Emory Inconsistency Profile

Findings associated with malingering:

(1) A complete absence of objective findings for organic pathology.

(2) Complaints that are overly dramatic and which do not fit any anatomic or physiologic pattern.

(3) The presence of logical inconsistencies between statements or between statements and behaviors.

(4) The patient is resistive to be evaluated for his or her ability to work or for a complete assessment of his or her medical difficulties, despite claiming that he or she wants to find the cause of the pain.

(5) Responses to diagnostic nerve blocks to not fit any predictable physiologic, pharmacologic or anatomic pattern.

(6) An increase in pain complaints while reporting improvement in other aspects of a pain rehabilitation program.

(7) Rewards for malingering compare favorably with alternative rewards (incentive for malingering identified).

(8) A history of manipulative behaviors.

(9) Discrepancies between reports of the patient and the spouse regarding pain behavior at home.

(10) Unprompted expressions of desire to work, inconsistent with behavior.

(11) Unprompted denial of malingering.

(12) Inappropriate flat or histrionic (dramatic) affect.

(13) The presence of certain patterns in Minnesota-Multiphasic Personality Inventory (MMPI).

Patterns in the MMPI:

(1) extreme elevations in 1 or more of the following scales: lie (L), defensiveness (K), hypochondriasis (Hs).

(2) extreme number of bizarre psychological complaints (high score in scale F)

(3) high psychopathic deviance scale score (Pd)

(4) inconsistencies in responses to repeated items on the MMPI

(5) all scores are well above normal despite reports of continuing, severe, and disabling pain.

Interpretation:

• The presence of one or more of these traits may indicate some degree of malingering.

• The findings of the profile should be combined with other evidence before a person is identified as a malingerer. A person should not be classed as a malingerer based on a single bit of evidence.