Distinguishing Feigned From Sincere Performance in Psychophysical Pain Testing

Area of Science:

• Pain research
• Psychophysics
• Deception detection

Background:

• Self-report is the gold standard for pain assessment but lacks methods to detect dishonesty.
• Incentivized pain deception poses challenges for accurate diagnosis and management.
• Novel approaches are needed to identify feigned pain reports in clinical and research settings.

Purpose of the Study:

• To develop and validate a novel method for detecting dishonesty in psychophysical pain testing.
• To analyze performance patterns differentiating sincere from feigned pain reports.
• To assess the utility of sensory interference in enhancing deception detection accuracy.

Main Methods:

• Measured warmth sensation threshold (WST) and heat pain threshold (HPT) in healthy individuals under sincere and feigned pain conditions.
• Analyzed repeatability and variability indices of performance.
• Introduced sensory interference during HPT measurement in a separate cohort to evaluate its impact on deception detection.

Main Results:

• Feigned pain reports showed significantly increased WST and decreased HPT compared to sincere reports.
• Repeatability and variability indices were initially indistinguishable between conditions.
• With sensory interference, feigned pain reports exhibited significantly higher variability and poorer repeatability, achieving 83% sensitivity and 84% specificity in distinguishing deception.

Conclusions:

• A novel method analyzing psychophysical performance patterns can detect dishonesty in pain reporting.
• Sensory interference significantly improves the ability to distinguish feigned from sincere pain reports.
• This approach holds potential for identifying chronic pain malingering in contexts with incentives to deceive.