Validity and Utility of the Miller Forensic Assessment of Symptoms Test (M-FAST) on an Inpatient Epilepsy Monitoring Unit

AbstractAs overreporting of symptoms threatens the integrity and utility of the neuropsychological evaluation, symptom validity test (SVT) usage has become a standard of practice. The Miller Forensic Assessment of Symptoms Test (M-FAST) SVT has been validated in various forensic contexts, though its utility in specific medical settings remains under-explored. The current study examined the validity and diagnostic utility of the M-FAST among 123 inpatient veterans on a long-term video electroencephalogram (V-EEG) epilepsy monitoring unit (EMU). Select scores from the Structured Inventory of Malingered Symptomatology and the Minnesota Multiphasic Personality Inventory-2-Restructured Form were combined into an SVT composite used as a criterion for validating the M-FAST with receiver operating characteristic (ROC) curves. A Student ’st-test revealed significantly higher total M-FAST scores among the symptom invalidity group compared to individuals with valid symptom reports (Cohen ’sd = 1.24). An optimal M-FAST cut score of ≥ 5 was identified to detect symptom overreporting, with .65 sensitivity and .85 specificity (AUC = .82). However, ROC curve analysis indicated that the M-FAST had poor diagnostic classification accuracy for V-EEG-confirmed epilepsy (ES;n = 21) versus V-EEG-confirmed psychogenic non-epileptic events (PNEE;n = 46; AUC = .56). Although diagnostic utility of the M-FAST for PNEE versus ES was not supported within our sample, results d...
Source: Psychological Injury and Law - Category: Medical Law Source Type: research