How to detect tendencies of Denial or Malingering: Most of the 250 items are stated blatantly pathologically, i.e., endorsement of the item with a 3 or 4 is an endorsement of psychopathology. The column Norm Frequency is based on a normal sample of responding, thus, only 30 times (on average) did the normal sample answer (4) Strongly True, and only 54 times (on average) did the normal sample answer (3) More True than False. Therefore, the normal sample chose (3) or (4) a total of 84 times, which indicates even a normal sample will report some psychopathology.

It may indicative of Denial if your patient (Patient heading) chose (3) or (4) less than 84 times. You may use the Standard Deviation (SD) column for an expected range of normal scores. For an answer of (4) Strongly True, the standardized Norm Frequency is 30 and the SD is 18. If your patient has a (4) frequency of less than 30, then your patient might be denying more than the average normal person. If your patient has a total of less than 84 for items (3) and (4), then your patient might also be denying too much.

It may also indicative of Denial if your patient chose (1) or (2) more than 166 times. For an answer of (1) Strongly False, the standardized Norm Frequency is 93. If your patient has a (1) frequency of one SD more than 93, i.e., 133, then your patient might be again denying more than the average normal person.

In clinical practice, particularly in institutional settings, Denial is more common than Malingering. However, if your patient does have an exceptionally high total sum for (3) and (4) answers, e.g., over 160, then the patient may either consciously or unconsciously exaggerating their psychopathology, and it may represent a cry for help.

This table reports the frequency for which the Patient chose

(1) Strongly False

(2) More False than True

(3) More True than False, or

(4) Strongly True.

It also reports the frequencies for which the purportedly normal sample (Norm Frequency [SD]) chose

(1) Strongly False

(2) More False than True

(3) More True than False, or

(4) Strongly True.