Development of Cut Scores for Feigning Spectrum Behavior on the Orebro Musculoskeletal Pain Screening Questionnaire and the Perceived Stress Scale: A Simulation Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measures
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Demographic Differences
3.2. Analysis of Covariance Between Conditions
3.3. Short-Term Test-Retest Reliability
3.4. Receiver Operator Characteristics
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
FSB | Feigning spectrum behavior |
SF | Short form |
OMPSQ | Orebro musculoskeletal pain screening questionnaire |
PSS | Perceived stress scale |
PSS-4 | Perceived stress sale–4 item |
ANCOVA | Analysis of covariance |
AUC | Area under the curve |
ROC | Receiver operator characteristics |
MMPI | Minnesota multiphasic personality inventory |
RF | Restructured format |
TOMM | Test of memory malingering |
IW | Injured workers |
CS | Community sample |
CSS | Community sample simulating |
CSG | Community sample genuine responding |
BFCT | Brief forced choice test |
Sn | Sensitivity |
Sp | Specificity |
PPP | Positive predictive power |
NPP | Negative predictive power |
SD | Standard deviation |
Min | Minimum |
Max | Maximum |
N/A | Not applicable |
Sig. | Significance |
Appendix A
Targe Words | Foil |
Cat | Rat |
Boat | Coat |
Rope | Hope |
Van | Can |
Book | Look |
Hotel | Motel |
Moose | Goose |
Boot | Shoot |
Pig | Jig |
Tango | Mango |
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Variable | Injured Workers | Community Sample |
---|---|---|
N | 40 | 40 |
Age (SD, Median, IQR, Max and Min) | 41.575 (12.226, 39, 18, Min = 18 Max = 66) | 34.95 (14.016, 28, 24, Min = 19 Max = 72) * |
Gender: Male/Female | 33 (82.5%)/7 (17.5%) | 9 (22.5%)/31 (77.75%) * |
Professional with Degree | 5 (12.5%) | 14 (25%) |
Qualified Trades (mechanics, chefs, etc.) | 14 (35%) | 11 (27.5%) |
General Labor/Farm Worker/Machine Operator/Driver | 14 (35%) | 0 (0%) |
Mining Industry | 5(12.5%) | 0 (0%) |
Hospitality | 3(5%) | 2 (5%) |
Students | 8 (20%) | |
Mean days from injury to | 38.7 (13.2) | N/A |
Test Score | GSG Trial 1 Mean (SD) [Range] | CSG Trial 2 Mean (SD) [Range] | IWMean (SD) [Range] | CSS Trial 1 Mean (SD) [Range] | CSS Trial 2 Mean (SD) [Range] |
---|---|---|---|---|---|
OMPSQ | 38.67 *CDE (21.87) [7–113] | 40.50 *CDE (22.89) [4–112] | 84.15 *ABCD (28.83) [14–152] | 118.08 *ABC (36.01) [46–192] | 112.25 *ABC (35.15) [32–186] |
OMPSQ-Short Form | 20.96 *CDE (12.97) [1–63] | 21.88 *CDE (13.05) [2–58] | 41.20 *ABDE (13.87) [10–87] | 59.73 *ABC (18.93) [18–91] | 56.18 *ABC (18.32) [28–85] |
PSS Total | 13.11 *DE (6.251) [1–23] | 12.51 DE (6.76) [2–27] | 14.94 *DE (7.23) [2–30] | 22.10 *ABC (8.01) [0–39] | 22.16 *ABC (6.28) [8–36] |
PSS-4 Total | 4.55 *DE (2.60) [0–9] | 4.35 *DE (2.78) [0–11] | 5.45 *DE (2.82) [0–12] | 8.53 *ABC (3.41) [0–15] | 8.38 *ABC (2.71) [3–15] |
Finance Rating | 8.43 *DE (2.03) [2–10] | 8.53 *DE (1.96) [2–10] | 6.85 *DE (3.45) [0–10] | 5.48 *ABC (3.57) [0–10] | 4.78 *ABC (3.29) [0–10] |
Forced Choice Test | 9.35 (0.80) [7–10] | 9.05 (1.20) [5–10] | 9.30 (1.07) [6–10] | 9.00 (1.78) [1–10] | 8.65 *AC (1.59) [3–10] |
Measure | ICC (95% CI) | p-Value | Minimal Detectable Change |
---|---|---|---|
OMPSQ | 0.954 (0.943–0.964) | <0.001 | 21.719 |
OMPSQ-SF | 0.905 (0.882–0.926) | <0.001 | 10.56 |
PSS | 0.926 (0.908–0.942 | <0.001 | 13.509 |
PSS-4 | 0.836 (0.791–0.874) | <0.001 | 6.114 |
Measure | Comparison | Area Under Curve | Std. Error | Asymptotic Significance | 95% Confidence Interval Lower-Upper |
---|---|---|---|---|---|
OMPSQ | CSG v IW CSS v IW | 0.897 0.751 | 0.032 0.461 | <0.000 <0.001 | 0.834–0.959 0.661–0.849 |
OMPSQ-SF | CSG v IW CSS v IW | 0.700 0.835 | 0.51 0.040 | <0.001 <0.001 | 0.834–0.959 0.757–0.913 |
PSS | CSG v IW CSS v IW | 0.567 0.771 | 0.056 0.046 | 0.235 <0.001 | 0.457–0.676 0.681–0.862 |
PSS-4 | CSG v IW CSS v IW | 0.587 0.760 | 0.055 0.046 | 0.078 <0.001 | 0.489–0.704 0.670–0.849 |
Finance | CSG v IW CSS v IW | 0.370 0.354 | 0.055 0.540 | 0.180 0.007 | 0.263–0.478 0.247–0.460 |
BCFT | CSG v IW CSS v IW | 0.545 0.581 | 0.056 0.056 | 0.425 0.150 | 0.434–0.656 0.471–0.691 |
OMPSQ Cut Score [Range] | Sn ×100 | 1-Sp ×100 | NPP % | PPP % |
---|---|---|---|---|
49 [0–50] | 95.0 | 92.5 | 33 | 92.68 |
59 [51–60] | 93.8 | 82.5 | 36.84 | 86.21 |
69 [61–70] | 87.5 | 70.0 | 36.11 | 75.26 |
79 [71–80] | 83.8 | 50.5 | 36.73 | 68.36 |
90 [81–90] | 75.0 | 45.0 | 33.87 | 59.41 |
99 [91–100] | 68.8 | 25.0 | 35.36 | 48.18 |
110 [101–110] | 53.8 | 12.5 | 32.38 | 37.72 |
120 [111–120] | 47.5 | 10.0 | 31.85 | 33.04 |
126 [121–130] | 37.5 | 10.0 | 29.75 | 26.09 |
140 [131–140] | 28.8 | 5.0 | 28.57 | 18.80 |
150 [141–150] | 16.3 | 2.5 | 26.89 | 10.17 |
OMPSQ-SF Cut Score [Range] | Sn ×100 | 1-Sp ×100 | NPP % | PPP % |
---|---|---|---|---|
10 [0–10] | 100 | 100.0 | 100 | 100 |
20 [11–20] | 100 | 95.0 | 50 | 98.76 |
30 [21-30] | 98.8 | 80.0 | 47.05 | 89.655 |
39 [31–40] | 90.0 | 50.0 | 41.67 | 71.71 |
50 [41–50] | 75.0 | 17.5 | 38.37 | 52.67 |
58 [51–60] | 52.5 | 7.5 | 33.63 | 36.21 |
70 [61–70] | 25.0 | 5 | 28.27 | 17.09 |
79 [71–80] | 8.8 | 2.5 | 5.04 | 5.04 |
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McMahon, J.E.; Craig, A.; Cameron, I.D. Development of Cut Scores for Feigning Spectrum Behavior on the Orebro Musculoskeletal Pain Screening Questionnaire and the Perceived Stress Scale: A Simulation Study. J. Clin. Med. 2025, 14, 5504. https://doi.org/10.3390/jcm14155504
McMahon JE, Craig A, Cameron ID. Development of Cut Scores for Feigning Spectrum Behavior on the Orebro Musculoskeletal Pain Screening Questionnaire and the Perceived Stress Scale: A Simulation Study. Journal of Clinical Medicine. 2025; 14(15):5504. https://doi.org/10.3390/jcm14155504
Chicago/Turabian StyleMcMahon, John Edward, Ashley Craig, and Ian Douglas Cameron. 2025. "Development of Cut Scores for Feigning Spectrum Behavior on the Orebro Musculoskeletal Pain Screening Questionnaire and the Perceived Stress Scale: A Simulation Study" Journal of Clinical Medicine 14, no. 15: 5504. https://doi.org/10.3390/jcm14155504
APA StyleMcMahon, J. E., Craig, A., & Cameron, I. D. (2025). Development of Cut Scores for Feigning Spectrum Behavior on the Orebro Musculoskeletal Pain Screening Questionnaire and the Perceived Stress Scale: A Simulation Study. Journal of Clinical Medicine, 14(15), 5504. https://doi.org/10.3390/jcm14155504