Psychometrics for Detecting Pain-Related Malingering

Malingering in chronic pain patients, especially when significant incentives are present, is a substantial problem. Recent advances in understanding malingered pain and assessment techniques have contributed to improved accuracy in classifying patients who are malingering. This is especially true in the field of neuropsychological assessment and psychometric testing. Clinicians now have available tools to effectively screen for feigning and for determining the likelihood of malingering when assessing chronic pain patients. The detection of malingering depends on choosing validated detection strategies to determine the likelihood of feigning. The presence of utility measures (e.g., positive predictive power) and empirically derived cut scores is critical in the decision-making process. Diagnosing malingering requires reaching conclusions about motivation and eliminating all alternative explanations. The application of ethical principles in the use of psychological tests to determine malingering is paramount.