The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies

Journal article

[EN] Objective The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs. Methods We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020. Results Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed. Conclusions Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.Open access funding provided by Universita degli Studi di Padova within the CRUI-CARE Agreement. This work was supported by funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 777090.Monaro, M.; Baydal Bertomeu, JM.; Zecchinato, F.; Fietta, V.; Sartori, G.; De Rosario Martínez, H. (2021). The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies. International Journal of Legal Medicine. 135(5):2017-2032. https://doi.org/10.1007/s00414-021-02589-wS20172032135

Authors: Monaro, M; Bertomeu, CB; Zecchinato, F; Fietta, V; Sartori, G

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: International Journal of Legal Medicine
• Volume: 135
• Issue: 5
• Pages: 2017-2032
• Publication date: 2021-04-07
• Acceptance date: 2021-03-26
• DOI: 10.1007/s00414-021-02589-w
• EISSN: 1437-1596
• ISSN: 0937-9827
• Language: English
• Keywords: Pathology; Systematic review; MEDLINE; Human factors and ergonomics; Injury prevention; Political science; Context (archaeology); Medical emergency; Malingering; Occupational safety and health; Poison control; Psychology; Psychiatry; Whiplash; Medicine