Tuesday, May 29, 2007

A COMBINATION OF GENUINE AND EXAGGERATED DEPRESSION THAT RESULTS IN DISABILITY FOR WORK

Not long ago, I was retained to conduct a psychological evaluation of an employee who was alleging severe depression resulting in disability for work. Her employer believed she may have had a mild non-disabling depression but that she was presenting with a more severe, possibly exaggerated depression.

The examinee, a female, was age 49 when I met with her in my office in Brighton, Massachusetts, and reported to me that she first experienced depression while in college around 30 years earlier. Her initial symptoms of depression included difficulty arising in the morning, increased appetite, crying and missing classes at college.

Upon clinical interview, the examinee reported that her current symptoms of depression included sad mood, loss of interest in previously preferred activities, decreased appetite, insomnia, fatigue, low energy level, worthlessness and concentration problems. She denied recurrent thoughts of death or suicidal ideas. Her current treatment plan includes psychotherapy and antidepressant medications. She had never been treated for depression in a psychiatric hospital setting.

In addition to a clinical interview, I also administered psychological tests including the reading subtest from the Wide Range Achievement Test, the Miller Forensic Assessment of Symptoms Test (M-FAST) and the Minnesota Multiphasic Personality Inventory (MMPI-2). I used these tests to (a) determine that her reading skills were strong enough that she could respond to the other psychological tests I administered (b) to confirm findings from the clinical interview and (c) to determine if the claimant is exaggerating or faking (malingering) psychological symptoms. Clinical interview without psychological testing is not a reliable indicator of malingering.

On the basis of my examination of this individual, I concluded that she met all the diagnostic criteria for Dysthymic Disorder, a chronic type of depression. However, I noted on the basis of the clinical interview that she appeared to exaggerate some of the symptoms of her depression when she described them to me during the interview. She seemed able to perform usual daily activities in a way that seemed inconsistent with her claim of severe depression. In addition, I found that her claim of severe fatigue and concentration difficulties was not consistent with her ability to cooperate with a four-hour examination. In addition, I found that her scores on the “validity” scales of the MMPI-2 and her score on the M-FAST were consistent with exaggerated depression.

Although I found that she exaggerated some symptoms of depression, my opinion was that she had genuine symptoms of depression that were significant enough at the time I met with her to interfere with her ability to meet some requirements of her job description. I concluded that , despite some exaggeration of depressive symptoms, she was unable to work at her job due to a genuine, chronic depression.

I am a licensed psychologist in Massachusetts and I conduct psychological evaluations for insurance companies and lawyers in connection with Workers Compensation, Disability and Personal Injury claims. More information about my services is available at my website.



1 comment:

Wilbur Mills said...

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