Malingering and Psychogenic Deafness

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Abstract
Four measurements are made in the D-S Test. They are: (1) the speech reception threshold, (2) the noise perception threshold, (3) the noise interference level, and (4) the repeat speech reception threshold. The relationships between these measurements are used as the basis for isolating cases of psychological deafness. One or more of the following conditions raise the suspicion that the patient exhibits non-organic loss: 1) When speech reception is inhibited by a noise interference level less intense than the speech presentation level; 2) when the noise perception threshold is poorer than the speech reception threshold; and 3) when there is sharp discrepancy between the 2 speech-reception thresholds. Variations of the techniques presented have been used successfully. Even more definition can be achieved by interpreting the D-S Test in conjunction with an associated audiogram and a medical history. Treatment of psychogenic losses encountered at Deshon General Hospital has become more precise and rapid since the D-S Test was incorporated as a clinical routine. Basically, the D-S Test determines four measurements of audition. These are: Speech-reception threshold; noise-interference level; noise-perception threshold; and a repeat threshold on speech reception. A continuous series of spondees is spoken 5 db above the speech reception threshold. Simultaneously, the masking noise is introduced and then gradually increased. This procedure is continued until the masking noise reaches a level where it inhibits speech reception and prevents repetition of the words by the patient.

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