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We explored how feigning impacts the Rorschach task, a typical performance test, with a preregistered meta-analysis of 21 studies (32 contrasts) comparing feigners of severe psychopathology (including experimental simulation and suspected malingering designs) to both nonclinical and clinical control groups. We investigated hypothesized Rorschach variables, controlling for the Number of Responses and adjusting for skewness when feasible. Compared with nonclinical controls, feigners simulate by increasing indicators of perception and thinking problems and exaggerating indicators of stress and distress; however, their task engagement remained similar. Relative to clinical controls, feigners provided less simplistic responses, displayed fewer thinking problems, similar perceptual difficulties, and exaggerated stress and distress indicators. We discuss three novel composites that may improve the detection of feigned severe psychopathology. These findings contribute to future research and clinical assessment in forensic contexts.<\/jats:p>","DOI":"10.1177\/10731911261462465","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:32:45Z","timestamp":1785295965000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Feigning and Malingering Severe Psychopathology on the Rorschach Test: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-2342","authenticated-orcid":false,"given":"Ruam P. F. 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