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Negative response bias, malingering, and symptom validity in psychology: A Türkiye focused-review

Yıl 2025, Cilt: 9 Sayı: 2, 242 - 263, 25.08.2025
https://doi.org/10.57127/kpd.26024438.1302390

Öz

The literature suggests that individuals undergoing psychological and/or neuropsychological assessments or referred for such assessments in certain contexts (e.g., medicolegal), may not always be honest about their reported problems or symptoms. Accordingly, individuals, particularly in the case of subjective self-reports, may exhibit a response style that biases or even invalidates assessment results based on a number of factors. These factors may include the nature of the questions, the context of the test, the mood of the individual during the assessment process, and/or the motive to obtain a benefit. For example, a response style defined as response bias, which is intended to distort assessment results, may involve some individuals presenting a situation as better than it actually is (positive response bias) and others presenting it as worse than it actually is (negative response bias). There may be internal (e.g., psychological benefit) and/or external (e.g., financial benefit) incentives behind this. Intentionally exaggerating or fabricating one's own psychological and/or physical symptoms in order to gain benefits motivated by an obvious external incentive is also a response style and is defined in the literature as malingering. In this context, symptom validity is a concept that refers to the accuracy of the symptoms reported by individuals (e.g., through self-report). In light of the above findings, this review is based on the international literature on response bias, malingering, and symptom validity, as well as studies conducted in Türkiye, targeting the Turkish population, or written in Turkish. In this context, the definition of malingering in the DSM (The Diagnostic and Statistical Manual of Mental Disorders), criticisms of the DSM definition, prevalence rates, consequences of detection failures, alternative detection systems, symptom validity assessment, recommended objective psychometric test types, and recent findings and developments in general were reviewed. Recommendations are made in light of the findings.

Etik Beyan

This is a review study that does not require ethical approval.

Destekleyen Kurum

This study was not conducted within the scope of any project and no funds or grants were used.

Teşekkür

Declaration of Conflict of Interest: All authors of this article declare that they have no conflict of interest regarding the article. Consent Form: It is not suitable for the type of research. Project/Funding Information: This study was not conducted within the scope of any project and no funds or grants were used. Data Sharing/Appropriateness: There is no data obtained from the participants within the scope of the study. Author(s) Contribution: [AYEA and AÇ] conceived and designed the analysis; collected the data by conducting the systematic review process including article screening and selection; performed the analysis by synthesizing and interpreting the findings; wrote the first draft of the paper including the introduction, methods, and results sections. [EA and MST] provided methodological guidance throughout the review process; revised and edited the manuscript, particularly contributing to the refinement of the introduction and discussion sections. All authors re-viewed and approved the final manuscript.

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Psikolojide olumsuz yanıt yanlılığı, temaruz ve belirti geçerliliği: Türkiye odaklı bir gözden geçirme

Yıl 2025, Cilt: 9 Sayı: 2, 242 - 263, 25.08.2025
https://doi.org/10.57127/kpd.26024438.1302390

Öz

Alanyazın, psikolojik veya nöropsikolojik değerlendirmeler geçiren veya belirli bağlamlarda (örn., adli tıp) bu tür değerlendirmeler için yönlendirilen bireylerin, bildirdikleri sorunlar veya belirtiler konusunda her zaman doğru olmadıklarını göstermektedir. Buna göre; bireyler, özellikle öznel bildirimlerde, birtakım faktörlere dayalı değerlendirmelerin sonuçlarını çarpıtan ve hatta geçersiz kılan bir yanıt tarzı sergileyebilirler. Bu faktörler arasında soruların niteliği, testin bağlamı, kişinin değerlendirme sürecindeki ruh hali ve/veya fayda sağlama güdüsü yer alabilir. Örneğin, yanıt yanlılığı olarak tanımlanan ve değerlendirme sonuçlarını çarpıtmaya yönelik olan bir yanıt tarzı, bazı kişilerin bir durumu gerçekte olduğundan daha iyi (olumlu yanıt yanlılığı), diğerlerinin ise gerçekte olduğundan daha kötü (olumsuz yanıt yanlılığı) olarak sunmasını içerebilir. Bu durum iç (örn., psikolojik fayda) ve/veya dış (örn., finansal fayda) teşvikler tarafından güdülenebilmektedir. Buradan hareketle, bariz bir dış teşvik doğrultusunda fayda sağlama amacıyla kişinin kendi psikolojik ve/veya fiziksel belirtilerini istemli olarak abartması veya bunları uydurması da bir yanıt tarzıdır ve alanyazında temaruz olarak tanımlanmaktadır. Bu bağlamda, belirti geçerliliği, bireyler tarafından sunulan (örn., öz bildirim yoluyla) belirtilerin doğruluğuna atıfta bulunmak için kullanılan bir kavramdır. Yukarıdaki bilgiler ışığında, bu gözden geçirme çalışması, yanıt yanlılığı, temaruz ve belirti geçerliliğine ilişkin uluslararası alanyazının yanı sıra Türkiye’de, Türk toplumuna yönelik veya Türkçe yazılmış çalışmalara dayanmaktadır. Bu kapsamda, DSM’deki (Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı) temaruz tanımı, DSM tanımına yönelik eleştiriler, yaygınlık oranları, tespit başarısızlıklarının sonuçları, alternatif tespit sistemleri, belirti geçerliliğinin değerlendirilmesi, önerilen nesnel psikometrik test türleri ve genel olarak güncel bulgular ve gelişmeler gözden geçirilmiştir. Elde edilen bilgiler ışığında önerilerde bulunulmaktadır.

Etik Beyan

Etik izin gerektirmeyen, sistematik derleme çalışmasıdır.

Destekleyen Kurum

Bu çalışma herhangi bir proje kapsamında gerçekleştirilmemiş ve herhangi bir fon veya ödenek kullanılmamıştır.

Teşekkür

Etik Kurul Onayı: Etik izin gerektirmeyen, sistematik derleme çalışmasıdır. Çıkar Çatışması Beyanı: Bu makalenin tüm yazarları, makaleye ilişkin herhangi bir çıkar çatışması olmadığını beyan ederler. Onam Formu: Araştırma türüne uygun değildir. Proje/Ödenek Bilgisi: Bu çalışma herhangi bir proje kapsamında gerçekleştirilmemiş ve herhangi bir fon veya ödenek kullanılmamıştır. Data Paylaşımı/Uygunluğu: Çalışma kapsamında katılımcılardan elde edilen herhangi bir veri yoktur. Yazar(lar)ın Katkısı: [AYEA ve AÇ], sistematik derleme sürecini (makale tarama, seçme ve eleme) yürüterek verileri topladı; bulguları sentezleyip yorumladı; makalenin ilk taslağını, giriş, yöntem ve sonuç bölümleri dâhil olmak üzere yazdı. [EA ve MST], derleme süreci boyunca yöntemsel rehberlik sağladı; özellikle giriş ve tartışma bölümlerinin geliştirilmesi olmak üzere metni gözden geçirdi ve düzenlemeler yaptı. Tüm yazarlar makalenin son halini gözden geçirdi ve onayladı.

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  • Savaşır, I. (1978). Minnesota Çok Yönlü Kişilik Envanterinin Türkçeye uyarlanışı ve standardizasyon projesi. Türk Psikoloji Dergisi, 1(1), 18-24.
  • Schroeder, R. W., Clark, H. A. ve Martin, P. K. (2022). Base rates of invalidity when patients undergoing routine clinical evaluations have social security disability as an external incentive. The Clinical Neuropsychologist, 36(7), 1902-1914.
  • Schroeder, R. W., Martin, P. K. ve Odland, A. P. (2016). Expert beliefs and practices regarding neuropsychological validity testing. The Clinical Neuropsychologist, 30(4), 515-535.
  • Sherman, E. M. S., Slick, D. J. ve Iverson, G. L. (2020). Multidimensional malingering criteria for neuropsychological assessment: A 20-year update of the malingered neuropsychological dysfunction criteria. Archives of Clinical Neuropsychology, 35(6), 735-764.
  • Singh, J., Avasthi, A. ve Grover, S. (2007). Malingering of psychiatric disorders: A review. German Journal of Psychiatry, 10(4), 126-132.
  • Slick, D. J., Sherman, E. M. S. ve Iverson, G. L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13(4), 545-561.
  • Smith, G. P. ve Burger, G. K. (1997). Detection of malingering: Validation of the Structured Inventory of Malingered Symptomatology (SIMS). The Journal of the American Academy of Psychiatry and the Law, 25(2), 183-189.
  • Soliman, S. ve Resnick, P. J. (2010). Feigning in adjudicative competence evaluations. Behavioral Sciences & the Law, 28(5), 614-629.
  • Soysal, H. (2022). Hekimi yanıltıcı davranış. N. Uygur (Ed.), Adli psikiyatri uygulama kılavuzu (4. baskı, s. 281-299). Türkiye Psikiyatri Derneği.
  • Stevens, A. (2022). The validity of clinicians’ diagnoses: Is it bread and butter? European Psychiatry, 65(S1), S46-S47.
  • Suchy, Y. (2019). Introduction to special issue: Current trends in empirical examinations of performance and symptom validity. The Clinical Neuropsychologist, 33(8), 1349-1353.
  • Sweet, J. J., Heilbronner, R. L., Morgan, J. E., Larrabee, G. J., Rohling, M. L., Boone, K. B., Kirkwood, M. W., Schroeder, R. W., Suhr, J. A. ve Participants, C. (2021). American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 35(6), 1053-1106.
  • Sweet, J. J. ve Guidotti Breting, L. M. (2013). Symptom validity test research: Status and clinical implications. Journal of Experimental Psychopathology, 4(1), 6-19.
  • Şener, M. T. ve Ancı, Y. (2013). Adli psikiyatride temaruzun belirlenmesinde hekim tecrübesi: Olgu sunumu. Türkiye Klinikleri Journal of Case Reports, 21(2), 94-97.
  • Thomas, R. P. ve Lawrence, A. (2018). Assessment of expert performance compared across professional domains. Journal of Applied Research in Memory and Cognition, 7(2), 167-176.
  • Tombaugh, T. N. (1996). Test of Memory Malingering (TOMM). Multi Health Systems.
  • Türkçüer, İ., Serinken, M., Sengül, C. ve Özen, M. (2010). Munchausen sendromu mu? Yoksa temaruz mu? Turkish Journal of Emergency Medicine, 10(1), 38-40.
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  • Van der Heide, D., Boskovic, I., van Harten, P. ve Merckelbach, H. (2020). Overlooking feigning behavior may result in potential harmful treatment interventions: Two case reports of undetected malingering. Journal of Forensic Sciences, 65(4), 1371-1375.
  • Van Dyke, S. A., Millis, S. R., Axelrod, B. N. ve Hanks, R. A. (2013). Assessing effort: Differentiating performance and symptom validity. The Clinical Neuropsychologist, 27(8), 1234-1246.
  • Van Egmond, J., Kummeling, I. ve Balkom, T. A. (2005). Secondary gain as hidden motive for getting psychiatric treatment. European Psychiatry, 20(5-6), 416-421.
  • Van Egmond, J. ve Kummeling, I. (2002). A blind spot for secondary gain affecting therapy outcomes. European Psychiatry, 17(1), 46-54.
  • Van Helvoort, D., Merckelbach, H., van Nieuwenhuizen, C. ve Otgaar, H. (2022). Traits and distorted symptom presentation: A scoping review. Psychological Injury and Law, 15(2), 151-171.
  • Van Impelen, A., Merckelbach, H., Jelicic, M., Niesten, I. J. M. ve à Campo, J. (2017a). Differentiating factitious from malingered symptomatology: The development of a psychometric approach. Psychological Injury and Law, 10(4), 341-357.
  • Van Impelen, A., Merckelbach, H., Niesten, I. J. M., Jelicic, M., Huhnt, B. ve à Campo, J. (2017b). Biased symptom reporting and antisocial behaviour in forensic samples: A weak link. Psychiatry, Psychology and Law, 24(4), 530-548.
  • Viglione, D. J. ve Giromini, L. (2020). Inventory of problems–29: Professional manual. IOP-Test, LLC.
  • Viglione, D. J., Giromini, L. ve Landis, P. (2017). The development of the inventory of problems–29: A brief self-administered measure for discriminating bona fide from feigned psychiatric and cognitive complaints. Journal of Personality Assessment, 99(5), 534-544.
  • Walters, G. D., Rogers, R., Berry, D. T. R., Miller, H. A., Duncan, S. A., McCusker, P. J., Payne, J. W. ve Granacher Jr, R. P. (2008). Malingering as a categorical or dimensional construct: The latent structure of feigned psychopathology as measured by the SIRS and MMPI-2. Psychological Assessment, 20, 238-247.
  • Widows, M. R. ve Smith, G. P. (2005). SIMS – Structured Inventory of Malingered Symptomatology. Professional Manual. Psychological Assessment Resources.
  • Wooley, C. N. ve Rogers, R. (2015). The effectiveness of the personality assessment inventory with feigned ptsd: An initial investigation of Resnick’s model of malingering. Assessment, 22(4), 449-458.
  • Yıldırım, E. (2017). Adli nöropsikoloji ve temaruz (malingering). E. Şenol-Durak ve M. Durak (Ed.), Adli psikolojide gözlem-görüşme ve psikolojik değerlendirme (s. 159-186) içinde. Nobel Akademik Yayıncılık Eğitim Danışmanlık.
  • Yıldız, M. ve Nart, Ö. (2017). Klinik ortamlarda gözden kaçabilen temaruz olguları. Anadolu Psikiyatri Dergisi, 18(4), 413-414.
  • Young, G. (2014). Malingering, feigning, and response bias in psychiatric/psychological injury: Implications for practice and court. Springer Science+Business Media.
  • Young, G. (2015a). Detection system for malingered ptsd and related response biases. Psychological Injury and Law, 8(2), 169-183.
  • Young, G. (2015b). Malingering in forensic disability-related assessments: prevalence 15 ± 15 %. Psychological Injury and Law, 8(3), 188-199.
  • Young, S., Jacobson, R., Einzig, S., Gray, K. ve Gudjonsson, G. H. (2016). Can we recognise malingerers? The association between malingering, personality traits and clinical impression among complainants in civil compensation cases. Personality and Individual Differences, 98, 235-238.
Toplam 130 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Psikoloji
Bölüm Derlemeler
Yazarlar

Ali Yunus Emre Akca 0000-0002-3450-7059

Alpay Çiller 0000-0003-2988-8288

Elif Akyüz 0000-0002-2458-4368

Mehmed Seyda Tepedelen 0000-0002-7704-8606

Yayımlanma Tarihi 25 Ağustos 2025
Gönderilme Tarihi 25 Mayıs 2023
Yayımlandığı Sayı Yıl 2025 Cilt: 9 Sayı: 2

Kaynak Göster

APA Akca, A. Y. E., Çiller, A., Akyüz, E., Tepedelen, M. S. (2025). Psikolojide olumsuz yanıt yanlılığı, temaruz ve belirti geçerliliği: Türkiye odaklı bir gözden geçirme. Journal of Clinical Psychology Research, 9(2), 242-263. https://doi.org/10.57127/kpd.26024438.1302390