McGuire B E, Shores E A
Macquarie University, Sydney, Australia.
J Clin Psychol. 2001 Dec;57(12):1589-96. doi: 10.1002/jclp.1121.
This study investigated whether a pain clinical sample and pain simulators could be distinguished by their responses on the Symptom Checklist 90-Revised (SCL-90-R). Fifty patients with a pain condition completed the SCL-90-R under normal instructions while 20 students responded under instructions to feign a pain disorder to obtain compensation but to attempt to avoid detection. Pain patients obtained generalized elevations, with the highest scores on Depression, Obsessive-Compulsive, and Somatization. The simulators exceeded the pain group on all clinical scales of the SCL-90-R, tending to greatly overestimate the degree of psychological distress in pain patients. Simulators had extreme elevations and were more likely to obtain a T score greater than 70 on each of the clinical scales. Sensitivity, specificity, positive and negative predictive power values, and optimal diagnostic cutoff scores for the clinical scales are reported. The recommended Positive Symptom Total (PST) cutoff score for "faking bad" in the SCL manual had poor specificity. The SCL-90-R warrants further study as an aid to identifying pain simulation.
本研究调查了疼痛临床样本和疼痛模拟器是否能通过其在症状自评量表90修订版（SCL - 90 - R）上的反应加以区分。五十名患有疼痛疾病的患者在正常指导下完成了SCL - 90 - R测试，而二十名学生在指导下假装患有疼痛障碍以获取赔偿，但试图避免被发现。疼痛患者的各项得分普遍升高，在抑郁、强迫和躯体化方面得分最高。模拟器在SCL - 90 - R的所有临床量表上的得分均超过了疼痛组，倾向于极大地高估疼痛患者的心理困扰程度。模拟器的得分极高，更有可能在每个临床量表上获得大于70的T分。报告了各临床量表的敏感性、特异性、阳性和阴性预测力值以及最佳诊断临界分数。SCL手册中推荐的用于“假装病情严重”的阳性症状总分（PST）临界分数特异性较差。SCL - 90 - R作为识别疼痛模拟的辅助工具值得进一步研究。
