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Biomedical subjects

B E McGuire

Publications and source records attributed to B E McGuire.

12 recordsLinked to original sources
PubMed2001

Pain patient profile and the assessment of malingered pain.

This study investigated whether a pain sample and pain simulators could be distinguished on the Pain Patient Profile (P3). Forty patients with a pain condition completed the P3 under normal instructions, while 20 students responded under instructions to feign a pain disorder but to attempt to avoid detection. The simulators did not differ on the P3 Validity Scale compared with the pain group, but scored significantly higher than the pain group on the P3 clinical scales (Depression, Anxiety, Somatization). The simulators were more likely to obtain an abnormal score (T score > 55) on all of the clinical scales. The Depression scale had highest positive and negative predictive power and correctly classified 80% of the participants. The P3 may be a useful screening tool for assessing those feigning pain but requires further research.

Adolescent↗
PubMed2001

Simulated pain on the Symptom Checklist 90-Revised.

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.

Adult↗
PubMed2001

Simulated malingering in pain patients: a study with the Pain Patient Profile.

OBJECTIVE: To investigate the utility of the Pain Patient Profile (P3) in detecting those who are faking or exaggerating complaints of pain while attempting to avoid detection. METHOD: A control group of pain patients ('Pain Controls'; PC; N = 62) was compared with a general clinical group who did not report pain but were instructed to simulate malingered pain ('General Rehabilitation Simulators', GR, N = 34); and a group whose primary problem was chronic pain who were instructed to exaggerate the extent of their pain and related problems ('Pain Simulators' PS; N = 26). RESULTS: Both groups of simulating participants reported significantly higher scores on all clinical scales (anxiety, depression, somatization) compared with non-simulating control participants and were more likely to obtain an abnormal T-score on the clinical scales. The validity scale was able to differentiate the PS group from the PC group, but the GR group was not differentiated from the PC group by the validity scale. CONCLUSIONS: The results indicate that with further study, the P3 may be a useful adjunct to the clinical assessment of symptom magnification in pain claimants.

Adult↗
PubMed2000

Intensive care unit syndrome: a dangerous misnomer.

The terms intensive care unit (ICU) syndrome and ICU psychosis have been used interchangeably to describe a cluster of psychiatric symptoms that are unique to the ICU environment. It is often postulated that aspects of the ICU, such as sleep deprivation and sensory overload or monotony, are causes of the syndrome. This article reviews the empirical support for these propositions. We conclude that ICU syndrome does not differ from delirium and that ICU syndrome is caused exclusively by organic stressors on the central nervous system. We argue further that the term ICU syndrome is dangerous because it impedes standardized communication and research and may reduce the vigilance necessary to promptly investigate and reverse the medical cause of the delirium. Directions for future research are suggested.

Cognition Disorders↗
PubMed2000

Suppressing and attending to pain-related thoughts in chronic pain patients.

Attempted suppression of pain-related thoughts was investigated in consecutive referrals for pain management (N = 39). Participants monitored their pain-related thoughts for three 5-min periods. In period 1, all participants were instructed to think about anything. For period 2, participants were instructed to either suppress pain-related thoughts, attend to pain-related thoughts, or to continue to think about anything. In period 3, all participants were again instructed to think about anything. Participants instructed to attend to their pain reported more pain-related thoughts than suppressors and controls in both periods 2 and 3. Suppressors experienced reduced pain-related thoughts during period 2. There was no immediate enhancement or delayed increase.

Adaptation, Psychological↗
PubMed1998

Malingering of memory impairment on the Colorado Priming Test.

OBJECTIVES: We hypothesized that simulated malingerers would show a weaker priming effect and a longer response latency than control patients and patients with a brain injury on a priming test. DESIGN: Participants were compared on their performance on the Colorado Priming Test to replicate and extend the original validation study. METHODS: Of 33 participants, 16 were people with a brain injury and 17 were non-head injured control patients who were also instructed to feign cognitive impairment (simulators N = 17). RESULTS: Up to 88 per cent of simulating malingerers and 75 per cent of head-injured participants were correctly classified. CONCLUSIONS: The Colorado Priming Test may be useful in identifying patients feigning memory impairment.

Adult↗
PubMed1995

Multiple personality disorder in an intellectually disabled man: a case report.

The case of a young man with the dual diagnoses of severe intellectual handicap (IQ 30 and mental age 4 years) and Multiple Personality Disorder is presented. The intellectual handicap is probably due to hypoxia in infancy and the Multiple Personality Disorder follows prolonged physical and sexual abuse. The patient frequently switches between any of nine discrete but incompletely formed identities. Although some personalities seem more capable than others, all have similar levels of disability on testing. The diagnosis of psychiatric disorders coexistent with the intellectual handicap is hindered by the difficulty in separating psychiatric phenomena from the behavioural disturbances associated with the disability. Differential diagnosis and management are discussed.

Adult↗
PubMed1994

Somatic sexual hallucinations and erotomanic delusions in a mentally handicapped woman.

A case of erotic delusion and concurrent somatic sexual hallucination is described in a 66-year-old mentally handicapped woman. The history, mental state and biological investigations convey the impression of erotomania, or de Clerambault's syndrome. Treatment with Pimozide has resulted in a remarkable improvement such that the patient has been symptom free for 8 months at the time of reporting. In the authors' opinion, the case lends support to the argument that erotomania exists as a mono-delusional disorder and is equivalent to the DSM-III-R classification of Paranoid Disorder, Erotomanic Type.

Aged↗