, research on response bias in symptom reports covers two extreme ends of the spectrum: overreporting and underreporting. Yet, little is known about symptom presentation that includes both types of response bias simultaneously (i.e., mixed presentation). We experimentally checked how overreporting, underreporting, and mixed reporting reflect in trauma symptom reports. Undergraduate students (N = 151) were randomly allocated to one of four conditions: control group (n = 40), overreporting (n = 37), underreporting (n = 36), or a mixed reporting (n = 38) group. The control group was asked to be honest, whereas the simulation groups received instructions they were expected to be able to relate to. Participants were administered a PTSD checklist, the Supernormality Scale-Revised, which screens for symptom denial, and the Inventory of Problems-29, which gauges overreporting. For all three measures, group differences were significant (F(3, 147) > 13.78, ps < . 001, ɳ2 > .22), with the overreporting group exhibiting the most severe symptom presentation and the underreporting group endorsing the fewest symptoms, while the mixed group almost perfectly imitated the results of the control group on all measures. Thus, instructing individuals to strategically exhibit both overreporting, to a functional degree, and underreporting results in a symptom presentation that is relatively similar to genuine performance. To optimize accuracy statistics, researchers might want to consider including such mixed group condition in future simulation studies.

The paper “Neuropsychological malingering determination: The illusion of scientific lie detection” by Chunlin Leonhard and Christoph Leonhard (2024) critically assesses the use of symptom and performance validity tests (SVTs/PVTs) in forensic settings. The authors argue that the research community’s lack of critical examination leads to a flawed peer review process and scientifically dubious SVTs/PVTs, making them unsuitable for expert testimony. We comment on the arguments presented by Leonhard and Leonhard, questioning the scientific rigor of their approach, the limited scope of their literature review, their mischaracterization of validity tests as “malingering tests,” and their naive reliance on medical standards for evaluating SVTs/PVTs. We assert that referring to validity tests as “malingering tests” is a straw-man argument, as SVTs/PVTs are designed not to detect malingering per se, but to identify symptom overreporting or cognitive underperformance, respectively. In contrast to Leonhard and Leonhard’s stance on the inadmissibility of validity tests, other researchers offer a more balanced perspective, indicating that SVTs/PVTs, despite their limitations, receive favorable reviews and general acceptance in the field. In conclusion, we find Leonhard and Leonhard’s analysis unconvincing and argue that their questionable arguments undermine the credibility of symptom and performance validity research. The potential consequences of this include diminished funding prospects. We emphasize that SVTs/PVTs provide valuable insights into symptom overreporting and cognitive underperformance, which are crucial for accurate diagnosis and treatment.

We asked 463 participants from 21 countries whether they had feigned and/or concealed having a coronavirus infection during the pandemic period. 384 respondents (83%) reported having experienced a coronavirus infection. They were, on average, younger and reported more chronic health issues than participants who said they had never been infected. 65 (14%) admitted to having feigned the infection. Prevalence doubled (28%) when asked if they knew anyone who had feigned a coronavirus infection. Main motives for feigning were to stay at home and to obtain sick leave. As to having concealed a coronavirus infection, 56 (12%) responded affirmatively, but when asked about others, the prevalence reached 51% (n = 210). The most common reasons for concealment were to avoid letting others know and to not miss an event. Thus, both feigning and concealing infections can occur on a nontrivial scale, directly affecting prevalence rates in studies that rely on self-reported data collected from social platforms.

Abstract. The Self-Report Symptom Inventory (SRSI) intends to measure symptom overreporting. To assess the Dutch and German SRSI equivalence, both versions were split into two half-forms. Forty bilingual participants were randomly allocated to two groups that completed the first half in German and the second half in Dutch or vice versa. Each group completed the SRSI honestly and then under feigning instructions. For both conditions, the Dutch and German SRSI did not statistically significantly differ within and across the two groups. For most comparisons, the Bayes factor was ≥ 3, indicating moderate evidence favoring the equivalence of language versions and half-forms. Genuine and pseudosymptoms endorsement was significantly higher in the feigning than in the honest condition (both Zs = 5.44, r rb = 1.00). The SRSI standard cut score correctly identified honest responding and detected 80% of feigned responses. Our results align with Giger and Merten’s (2019) German and French SRSI equivalence study.

The use of alternative scenarios has been advocated as a method to mitigate bias when evaluating the reliability of testimonies. In two experiments, undergraduate students acted as expert witnesses when reading an alleged child sexual abuse case file and evaluated the reliability of the statements. In the first experiment, a subgroup of participants were encouraged to think about alternative scenarios (i.e. the statements are fabricated) when evaluating statements (N = 150). Contrary to our expectations, these participants were not more skeptical about the reliability of the alleged victim's testimony than the control participants. In the second experiment (N = 205), we tested whether scenario-thinking protected against context effects (i.e. the unintended influence of irrelevant information) from a defense lawyer or prosecutor. We found no support that being sensitized to alternative scenarios made participants more skeptical of the reliability of testimonies. However, when we performed an internal joint analysis of Experiments 1 and 2, we did find some evidence that considering alternative scenarios made participants more skeptical of the suspect's guilt than those in the control group. We discuss the use of alternative scenarios in expert witness work and potential ways to empirically test the alternative scenario approach in the future.