Symptom and complaint validation of chronic pain in social medical evaluation. Part I: Terminological and methodological approaches

Chronic pain accompanied by disability and handicap is a frequent symptom necessitating medical assessment. Current guidelines for the assessment of malingering suggest discrimination between explanatory demonstration, aggravation and simulation. However, this distinction has not clearly been put into operation and validated. The necessity of assessment strategies based on general principles of psychological assessment and testing is emphasized. Standardized and normalized psychological assessment methods and symptom validation techniques should be used in the assessment of subjects with chronic pain problems. An adaptive procedure for assessing the validity of complaints is suggested to minimize effort and costs.