There are many terms that address the notion of truthfulness within the context of assessment, treatment and rehabilitation, including denial, problem minimization, misrepresentation and equivocation. The prevalence of denial among patients and offenders is extensively discussed in the psychological literature (Marshall, Thornton, Marshall, Fernandez, & Mann, 2001; Brake & Shannon, 1997; Barbaree, 1991; Schlank & Shaw, 1996). The impact the Truthfulness Scale score has on other scale or test scores is contingent upon the severity of denial or untruthfulness. In assessment, socially desirable responding impacts assessment results when respondents attempt to portray themselves in an overly favorable light (Blanchett, Robinson, Alksnis & Sarin, 1997).
Truthfulness Scale awareness increased with the release of the Minnesota Multiphasic Personality Inventory (MMPI) almost six decades ago. Soon thereafter, socially-desirable responding was demonstrated to impact assessment results (Stoeber, 2001; McBurney, 1994; Alexander, Somerfield & Ensminger, 1993; Paulhus, 1991). Truthfulness Scale conceptualization began in earnest with the idea of self-response accuracy. Test users wanted to be sure that respondents' self-report answers were truthful. Evaluators and assessors need to know if they can rely upon the test data being accurate. In other words, can the respondent's self-report answers be trusted? Research also shows that truthfulness is also a factor in diagnosis, treatment effectiveness and recidivism.
Client (patient or offender) truthfulness has been associated with more positive treatment outcomes (Barber, et. al., 2001). Denial often accompanied lack of accountability, lack of motivation to change, resistance and general uncooperativeness (Simpson 2004). Problem minimization has also been linked to lack of treatment progress (Murphy & Baxter, 1997); treatment dropout (Daly & Peloski, 2000; Evans, Libo & Hser, 2009); and offender recidivism (Nunes, Hanson, Firestone, Moulden, Greenberg & Bradford, 2007; Kropp, Hart, Webster & Eaves, 1995; Grann & Wedin, 2002). Some researchers have suggested that client denial should be eliminated prior to commencing treatment. Denial reduction methods include use of survivor reports, directed group work, or addressing cognitive distortions that may cause denial (Schneider & Wright, 2004).
As multidimensional as denial is (Barrett, Sykes, & Byrnes, 1986; Brake & Shannon, 1997; Happel & Auffrey, 1995; Laflen & Sturm, 1994; Langevin, 1988; Orlando, 1998; Salter, 1988; Trepper & Barrett, 1989), truthfulness is equally multifaceted. Yet, client truthfulness (and denial) are integral to accurate assessment, testing and evaluation. Consequently, truthfulness will continue to be studied in the future.
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