Complex trauma resulting from neglect and abuse in early childhood is frequently misdiagnosed.

This presentation shares emerging “best assessment practices” that help to differentiate complex trauma from Schizophrenia.

The case study demonstrates that a wide-ranging psychometric assessment and the application of Lacter & Lehmann (2008) guidelines provide accurate results while MCMI-III results can be spurious.

“Unbelievable” disclosures of an adult survivor prompted a search for scientific references, experiences in the survivor scene and historical examples. Work-related personality questionnaires, in-depth ability tests and Lacter & Lehmann (2008) guidelines were deployed to differentiate complex trauma from an erroneous diagnosis based largely on MCMI-III results.

The research identified measurement issues with the MCMI-III clinical personality questionnaire that generated spurious elevations on Narcissistic, Delusional and Paranoid scales. Work-related personality questionnaires provided much more useful information showing no “personality disorder” risks at all. WAIS results confirmed an earlier “Twice Exceptional” ability pattern with very high verbal IQ (95%ile) and extraordinarily poor auditory working memory (2nd%ile) i.e. a “Dyslexia” performance pattern. Lacter & Lehmann (2008) guidelines showed that none of the 42 schizophrenia indicators applied and only 1/3 of the complex trauma indicators.

Mental health professionals must remain cognizant to the chilling notion that extreme abusers may “frame” victims in order to make them “appear” schizophrenic. As MCMI-III was developed originally for those seeking therapy, its use in forensic settings with the general population should be avoided. Tests do not diagnose people – people do!

The authors have not supplied their declaration of competing interest.