Noncredible symptom reporting in whiplash injury: The role of financial incentives and validity testing with the Self-Report Symptom Inventory (SRSI)

Research on malingering shows that symptom overreporting is more frequent when financial compensation is involved, particularly in whiplash cases where symptoms are subjective and difficult to verify. Individuals motivated by gain often score higher on symptom validity tests, suggesting that they may intentionally exaggerate symptoms for insurance or legal purposes. To investigate this phenomenon, we administered the Italian version of the Self-Report Symptom Inventory (SRSI-It) to 594 participants (65.8% women), randomly assigned to one of three instructional conditions: (1) Simulators with Compensation (<i>n</i> = 185), instructed to feign whiplash symptoms for financial gain; (2) Pure Simulators (<i>n</i> = 183), asked to simulate without monetary incentive; and (3) Honest Respondents (<i>n</i> = 226), instructed to respond truthfully. Results showed that compensation simulators reported significantly more pseudosymptoms and genuine symptoms than honest participants, supporting the role of financial incentives in amplifying symptom overreporting. Pure simulators also exaggerated symptoms, but to a lesser degree. The ratio of pseudosymptoms to genuine symptoms distinguished simulators from honest respondents, although it did not differ significantly between the two simulator groups. These findings underscore the influence of external incentives on symptom presentation and support the utility of the SRSI-It in detecting feigning. However, high false positive rates raise concerns about cutoff specificity, warranting further validation.