Assessing Symptom Validity in Psychological Injury Evaluations Using the MMPI-2-RF and the PAI: an Updated Review

Among the most pressing considerations in psychological injury litigation is potential overreporting of symptoms or impairments by the plaintiff. It is thus imperative for psychological injury evaluators to possess a working understanding of the conceptual and empirical foundations of symptom validity tests (SVTs). This literature review first covers foundational knowledge to guide evaluators in the careful interpretation of SVTs. It then focuses on two of the most well-established SVTs, i.e., the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Personality Assessment Inventory (PAI). Each instrument is reviewed for its overreporting scales, including scale development strategies, standard cutoff values, and research support, with particular attention afforded to psychological injury litigation considerations. Findings from this narrative review suggest that both the MMPI-2-RF and the PAI are sound SVTs with growing bodies of empirical support. However, they must be interpreted with special caution in the unique context of psychological injury evaluations, where there runs a greater risk of false-positive identification of overreporting. The strengths of each measure are contrasted, revealing general themes. Notably, the MMPI-2-RF excels in its accumulation of research support and civil litigant-specific norms, whereas the PAI leads SVT research in innovation and advanced detection techniques. Both measures are better equipped to detect feigned psychopathology than cognitive or medical impairments. Recommendations for forensic evaluators and areas for future research are presented accordingly.