Why do all individuals fall short of full and accurate self-disclosure?

Complete and accurate self-disclosure is rare, because everybody is selective in sharing personal information. The decisions we make about our response styles, whether we disclose or deceive, are mostly rational and based on various circumstances (multidetermined). Also, we do not have one general response style, but individualize our response to interpersonal variables (liking or disliking the other person) or situational demands (explaining your former behavior). Most response styles are based on personal goals in particular settings. The response styles are both internally and externally influenced. These influences have to be considered when looking at ones self-report. This is quite difficult because we lack standardized measures to systematically evaluate these personal factors.

According to Rogers, when should deceptions be considered with regards to response styles?

The author of this article states that only consequential deceptions and distortions should be considered in the context of response styles. He also states that mental health professionals should decide if any evidence, even when it’s questionable, should be routinely included in forensic and clinical reports. This decision, which will be taken with ethical and professional consideration, will most likely be influenced by two factors:

• Do you want a report to be accurate or complete?
• Will the clinical findings be used or misused by others?

How can we define response styles?

In order to perform proper research, standardization of terms and operationalization of response styles is necessary. The response styles are divided into four categories, namely nonspecific terms, overstated pathology, simulated adjustment, and other response styles.

What is meant with overspecification of response styles?

One of the most common mistakes clinicians make is the overspecification of response styles. Practitioners try to determine a specific response style that best fits the clinical data, but this often results in the specification of a response style even when the data is conflicting or unconvincing. Therefore, clinicians should always consider whether the clinical data support nonspecific descriptions and, if so, if there is enough data to determine a specific response style.

What are nonspecific terms?

Some nonspecific terms that can be used are:

• Unreliability: describes doubts about the accuracy of reported information without making assumptions about the intent of the individual. Most useful with conflicting clinical data.
• Nondisclosure: describes the withholding of information without making assumptions about the intent of the individual, as people are free to decide what information they want to share.
• Self-disclosure: low self-disclosure does not imply dishonesty, but an unwillingness to share personal information.
• Deception: describes any consequential attempts by individuals to distort or misrepresent their self-report. It includes acts of deceit, often accompanied by nondisclosure.
• Dissimulation: describes someone who is intentionally misrepresenting or distorting psychological symptoms, but does not show malingering, defensiveness or other specific response style.

How can overstated pathology be categorized?

It is important to distinguish between malingering and other terms to describe overstated pathology. The recommended terms for categorizing overstated pathology are:

• Malingering: intentionally producing grossly exaggerated or false psychological or physical symptoms motivated by external incentives. This does not completely exclude the co-occurrence of internal motivations. Isolated symptoms or minor exaggerations do not qualify for the diagnosis.
• Factitious presentations: intentionally producing or feigning grossly exaggerated or false psychological or physical symptoms motivated by assuming the sick role. The presence of external motivation excludes this diagnosis.
• Feigning: intentionally producing grossly exaggerated or false psychological or physical symptoms without any clear motivation or goal.

Because of the importance of well-defined and validated descriptions, some terms should be avoided by clinicians because they lack precision or clarity, or have conflicting meanings. Therefore, terms such as suboptimal effort, overreporting and secondary gain shouldn’t be used.

How can simulated adjustment be categorized?

There are three terms used to categorize simulated adjustment:

• Social desirability: desire to present oneself in the most desirable way, by the attribution of positive characteristics and denial of negative characteristics.
• Defensiveness: describes the intentional denial or gross minimization of physical and psychological symptoms.
• Impression management: intentional efforts to control how others perceive the individual. This is often more situationally driven than based on social desirability, and individuals may use this response style for several different purposes which are not prosocial.

What other response styles can be identified?

Some response styles are less well understood than terms like malingering. They are categorized as ‘other response styles’, and four of them will be outlined:

• Hybrid responding: using more than one response style in a particular situation. It shows the importance of considering response styles to be adaptive.
• Irrelevant responding: used when the individual isn’t psychologically engaged in the assessment procedures, and gives answers that are not particularly related to the content of the investigation.
• Random responding: responding in an irrelevant way, based on chance factors (e.g. finishing a test in 5 minutes that usually takes 1,5 hours).
• Role assumption: when an individual assumes the role of another character when responding to the psychological measures. This response style is still poorly understood.

What misconceptions exist about malingering?

Many misconceptions are held by both the general public and clinicians. The most commonly used misconceptions are summarized here:

• Deception is evidence for malingering: you cannot say that every liar is malingering.
• Malingering is a non-changeable response style: on the contrary, more often malingering appears to be related to specific goals in specific contexts.
• Antisocial persons use malingering, because it is an antisocial act: this misconception exists because the DSM uses an antisocial personality disorder as an indicator for malingering. We shouldn’t confuse common characteristics with discriminating characteristics.
• Malingering is very rare: some practitioners just simply ignore the possibility of malingering, even though its neglect is a serious omission.
• Someone who is malingering cannot suffer from genuine disorders: when practitioners find out that some of the symptoms were fabricated, they usually dismiss all symptoms as bogus. This isn’t always the case.
• Malingering has stable base rates: on the contrary, they are quite variable.
• Malingering is similar to the iceberg phenomenon: not any evidence for malingering is sufficient in order to get the diagnosis. People falsely assume that any observable feigning, similar to the visible tip of the iceberg, proves a pervasive pattern of malingering

Which clinical and research models can be identified to help understand response styles?

• The predicted-utility model. The motivational basis for response styles has also been referred to as explanatory models. Essentially, choosing a certain response style is almost always based on predicted utility, even though general deception consists of various forms of nondisclosure and dishonesty. We call this the predicted-utility model. Although this is the most commonly used model, there are some other models explaining different motivations for malingering.
• The adaptational model. This model states that malingerers make a cost-benefit analysis in order to choose feigning psychological impairments.
• The pathogenic model states that an underlying disorder motivates the malingering. They produce symptoms because of their inability to control their underlying disorder, and as their condition deteriorates, can possibly lose control over their feigned disorder. This model is not representative for most malingerers.
• The criminological model explains the primary motivation for malingering as being an antisocial act committed by an antisocial person. This conception exists, because the DSM uses an antisocial personality disorder as an indicator for malingering. We shouldn’t confuse common characteristics with discriminating characteristics.

Which research designs are related to response styles?

There are four basic research designs used in studies concerning response styles. They all have their strengths, but can also be misused by clinicians. A quick overview:

• Simulation Design: participants are randomly assigned to different experimental groups, and afterwards compared with the results of relevant clinical groups. This method has strong internal validity, but the external validity is limited because the participants don’t face the same difficult circumstances of succeeding or failing.
• Known-groups comparison: uses independently established groups to evaluate specific response styles. The internal validity is weak, because researchers have no control over experimental assignment or other standardized procedures. External validity is strong, because the participants, settings, issues and incentives fit real-world consideration.
• Differential prevalence design: based on assumed incentives, greater numbers of broadly defined groups are presumed to have specific response styles when compared with a second group. The internal validity is weak, because researchers have no control over experimental assignment or other standardized procedures.The external validity is moderate, because of the lack of ground truth, like independent classification of response styles, battles against knowing which participants are tempting to engage in which response styles. This research design cannot be clinically used.
• Bootstrapping comparisons: specificity is maximized (no genuine patients are labeled malingerers) by using multiple detection strategies and the application of cut scores. This makes it possible to preserve moderate sensitivity (most feigners are labeled malingerers). The internal validity is weak, because researchers have no control over experimental assignment or other standardized procedures. External validity is moderately strong, because the participants, settings, issues and incentives fit real-world consideration and researchers typically have a high level of confidence for one relevant group.