Analysis of malingered psychological symptoms in a clinical sample for early detection in initial interviews, 2022, Barbosa-Torres et al

Abstract

Malingering consists of the production of false physical or psychological symptoms motivated by external incentives that are normally reproduced in pathologies that are not related to organic origin or there are no laboratory tests for their diagnosis, as is the case of mixed anxiety–depressive disorder and fibromyalgia syndrome. The objective of this research consisted of comparing the profile of simulative patients with fibromyalgia and mixed anxiety–depressive disorder to obtain a profile and facilitate its detection in initial interviews. The research was carried out with 78 patients (42 patients with fibromyalgia and 36 patients with mixed anxiety–depressive disorder) who were administered the professional's structured clinical judgment, the Beck Depression Inventory, the State-Trait Anxiety Questionnaire, and the Structured Symptom Simulation Inventory.

The main obtained results show that the simulation classification proposed by the questionnaire is in the range of 66.67–80% with regard to coinciding with the judgment of experts, and people with suspicion of simulation of both groups of patients present similar characteristics. The simulators thus present incongruous responses in relation to the questionnaires, and high levels of trait anxiety, state, and depression predict the simulation of symptoms.

Open access, https://link.springer.com/article/10.1007/s00406-022-01422-8

 

Trying to make sense of this nonsense, there are so many bizarre claims and blatant assertions of ignorance, but what this appears to me is to build up BS evidence that it's possible to check for simulated symptoms to use in a court setting and reject claims. Which is in a way bizarre since the way they "check" for simulated symptoms is a small bunch of questionnaires, not exactly an expensive or time-consuming process.

Basically they compare suspicions of malingering with a set of questionnaires for malingering, then do a bunch of fuzzy maths on those guesstimates and confirm that this dowsing rod was validated with this other dowsing rod (to 66-80% accuracy) and that means that not only are dowsing rods effective, but dowsing rod experts' predictions of where a dowsing rod will point down are 66-80% just as good/bad at actually using the dowsing rod.

Also: symptoms are associated with symptoms. Truly groundbreaking stuff. In other news: fibromyalgia does not have cognitive symptoms, which would be news to fibromyalgia sufferers, who will then be assured that their reports of "fibro fog" can't be true because some people said so.

The race to the intellectual bottom leads to an ethical bottom as well. It's easy to be disappointed in how many very smart people wasted their intellect trying to automate trading and extract value out of milliseconds of time lag, but this is far worse. It's equal intellectual bankruptcy as moral bankruptcy. It hurts just as many people in the end.

 

That seems to show that a patient being labelled as malingerer may just mean that they don't have a normative symptom profile. Which could easily occur due to for example the patient having one diagnosed illness and one undiagnosed one, giving the impression that the patient has more symptoms than they should have, and that some symptoms are not typical for their diagnosis.

 

Once again, do surface/minor biomedical testing. These tests don't indicate a problem.

These patients are not viewed as worth the cost of more in-depth investigations.

Then put them through questionnaires and an interview to help "confirm" initial suspicions that the patients are liars.

 

I can think of two patients who were judged attention seeking, malingering, or making a big deal out of symptoms. Both were fobbed off. One had leukemia and died shortly after finally getting a diagnosis. The other also had a life threatening condition. After medical system goof ups and dismissals, they finally received much delayed treatment.

 

How is there endless funding for this psychobabble?

 

You would not rely on a paper written by people capable of producing that first sentence. Perhaps it did not translate well from the Spanish.

 

It's because governments want the cheaper option which is to label patients with unexplained physical disorders as being malingerers and hypochondriacs rather than spending a £100,000,000 a year in research and paying for testing/benefits/housing/social care.