OBJECTIVE: To provide an empirical estimate of the prevalence of malingered disability in patients with chronic pain who have financial incentive to appear disabled. DESIGN: Retrospective review of cases. SETTING: A private neuropsychologic clinic in a southeastern metropolitan area. PARTICIPANTS: Consecutive patients (N=508) referred for psychologic evaluation related to chronic pain over a 10-year period (1995-2005). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence of malingering was examined using 2 published clinical diagnostic systems (Malingered Pain-Related Disability and Malingered Neurocognitive Dysfunction) as well as statistical estimates based on well validated indicators of malingering. RESULTS: The prevalence of malingering in patients with chronic pain with financial incentive is between 20% and 50% depending on the diagnostic system used and the statistical model's underlying assumptions. Some factors associated with the medico-legal context such as the jurisdiction of a workers' compensation claim or attorney representation were associated with slightly higher malingering rates. CONCLUSIONS: Malingering is present in a sizable minority of patients with pain seen for potentially compensable injuries. However, not all excess pain-related disability is a result of malingering. It is important not to diagnose malingering reflexively on the basis of limited or unreliable findings. A diagnosis of malingering should be explicitly based on a formal diagnostic system.
OBJECTIVE: To provide an empirical estimate of the prevalence of malingered disability in patients with chronic pain who have financial incentive to appear disabled. DESIGN: Retrospective review of cases. SETTING: A private neuropsychologic clinic in a southeastern metropolitan area. PARTICIPANTS: Consecutive patients (N=508) referred for psychologic evaluation related to chronic pain over a 10-year period (1995-2005). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence of malingering was examined using 2 published clinical diagnostic systems (Malingered Pain-Related Disability and Malingered Neurocognitive Dysfunction) as well as statistical estimates based on well validated indicators of malingering. RESULTS: The prevalence of malingering in patients with chronic pain with financial incentive is between 20% and 50% depending on the diagnostic system used and the statistical model's underlying assumptions. Some factors associated with the medico-legal context such as the jurisdiction of a workers' compensation claim or attorney representation were associated with slightly higher malingering rates. CONCLUSIONS: Malingering is present in a sizable minority of patients with pain seen for potentially compensable injuries. However, not all excess pain-related disability is a result of malingering. It is important not to diagnose malingering reflexively on the basis of limited or unreliable findings. A diagnosis of malingering should be explicitly based on a formal diagnostic system.
Authors: Joukje Oosterman; Laura C Derksen; Albert J M van Wijck; Roy P C Kessels; Dieuwke S Veldhuijzen Journal: Pain Res Manag Date: 2012 May-Jun Impact factor: 3.037
Authors: Esteban Puente-López; David Pina; Reyes López-López; Héctor González Ordi; Irena Bošković; Thomas Merten Journal: Psychol Inj Law Date: 2022-07-26
Authors: Merylin Monaro; Andrea Toncini; Stefano Ferracuti; Gianmarco Tessari; Maria G Vaccaro; Pasquale De Fazio; Giorgio Pigato; Tiziano Meneghel; Cristina Scarpazza; Giuseppe Sartori Journal: Front Psychiatry Date: 2018-06-08 Impact factor: 4.157