The development and classification accuracy of the life assessment questionnaire in the detection of pain-related malingering.

This paper describes three phases of the development and validation of the Life Assessment Questionnaire (LAQ), a multi-scale inventory for assessing potential malingering in adults reporting chronic pain. Study 1 involved scale construction and item analysis. Discriminant validity was investigated in Study 2 by comparing scores for the clinical reference group with participants instructed to simulate chronic pain. Study 3 examined the convergent validity of the LAQ with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Behavioral Assessment of Pain (BAP). Results revealed that the simulation groups scored significantly higher than the clinical reference group across all scales. Receiver operating characteristic analysis revealed sensitivity and specificity scores ranging from 0.44 to 0.57 and 0.88 to 0.93, respectively. Positive predictive power values ranged between 0.79 and 0.88. Strong convergent validity was found for the LAQ. These studies demonstrated the effectiveness of the LAQ in classifying individuals who feign pain complaints, supporting the utility of the LAQ for reaching conclusions about the presence of malingering.

Physician ratings of pain descriptors: potential diagnostic utility.

A large sample of staff physicians and residents (n = 193) responded to a questionnaire in which they were asked to rate 10 pain descriptors for level of applicability to 4 common acute and chronic pain syndromes. The purpose of the study was to examine the extent to which physicians would agree on the ratings, and whether they would rate the descriptors in a way that would permit discriminations to be made between the pain syndromes. Physicians' opinions regarding the usefulness of pain descriptors and the effect of several practice-related variables on the usage of pain descriptors were also assessed. The results showed that physicians agreed on the ratings of the descriptors within pain syndromes, and that they rated the descriptors in a way that discriminated between pain syndromes. The ratings were not affected by specialty training, experience with pain patients, or amount of specialized training in pain. Physicians with more training in pain, however, considered the diagnostic utility of pain descriptors higher. For all physicians, the diagnostic utility of pain descriptors was rated higher for acute than for chronic pain. Other comparisons between acute and chronic pain revealed that acute pain was rated by physicians as more painful and more interfering with mood and physical activity. The implications of these findings are discussed.