Assessment of malingering in chronic pain patients using neuropsychological tests

Validity checks into neuropsychological tests have been successful at detecting malingering in litigant patients with mild brain injury in recent years. This study expanded on these findings and examined whether 6 neuropsychological tests could be used to detect malingering in litigant (n = 55) and nonlitigant (n = 53) patients claiming cognitive deficits due to chronic pain. Encouraging findings were found. When patients were matched on age, gender, racial or ethnic background, years of education, and time postinjury, almost one third (29%) of patients in the litigant group failed 2 or more validity checks in these 6 neuropsychological tests versus none (0%) of the patients in the nonlitigant group. This result challenges the validity of some litigant patients who complain of cognitive deficits due to chronic pain. Furthermore, the findings suggest that neuropsychological assessments can be used as part of the assessment of chronic pain complainants. Further investigation of the validity markers in these 6 neuropsychological tests is recommended.