Verifiability and Symptom Endorsement in Genuine, Exaggerated, and Malingered Pain

The current study has investigated whether pure malingering, in which reported symptoms are nonexistent, partial malingering, in which existent symptoms are exaggerated, and genuine symptoms could be differentiated by applying the verifiability approach (VA) and the Self-Report Symptom Inventory (SRSI). The logic behind the VA is that deceivers’ statements contain more non-verifiable information, whereas truth tellers’ accounts include more verifiable details. The SRSI taps into over-reporting by including a mix of genuine symptoms and implausible complaints (pseudosymptoms). We checked if participants (N = 167) allocated to one of three conditions (pure malingerers vs. exaggerators vs. truth tellers) can be differentiated in their pain symptom reports’ (non)verifiability and symptom endorsement. Findings revealed that deceptive reports were lengthier than truthful statements. However, this difference was not produced by a discrepancy in non-verifiable details, but rather by a higher production of verifiable information among malingerers and exaggerators. Thus, contrary to previous findings, our results indicate that pain reports rich in verifiable information should raise doubt about their veracity. Further, truth tellers endorsed less symptoms of the SRSI than exaggerators, but not than pure malingerers. Pure malingerers and exaggerators did not differ in symptom endorsement. Thus, our findings revealed that when compared with truth tellers, exaggerators exhibited stronger over-reporting tendencies than (pure) malingerers. However, due to inconsistent findings, further investigation of the efficacy of these methods in differentiation between exaggerated and malingered reports is required

The inventory of problems-29 is a cross‑culturally valid symptom validity test: Initial validation in a Turkish community sample

Because the actuarial evidence base for symptom validity tests (SVTs) is developed in a specific population, it is unclear whether their clinical utility is transferable to a population with different demographic characteristics. To address this, we report here the validation study of a recently developed free-standing SVT, the Inventory of Problems-29 (IOP-29), in a Turkish community sample. We employed a mixed design with a simulation paradigm: The Turkish IOP–29 was presented to the same participants (N = 125; 53.6% female; age range: 19–53) three times in an online format, with instructions to respond honestly (HON), randomly (RND), and attempt to feign a psychiatric disorder (SIM) based on different vignettes. In the SIM condition, participants were presented with one of three scripts instructing them to feign either schizophrenia (SIM-SCZ), depression (SIM-DEP), or posttraumatic stress disorder (SIM-PTSD). As predicted, the Turkish IOP–29 is effective in discriminating between credible and noncredible presentations and equally sensitive to feigning of different psychiatric disorders: The standard cutoff (FDS ≥ .50) is uniformly sensitive (90.2% to 92.9%) and yields a specificity of 88%. Random responding produces FDS scores more similar to those of noncredible presentations, and the random responding score (RRS) has incremental validity in distinguishing random responding from feigned and honest responding. Our findings reveal that the classification accuracy of the IOP–29 is stable across administration languages, feigned clinical constructs, and geographic regions. Validation of the Turkish IOP–29 will be a valuable addition to the limited availability of SVTs in Turkish. We discuss limitations and future directions

Seroprevalence of Toxoplasma gondii and Neospora spp. Infections in Arab Horses, Southwest of Iran

Background: Because of the economic importance of the Arab race horses and also the role of Toxoplasma gondii and Neospora spp. in abortion and reproductive failure of these animals, we decided to perform this study. Objectives: We designed this study to investigate the seroprevalence of anti-Toxoplasma gondii and anti-Neospora spp. antibodies in Arab horses from 12 cities of Khuzestan province in southwest of Iran. Materials and Methods: From October 2009 to March 2011, a total of 235 blood samples were collected from jugular veins of Arab horses of different ages and genders from 12 cities of Khuzestan province. All the sera were tested for anti-Toxoplasma antibodies using the modified agglutination test (MAT) and the existence of anti-Neospora antibodies were tested using N-MAT for Neospora spp. Results: According to the MAT results, antibodies to T. gondii were found in 114 (48.5%) of 235 sera with titers of 1:20 in 84, 1:40 in 19, 1:80 in four, 1:160 in four, and 1:320 in three horses. According to the N-MAT results, antibodies to Neospora spp. were found in 47 (20%) of 235 sera with titers of 1:40 in 39, 1:80 in five, and 1:160 in three horses. We did not observe any statistically significant differences regarding age groups and genders between seropositive and seronegative horses for Neospora spp. using chi-square (chi(2)) test, but it seemed that anti-Toxoplasma antibodies were more prevalent in older horses ( >= 10 years old). Conclusions: The results indicated that Arab horses are exposed to these parasites in southwest of Iran. Further research is required to determine the genomic structures of these parasites in Arab horses in southwest of Iran

Systemic versus localized coagulation activation contributing to organ failure in critically ill patients

In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation not only leads to activation of coagulation but coagulation also considerably affects inflammatory activity. The intricate relationship between inflammation and coagulation may not only be relevant for vascular atherothrombotic disease in general but has in certain clinical settings considerable consequences, for example in the pathogenesis of microvascular failure and subsequent multiple organ failure, as a result of severe infection and the associated systemic inflammatory response. Molecular pathways that contribute to inflammation-induced activation of coagulation have been precisely identified. Pro-inflammatory cytokines and other mediators are capable of activating the coagulation system and downregulating important physiological anticoagulant pathways. Activation of the coagulation system and ensuing thrombin generation is dependent on an interleukin-6-induced expression of tissue factor on activated mononuclear cells and endothelial cells and is insufficiently counteracted by physiological anticoagulant mechanisms and endogenous fibrinolysis. Interestingly, apart from the overall systemic responses, a differential local response in various vascular beds related to specific organs may occur