Skip to main content
Log in

Diagnosing Malingering in Chronic Pain

  • Published:
Psychological Injury and Law Aims and scope Submit manuscript

Abstract

Psychosocial factors are commonly present in cases involving chronic pain. There are numerous risks associated with unnecessary medical treatment and societal burdens associated with unwarranted disability compensation. A published system for the diagnosis of malingering pain-related disability (Bianchini, Greve, & Glynn, 2005, The Clinical Neuropsychologist, 20, 831–847) provides a framework for evaluating multiple sources of data in making decisions about the likelihood that intentional exaggeration may be present and differentiating malingering from other psychosocial factors. The application of the Bianchini et al. (The Clinical Neuropsychologist, 20, 831–847, 2005) system in chronic pain cases is illustrated, with an emphasis on integrating multiple sources of information.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: APA.

    Google Scholar 

  • Bianchini, K. J., Curtis, K. L., & Greve, K. W. (2006). Compensation and malingering in TBI: a dose-response relationship? The Clinical Neuropsychologist, 20, 831–847.

    Article  PubMed  Google Scholar 

  • Bianchini, K. J., Etherton, J. L., & Greve, K. W. (2004). Diagnosing cognitive malingering in patients with work-related pain: four cases. Journal of Forensic Neuropsychology, 4, 65–85.

  • Bianchini, K. J., Greve, K. W., & Glynn, G. (2005). On the diagnosis of malingered pain-related disability: lessons from cognitive malingering research. The Spine Journal, 5, 404–417.

  • Bianchini, K. J., Etherton, J. L., Greve, K. W., Heinly, M. T., & Meyers, J. E. (2008). Classification accuracy of MMPI-2 validity scales in the detection of pain-related malingering: a known-groups study. Assessment, 15, 435–449.

    Article  PubMed  Google Scholar 

  •  Boden, S. D., Davis, D. O., Dina, T. S., Patronas, N. J., & Wiesel, S. W. (1990). Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. Journal of Bone and Joint Surgery, 72, 403–408.

    PubMed  Google Scholar 

  • Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: an integrative conceptual model. Psychological Bulletin, 130, 793–812.

    Article  PubMed  Google Scholar 

  • Cassidy, J. D., Carroll, L., Cote, P., Berglund, A., & Nygren, A. (2003). Low back pain after traffic collisions: a population-based cohort study. Spine, 15, 1002–1009.

    Google Scholar 

  • Chafetz, M., & Underhill, J. (2013). Estimated costs of malingered disabiity. Archives of Clinical Neuropsychology, 28, 633–639.

  • Dansak, D. (1973). On the tertiary gain of illness. Comprehensive Psychiatry, 14, 523–534.

    Article  PubMed  Google Scholar 

  • Daubert vs. Merrell Dow Pharmaceuticals, Inc., 509 U. S. 579 (1993). 

  • Gatchel, R. J. (2004a). Comorbidity of chronic pain and mental health: the biopsychosocial perspective. American Psychologist, 59, 792–794.

    Article  Google Scholar 

  • Gatchel, R. J. (2004b). Psychosocial factors that can influence the self-assessment of function. Journal of Occupational Rehabilitation, 14, 197–206.

    Article  PubMed  Google Scholar 

  • Gatchel, R. J., Polatin, P. B., & Kinney, R. K. (1995). Predicting outcome of chronic back pain using clinical predictors of psychopathology: a prospective analysis. Health Psychology, 14, 415–420.

    Article  PubMed  Google Scholar 

  • Gervais, R. O., Green, P., Allen, L. M., & Iverson, G. L. (2001). Effects of coaching on symptom validity testing in chronic pain patients presenting for disability assessment. Journal of Forensic Neuropsychology, 2, 1–19.

    Article  Google Scholar 

  • Green, P., Allen, L. M., & Astner, K. (1996). The word memory test: a user’s guide to the oral and computer-administered forms, US version. Durham, NC: CogniSyst, Inc.

    Google Scholar 

  • Greve, K. W., & Bianchini, K. J. (2004). Setting empirical cut-offs on psychometric indicators of negative response bias: a methodological commentary with recommendations. Archives of Clinical Neuropsychology, 19, 533–541.

    Article  PubMed  Google Scholar 

  • Greve, K. W., Bianchini, K. J., Etherton, J. L., Meyers, J. E., Curtis, K. L., & Ord, J. S. (2010). The Reliable Digit Span test in chronic pain: classification accuracy in detecting malingered pain-related disability. The Clinical Neuropsychologist, 24, 137–152.

    Article  PubMed  Google Scholar 

  • Greve, K. W., Bianchini, K. J., Etherton, J. L., Ord, J. S., & Curtis, K. L. (2009a). Detecting malingered pain-related disability: classification accuracy of the portland digit recognition test. The Clinical Neuropsychologist, 23, 850–869.

    Article  PubMed  Google Scholar 

  • Greve, K. W., Etherton, J. L., Ord, J., Bianchini, K. J., & Curtis, K. (2009b). Detecting malingered pain-related disability: classification accuracy of the test of memory malingering. The Clinical Neuropsychologist, 23, 1250–1271.

    Article  PubMed  Google Scholar 

  • Greve, K. W., Ord, J. S., Bianchini, K. J., & Curtis, K. L. (2009c). Prevalence of malingering in patients with chronic pain referred for psychological evaluation in a medico-legal context. Archives of Physical Medicine and Rehabilitation, 90, 1117–1126.

    Article  PubMed  Google Scholar 

  • Harris, I., Mulford, J., Solomon, M., van Gelder, J. M., & Young, J. (2005). Association between compensation status and outcome after surgery: a meta-analysis. Journal of the American Medical Association, 293, 1644–1652.

    Article  PubMed  Google Scholar 

  • Iverson, G. L., King, R. J., Scott, J. G., & Adams, R. L. (2001). Cognitive complaints in litigating patients with head injuries or chronic pain. Journal of Forensic Neuropsychology, 2, 219–230.

    Article  Google Scholar 

  • Iverson, G., & McCracken, L. M. (1997). “Postconcussive” symtoms in persons with chronic pain. Brain Injury, 11, 783–790.

    Article  PubMed  Google Scholar 

  • Kay, N. R., & Morris-Jones, H. (1998). Pain clinic management of medico-legal litigants. Injury, 29, 305–308.

    Article  PubMed  Google Scholar 

  • Kwan, O., Ferrari, R., & Friel, J. (2001). Tertiary gain and disability syndromes. Medical Hypotheses, 57, 459–464.

    Article  PubMed  Google Scholar 

  • Larrabee, G. L. (1998). Somatic malingering on the MMPI and MMPI-2 in litigating subjects. The Clinical Neuropsychologist, 12, 179–188.

    Article  Google Scholar 

  • Larrabee, G. J. (2003). Exaggerated MMPI-2 symptom report in personal injury litigants with malingered neurocognitive deficit. Archives of Clinical Neuropsychology, 18, 673–686.

    Article  PubMed  Google Scholar 

  • Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157–169.

    Article  PubMed  Google Scholar 

  • Mittenberg, W., Patton, C., Canyock, E. M., & Condit, D. C. (2002). Baserates of malingering and symptom exaggeration. Journal of Clinical and Experimental Neuropsychology, 24, 1094–1102.

    Article  PubMed  Google Scholar 

  • Rogers, R. (1997). Clinical assessment of malingering and deception (2nd ed.). New York: Guilford.

    Google Scholar 

  • Rohling, M. L., Binder, L. M., & Langhinrichsen-Rohling, J. (1996). Money matters: A meta-analytic review of the association between financial compensation and the experience and treatment of chronic pain. Health Psychology, 14, 537–547.

    Article  Google Scholar 

  • Slick, D. J., Sherman, E. M. S., & Iverson, G. L. (1999). Diagnostic criteria for malingering cognitive dysfunction: proposal standards for clinical practice and research. The Clinical Neuropsychologist, 13, 545–561.

  • Tombaugh, T. (1996). Test of Memory Malingering (TOMM). North Tonawanda, NY: Multi Health Systems.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph L. Etherton.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Etherton, J.L. Diagnosing Malingering in Chronic Pain. Psychol. Inj. and Law 7, 362–369 (2014). https://doi.org/10.1007/s12207-014-9208-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12207-014-9208-9

Keywords

Navigation