Detection of Feigning of Head Injury Symptoms on the MMPI-2

Current epidemiological data suggest that traumatic brain injury (TBI) is among the most common neurological hospital discharge diagnoses in the United States (Kraus & Chu, 2005). These data also indicate that head injuries range considerably in severity. Although a number of alternative indices are available, the most well-accepted indicator of initial head injury severity is the Glasgow Coma Scale (GCS), which quantifies disturbance of consciousness on a scale ranging from 3 to 15 (Eisenberg & Weiner, 1987). Head injuries producing GCS scores in the moderate (9–12) to severe (3–8) range, particularly if accompanied by cerebral hemorrhage and/or skull fracture, are often associated with increased mortality and morbidity (Kraus & Chu, 2005). Head injuries resulting in GCS scores of 13–15 are classified as mild, and approximately 80% of all head injuries fall in this category (Kraus & Chu, 2005). In contrast to the outcome literature on moderate-to-severe head injury, the largest and best-controlled studies to date suggest that by 1-year postinjury, neuropsychological and psychosocial outcome for patients suffering an uncomplicated mild head injury (disturbance of consciousness lasting no more than 1 h and no other indicators of neurological disorder) is comparable to that experienced by patients suffering peripheral trauma not involving brain damage (Dikmen, Machamer, Winn, & Temken, 1995; Dikmen, Ross, Machamer, & Temkin, 1995). Of course, the general trends observed in group studies, however methodologically sound, do not preclude the possibility of poor outcome in selected individual cases.