Distinguishing Feigned from Sincere Performance in Psychophysical Pain Testing

Aaron Kucyi, Aviv Scheinman, Ruth Defrin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Self-report, the most widely used, gold standard measurement of pain, is crucial for pain research, diagnosis, and management. However, there are no accurate, reliable methods for detecting dishonesty in self-reports when there is incentive for pain deception. We introduce a novel approach to detecting pain deception by analyzing performance patterns of honest and dishonest psychophysical pain testing. Warmth sensation threshold (WST) and heat pain threshold (HPT) were measured in healthy individuals (N = 37) under 2 conditions: standard instruction (ie, provide sincere reports) and instructions to simulate intense pain (ie, provide feigned reports) with the intention of deceiving. In the feigned compared with sincere condition, participants had significantly increased WST and decreased HPT. Repeatability and variability indices were indistinguishable between conditions. In a second, separate cohort (N = 24), measurements were repeated with the addition of a sensory interference to influence task performance. When sensory interference during HPT measurement was introduced, feigned pain reports had significantly higher variability and poorer repeatability compared with sincere reports and were distinguishable from sincere reports, with high sensitivity (83%) and specificity (84%). The statistical properties of psychophysical performance under sensory interference provide a method for identifying feigned performance and could be applied to evaluations of pain malingering. Perspective This article introduces a method to detect whether individuals are being dishonest in psychophysical pain testing. The method could help clinicians to detect chronic pain malingering in contexts in which there is incentive to deceive.

Original languageEnglish
Pages (from-to)1044-1053
Number of pages10
JournalJournal of Pain
Issue number10
StatePublished - 1 Oct 2015


  • Key words Malingering
  • lie detection
  • pain psychophysics
  • sensory interference


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