Prevalence of malingering in inpatient suicide ideators and attempters

The purpose of the present study was to ascertain the prevalence of malingering by inpatients admitted to an urban hospital for suicidal ideation or attempt. Fifty-eight consecutively hospitalized suicidal patients were asked to participate, and of these 40 (70%) agreed to do so. Each patient was given an anonymous questionnaire asking whether they had lied or purposely exaggerated suicidal ideation to gain admission. A psychiatrist and masters-level psychologist, both blind to the patient responses, then rated each patient for suspicion of malingering. Each patient was also administered the MMPI-2 F, L, and K validity scales. Four patients (10%) indicated they had malingered and indicated that external incentives had motivated them to feign either suicidal ideation or a suicide attempt. None of the MMPI-2 validity scales correlated with self-reported malingering. The clinicians detected malingerers with 100% sensitivity, but the specificity rates were only 58% for the psychiatrist and 32% for the psychologist. The results indicate that some inpatients malinger about the extent of their suicidal intentions. The data demonstrate the difficulty inherent in detecting malingering by clinical interviewing and psychological testing.