Modified Somatic Perception Questionnaire
Modified Somatic Perception Questionnaire (MSPQ)
Purpose
The Modified Somatic Perception Questionnaire (MSPQ) is a self-report screening tool used to measure somatic awareness and autonomic symptom reporting. The questionnaire asks the evaluee to rate physical sensations such as increased heart rate, dizziness, sweating, muscle tension, stomach discomfort, and other bodily symptoms that may accompany pain, stress, injury, or illness.
Within a Functional Capacity Evaluation (FCE), the MSPQ is not used as a stand-alone measure of credibility, effort, symptom validity, malingering, or disability. It provides information regarding the extent to which an individual reports heightened bodily awareness or somatic distress.
Administration
- The evaluee rates each symptom on a scale from 0 to 3.
- Sum all item scores to obtain the Total MSPQ Score.
- The total score ranges from 0 to 39.
| Score | Rating |
|---|---|
| 0 | Not at all |
| 1 | Slightly |
| 2 | Moderately |
| 3 | Extremely |
Interpretation
Higher MSPQ scores indicate greater reporting of physical symptoms and bodily distress. Elevated scores may reflect increased somatic awareness, heightened symptom focus, anxiety-related physiological responses, pain-related distress, or other psychosocial influences affecting symptom perception.
The MSPQ does not determine whether symptoms are genuine or exaggerated. It identifies the degree to which an individual reports somatic symptoms and should be interpreted within the broader clinical context.
| MSPQ Score | Interpretation |
|---|---|
| 0–9 | Within expected range. Limited evidence of elevated somatic symptom reporting. |
| 10–13 | Mild to moderate elevation in somatic symptom reporting. May indicate increased symptom awareness or distress. |
| ≥14 | Marked elevation in somatic symptom reporting. Consider the potential influence of psychosocial factors, symptom amplification, or heightened somatic focus. Findings should be interpreted alongside objective examination findings and observed functional performance. |
Research Findings Related to Symptom Validity
Cut-off ≥10
A score of 10 or greater demonstrated approximately 90% sensitivity and 90% specificity for identifying elevated somatic symptom reporting or potential symptom over-reporting in the studied forensic pain context.
Cut-off ≥14
A score of 14 or greater demonstrated approximately 69% sensitivity and 99% specificity. The higher specificity associated with this threshold produces a very low false-positive rate, making this cut-off useful when the evaluator wants a more conservative indicator of significant somatic symptom elevation.
Elevated MSPQ scores should not be interpreted in isolation as evidence of symptom exaggeration, poor effort, malingering, or invalid performance. Best-practice interpretation requires integration with objective clinical findings, observed behaviours, physiological responses, performance consistency, and other psychometric measures.
Clinical Considerations
The MSPQ may assist the evaluator in considering somatic symptom reporting, pain-related distress, symptom amplification, psychosocial influences on function, and consistency between subjective reports and objective findings.
An elevated MSPQ score may help explain discrepancies between perceived disability and demonstrated functional capacity. However, elevated scores do not establish malingering and should never be used as the sole basis for determining symptom validity, effort, or work capacity.
Sample Documentation Statements
MSPQ <10
The evaluee obtained an MSPQ score of 8/39. This score falls within the expected range and does not indicate elevated somatic symptom reporting. Findings should be interpreted in conjunction with the remainder of the evaluation.
MSPQ 10–13
The evaluee obtained an MSPQ score of 12/39. This score reflects a mild elevation in somatic symptom reporting and may indicate increased symptom awareness or distress. Findings should be interpreted alongside objective examination findings and observed functional performance.
MSPQ ≥14
The evaluee obtained an MSPQ score of 18/39. This score represents a marked elevation in somatic symptom reporting. Research has demonstrated that scores at or above 14 are associated with high specificity for identifying individuals reporting elevated levels of somatic symptoms. This finding should be interpreted within the broader clinical context and considered alongside objective examination findings, observed behaviours, and performance consistency throughout the evaluation.
References
- Bianchini, K. J., Aguerrevere, L. E., Guise, B. J., et al. (2014). Accuracy of the Modified Somatic Perception Questionnaire and Pain Disability Index in the detection of malingered pain-related disability in chronic pain. Clinical Neuropsychologist, 28(8), 1376–1394.
- Crighton, A. H., Wygant, D. B., Applegate, K. C., Umlauf, R. L., & Granacher, R. P. (2014). Can brief measures effectively screen for pain and somatic malingering? Examination of the Modified Somatic Perception Questionnaire and Pain Disability Index. The Spine Journal, 14(9), 2042–2050.
- Greve, K. W., Bianchini, K. J., & Brewer, S. T. (2013). The assessment of performance and self-report validity in persons claiming pain-related disability. Clinical Neuropsychologist, 27(1), 108–137.
- Current Concepts in Functional Capacity Evaluation: A Best Practices Guideline. (2018).