Estimates of the incidence of functional involvement in patients referred to military audiology centers have varied from 8% to 35%.1,4-7,9,11 Such patients, though usually possessing a true organic loss, require careful and complex audiological testing in order to establish their actual degree of hearing loss. Typically, they show audiograms which vary widely from day to day, demonstrate internal inconsistencies, such as gross discrepancies between hearing for pure tones and hearing for speech, or they reveal peculiarities during special testing.
Various writers4,5,8,11 have commented on the psychological meaning of such behavior during audiological evaluation, but few specific or systematic formulations exist to account adequately for the phenomenon, and no quantitative psychological data have been presented in the literature. Inconsistency, almost without exception, represents an exaggeration of the actual hearing loss, and it is therefore necessary in a military setting to comprehend the psychological meaning of such behavior so that
GLEASON WJ. Psychological Characteristics of the Audiologically Inconsistent Patient. AMA Arch Otolaryngol. 1958;68(1):42–46. doi:10.1001/archotol.1958.00730020046007