(PS5-A19) Prevalence of Malingering in a Jail Sample Using the Personality Assessment Inventory: Implications for Detection and Feasibility

Jails have become the largest providers of mental health services in the United States, with more than two-thirds of individuals in jail meeting the criteria for a mental illness. Many of these facilities are not equipped to handle this rapidly growing problem with the currently available resources, given the high demands in costs and staffing. Furthermore, malingering, a phenomenon characterized by the feigning or exaggeration of psychiatric symptoms, has also been found to occur at high rates in jails. Findings have indicated a malingering prevalence rate anywhere from 17-66%. Some clinical tools that are used to identify and diagnose mental disorders, such as the Personality Assessment Inventory (PAI), have validity scales (inconsistency, infrequency, negative impression, and positive impression) built in to help detect symptom presentations that appear inaccurate or deceptive. However, elevated scores on these scales do not necessarily mean an individual is malingering. For example, elevated scores could be explained as a person in significant psychological distress, which may be exacerbated by placement in jail. Therefore, distinguishing feigned mental illness from true mental illness is ever more critical to appropriately allocate limited jail resources and services. Examining the relationship between scores on the validity scales and scores on the clinical scales (i.e. mania, schizophrenia, borderline, and antisocial features) of the PAI may provide more insight into the validity of one’s symptoms if the presentation appears questionable. Specifically, antisocial and attention-seeking traits have been associated with malingering in some studies, though findings are often mixed. 

The aim of this study is to examine the PAI scores of a sample of 311 male and female inmates from a jail in the Pacific Northwest. Specifically, descriptive statistics will be used to assess for base rates and prevalence of elevated scores on the validity scales and malingering index to compare to previous literature. Additionally, one-way ANOVA tests will be run to assess mean differences between elevated validity scale scores and the clinical scales (i.e. antisocial features) to determine if certain clinical profiles are more likely to malinger or answer inconsistently. Results may help guide future research into malingering detection in jails through a more comprehensive screening with psychopathology questionnaires like the PAI, and aid in reducing the burden of mental illness in jail systems.