Malingering and Illness Deception
About: This article is published in European Journal of Neurology.The article was published on 2004-03-01. It has received 18 citations till now. The article focuses on the topics: Malingering & Deception.
Citations
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TL;DR: Current medical models assume that all illness is secondary to disease, but revision is needed to explain illnesses without disease and improve organisation of health care.
Abstract: Current medical models assume that all illness is secondary to disease. Revision is needed to explain illnesses without disease and improve organisation of health care
441 citations
TL;DR: Results provide evidence for the greater efficacy of suggestion following a hypnotic induction and indicate direct involvement of a network of areas widely associated with the pain ‘neuromatrix’ in fibromyalgia pain experience.
146 citations
Cites background from "Malingering and Illness Deception"
...A network of cortical regions, including the anterior cingulate cortex (ACC), insula, prefrontal regions and primary (S1) and secondary (S2) somatosensory cortices, mediates pain experience (Apkarian et al., 2005; Derbyshire, 1999, 2000, 2003; Treede et al., 1999)....
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...Volitional responses to the demands of the experiment might be expected to activate supervisory neural structures such as the prefrontal cortex and medial ACC (Spence et al., 2003; Oakley et al., 2003)....
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TL;DR: Both accounts, verbal report as important but missing cue as well as an alerted cheating detection device, could account for underestimation of patients' pain.
Abstract: Two important influences on pain underestimation by health care professionals were investigated by varying specific cues with reference to underestimation of patients' pain: when observers are not allowed to talk to patients and when observers expect social cheating. One hundred and twenty health care professionals watched videotaped facial expressions of pain patients and estimated their pain. The first group only saw the faces, the second group was given patients' self-reports in addition and the last group was given a context cue priming them to expect cheating in addition to faces and patients' ratings. Health care professionals generally underestimated patients' pain, but this varied depending on the cues given. Those viewing the face without patients' ratings underestimated pain to a greater extent than health care professionals provided with patients' ratings. Health care professionals primed to expect cheating underestimated pain as much as those seeing only patients' faces. Therefore, both accounts, verbal report as important but missing cue as well as an alerted cheating detection device, could account for underestimation.
129 citations
Cites background from "Malingering and Illness Deception"
...This is a particular issue with subjectively reported disorders with no obvious confirming signs: health care professionals tend to suspect ‘secondary gain’ such as unwarranted absence from work, or prescription of opioids (Halligan et al., 2003)....
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TL;DR: Advances in neuroimaging techniques may be key in better understanding the meaning of border zone SVT failure, and a better understanding of how certain types of neurological, neuropsychiatric and/or even test conditions may affect SVT performance is needed.
Abstract: Background: To understand the neurocognitive effects of brain injury, valid neuropsychological test findings are paramount.Review: This review examines the research on what has been referred to a symptom validity testing (SVT). Above a designated cut-score signifies a ‘passing’ SVT performance which is likely the best indicator of valid neuropsychological test findings. Likewise, substantially below cut-point performance that nears chance or is at chance signifies invalid test performance. Significantly below chance is the sine qua non neuropsychological indicator for malingering. However, the interpretative problems with SVT performance below the cut-point yet far above chance are substantial, as pointed out in this review. This intermediate, border-zone performance on SVT measures is where substantial interpretative challenges exist. Case studies are used to highlight the many areas where additional research is needed. Historical perspectives are reviewed along with the neurobiology of effort. R...
86 citations
Cites background from "Malingering and Illness Deception"
...[26] begin their edited treatise with an overview of the commonness of deception at all levels of human behaviour as well as throughout the animal kingdom....
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TL;DR: Results support the use of social contract theory as a theoretical framework to explore pain judgements: high pain self-reports and stopping all tasks led to high pain estimates; pain was estimated to be lowest when characters stopped disliked but continued with liked tasks.
Abstract: Observer underestimation of others' pain was studied using a concept from evolutionary psychology: a cheater detection mechanism from social contract theory, applied to relatives and friends of chronic pain patients. 127 participants estimated characters' pain intensity and fairness of behaviour after reading four vignettes describing characters suffering from pain. Four cues were systematically varied: the character continuing or stopping liked tasks; continuing or stopping disliked tasks; availability of medical evidence; and pain intensity as rated by characters. Results revealed that pain intensity and the two behavioural variables had an effect on pain estimates: high pain self-reports and stopping all tasks led to high pain estimates; pain was estimated to be lowest when characters stopped disliked but continued with liked tasks. This combination was also rated least fair. Results support the use of social contract theory as a theoretical framework to explore pain judgements.
36 citations
Cites background from "Malingering and Illness Deception"
...…weight given to medical evidence by health care professionals (Chibnall and Tait 1999) who may tend, in the absence of supporting evidence for pain, to suspect cheating, i.e. behaviour intended to obtain such benefits as sanctioned absence from work, or receipt of opioids (Halligan et al. 2003)....
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...behaviour intended to obtain such benefits as sanctioned absence from work, or receipt of opioids (Halligan et al. 2003)....
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References
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TL;DR: Current medical models assume that all illness is secondary to disease, but revision is needed to explain illnesses without disease and improve organisation of health care.
Abstract: Current medical models assume that all illness is secondary to disease. Revision is needed to explain illnesses without disease and improve organisation of health care
441 citations
TL;DR: Results provide evidence for the greater efficacy of suggestion following a hypnotic induction and indicate direct involvement of a network of areas widely associated with the pain ‘neuromatrix’ in fibromyalgia pain experience.
146 citations
TL;DR: Both accounts, verbal report as important but missing cue as well as an alerted cheating detection device, could account for underestimation of patients' pain.
Abstract: Two important influences on pain underestimation by health care professionals were investigated by varying specific cues with reference to underestimation of patients' pain: when observers are not allowed to talk to patients and when observers expect social cheating. One hundred and twenty health care professionals watched videotaped facial expressions of pain patients and estimated their pain. The first group only saw the faces, the second group was given patients' self-reports in addition and the last group was given a context cue priming them to expect cheating in addition to faces and patients' ratings. Health care professionals generally underestimated patients' pain, but this varied depending on the cues given. Those viewing the face without patients' ratings underestimated pain to a greater extent than health care professionals provided with patients' ratings. Health care professionals primed to expect cheating underestimated pain as much as those seeing only patients' faces. Therefore, both accounts, verbal report as important but missing cue as well as an alerted cheating detection device, could account for underestimation.
129 citations
TL;DR: Advances in neuroimaging techniques may be key in better understanding the meaning of border zone SVT failure, and a better understanding of how certain types of neurological, neuropsychiatric and/or even test conditions may affect SVT performance is needed.
Abstract: Background: To understand the neurocognitive effects of brain injury, valid neuropsychological test findings are paramount.Review: This review examines the research on what has been referred to a symptom validity testing (SVT). Above a designated cut-score signifies a ‘passing’ SVT performance which is likely the best indicator of valid neuropsychological test findings. Likewise, substantially below cut-point performance that nears chance or is at chance signifies invalid test performance. Significantly below chance is the sine qua non neuropsychological indicator for malingering. However, the interpretative problems with SVT performance below the cut-point yet far above chance are substantial, as pointed out in this review. This intermediate, border-zone performance on SVT measures is where substantial interpretative challenges exist. Case studies are used to highlight the many areas where additional research is needed. Historical perspectives are reviewed along with the neurobiology of effort. R...
86 citations
TL;DR: Findings suggest that with increased age, participants became increasingly sophisticated in their use of display rule knowledge to conceal their deception.
31 citations