Miller Forensic Assessment of Symptoms Test (M-FAST)

The M-FAST is a brief 25-item screening interview for individuals ages 18 years and older that provides preliminary information regarding the probability that an individual is feigning psychiatric illness.  Most malingering and symptom validity instruments assess malingered cognitive and/or neuropsychological deficits.  The M-FAST focuses exclusively on malingered psychiatric illness.

The M-FAST takes 5-10 minutes to administer.  The brief interview format saves valuable clinical time and provides considerable flexibility for the clinician to determine when, where, and to whom the M-FAST should be administered.  The M-FAST may be integrated into a larger evaluation with minimal difficulty.

Reported vs. Observed (RO):  Compares the examinee’s self-report with observed behavior.  A high score (RP > 1) indicates that the examinee’s self report is inconsistent with his/her observed behavior.

Extreme Symptomatology (ES): Measures symptoms that are more extreme and less common than symptoms typically endorsed by genuine psychiatric patients.  A high score (ES > 2) indicates that the examinee is endorsing very extreme and uncommon symptoms.

Rare Combinations (RC): Includes symptoms that rarely, if ever, occur together.  A high RC score (RC > 2) indicates that the examinee is endorsing symptom combinations that are both unlikely and inconsistent with common mood and psychotic disorders.

Unusual Hallucinations (UH): Assesses symptoms that occur infrequently in psychiatric patients.  A high score on UH (UH > 2) indicates that the examinee has an atypical presentation and a tendency to endorse severe and psychotic symptoms.

Unusual Symptom Course (USC): An unusual course of illness that is inconsistent with the course of most psychiatric disorders recognized in clinical practice.  This is a single item and should be interpreted cautiously.

Negative Image (NI): Assesses whether an examinee has a negative self-perception.  This is a single item and should be interpreted cautiously.

Suggestibility (S): Two-part item indicates suggestibility.  Endorsement of the S item is highly suggestive of malingering.