Answer: Deliberate lying is only one factor that can lead to excessively low or high scores, depending on whether the respondent denies or exaggerates problems. Social desirability sets, exceptional scrupulousness, and misunderstandings can also affect ratings. Because of the variety of possible influences and because the items were selected to be meaningful in themselves, we did not add items designed to detect all such influences. We stress that scores should never be used to make clinical judgments in isolation from other information about the person and the respondent. Instead, the scores should always be compared with other data in order to identify major distortions and to determine the possible reasons for distortions. Extremely low or high Total Problems scores should always be followed up to determine whether they accurately reflect the respondent’s view. If extremely low or high Total Problems scores do reflect the respondent’s view, the user should then determine whether this view differs markedly from other people’s views of the person being assessed. In our answer to a previous question, we listed Total Problems scores that are so low as to invite further inquiry. The following Total Problems scores are so high as to raise questions about exaggeration or misunderstanding because these scores are higher than 98% of the scores in our factor analytic samples (described in Chapter 7): Total Problems scores >109 on the OASR, except >127 for 60- to 75-year-old women; and Total Problems scores >112 on the OABCL, except >126 for women over age 75.