Pseudohypocusis

Pseudohypocusis is the intentional, conscious act of feigning a hearing loss as a form of deception. Other terms include non-organic, functional, malingering.

Men are more apt to fake a loss if there is financial gain involved.

Women will fake if pressured.

Kids use it as an attention getting device, especially prepubescent females.

Signs of Pseudohypocusis

Patient often indicates a very specific incident that caused the “loss”

There is something to be gained financially from the “loss” (often referred by a lawyer)

Very exaggerated lip reading, movements, etc.

Audiological Findings

Test/retest will be all over the place, not within the acceptable 10 dB range.

Acoustic reflexes will be present.

No cross-over.

Special Tests

Stenger: test for unilateral loss. Have to have a 20 dB difference between the ears.

MADGE: minimal ascending descending gap evaluation. Start at 0 or -10, ascent until threshold at each frequency. Let patient rest, then start at very high level and descend to get thresholds at each frequency. Fakers will have a big difference between thresholds.

Delayed pure tone and speech feedback: fakers will get tripped up with delayed tones and speech feedback, but if there is a true loss it wouldn’t bother them.

Lombard Test: masking noise in the “bad” ear. Have them repeat words. Fakers voice will get louder to compensate for noise.

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