Relationship Between Performance Validity Testing, Disability Status, and Somatic Complaints in Patients With Fibromyalgia

Abstract

Fibromyalgia is a chronic pain-related disorder that typically includes cognitive complaints as well as non-specific somatic complaints, such as fatigue and sleep disturbance (Wolfe et al., 2010). Fibromyalgia has also been shown to be associated with a high rate of failure on performance validity testing (PVT), which has not been examined with respect to other self-reported symptoms that are now part of the diagnostic criteria for the disorder. We evaluated 85 patients with fibromyalgia who completed objective measures of pain, sleep, and fatigue along with symptom validity measures (Word Memory Test or Test of Memory Malingering and Reliable Digit Span). Three groups were formed based on effort testing: Two PVTs Failed, One PVT Failed, and No PVTs Failed. We also formed three groups based on disability status: On Disability, Applying for Disability, and Not on Disability. A total of 37% of the patients failed one or both PVTs. PVT group analyses were significant for daily pain, weekly pain, and sleep, but not fatigue. Disability status analyses were significant for daily pain, weekly pain, and fatigue, but not sleep. The implication of this study is that PVT performance and disability status are associated with exaggeration of non-cognitive symptoms such as pain, sleep, and fatigue in persons with fibromyalgia. This study reinforces the importance of effort testing when working with medical populations.

Einsatz des Beschwerdenvalidierungstests BEVA in der sozialmedizinischen Begutachtung

“…Bspw. im Kontext der Erwerbsminderungsrente sind negative Antwortverzerrungen der Untersuchten nicht auszuschließen, da von der Beschwerdendarstellung eine Rentenzahlung abhängt [2,3]. Die Beurteilung der Symptome sowie deren Schweregrad werden anhand der Beschreibungen des Untersuchten eingeschätzt.…”

Todd’s Syndrome: An Arabic Single Case of Prolonged Motor Impairment Presentation with Neuropsychological Tests Validation

“…Use of SVTs is generally recommended in evaluations of individuals with medically unexplained symptoms that include cognitive impairment (e.g. cognitive symptoms related to concentration, memory, or slowed thinking in patients with fibromyalgia or other medically unexplained pain syndromes) [8,9]. This can equally apply to motor impairment with no physical abnormality evident.…”

Symptom over-reporting ≠ malingering

“…For instance, Dandachi-FitzGerald, Ponds, Peters, and Merckelbach (2011) reported a prevalence of 10-30% among psychiatric outpatients. Comparable rates have been found among patients with vague physical and neurological symptoms that are diagnosed with labels such as fibromyalgia and persistent mild head injury (e.g., see Johnson-Greene, Brooks, & Ference, 2013;Stulemeijer, Andriessen, Brauer, Vos, & van Der Werf, 2007). Unfortunately, clinical judgment is a suboptimal tool for distinguishing between valid and non-valid symptom presentations.…”

“…Another issue that warrants attention relates to the interpretation of deviant SVT scores. Within medicolegal contexts, claims of medically unexplained symptoms -i.e., MUS -are widespread and SVT failure is not uncommon in disability-seeking patients with diagnoses that can be conceptualized as medically unexplained in nature, such as fibromyalgia, mild-traumatic brain injury, and whiplash injury (Johnson-Greene, Brooks, & Ference, 2013;Schmand et al, 1998;Stulemeijer, Andriessen, Brauer, Vos, & Van Der Werf, 2007). The conceptualization of malingered and hysterical symptoms as mutually distinct phenomena places clinicians who see these patients in a diagnostically but also morally difficult area.…”

“…Detection of malingered MVA related posttraumatic stress disorder: An investigation of the ability to detect professional actors by experienced clinicians, psychological tests and psychophysiological assessment. Journal of Forensic Psychology Practice, 2, 33-53. doi:10.1300/J158v02n01_02Johnson-Greene, D.,Brooks, L., & Ference, T. (2013). Relationship between performance validity testing, disability status, and somatic complaints in patients with fibromyalgia.…”