Abstracts d University of South-Eastern Norway, Health and Social Sciences, Drammen, Norway e Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Aim: Communication between patients and providers has been shown to be crucial for mutual understanding and improvement of medically unexplained symptoms (MUS). The aim of this systematic review is to gain a detailed understanding of recurrent communication practices and their functions in medical interactions about MUS, by synthesizing evidence from interactional and discourse analyses. Methods: Systematic review of qualitative linguistic and interactional studies. We searched 8 electronic databases, screened reference lists and consulted experts. We developed a data extraction template and appraised the quality of the studies. Findings were synthesized through an iterative process. Results: We found 5021 publications of which 17 met the inclusion criteria. We sorted findings into three different interactional areas: 1) patients and providers orient to the importance of recognition of symptoms and suffering, e.g. by using extreme case formulations (“terrible”) to portray the severity of complaints; 2) patients and providers orient to their separate conflicting epistemic territories (i.e. conflicts in knowledge domains), e.g. with physicians using restricted question-answer sequences; and 3) the diagnosis is constructed in interaction, e.g. by searching for common ground with frames that are acceptable for patients. Conclusion: Linguistic and interactional aspects in medical consultations show that talking about MUS is a very delicate activity. Treating MUS as delicate could elicit patient resistance. Providers can overcome resistance by constructing explanations in a collaborative manner and by searching for common ground. doi:10.1016/j.jpsychores.2019.03.031 SID90 Cloudy attitude? Healthcare professionals' one-word descriptions of working with patients with medically unexplained symptoms Denise Hanssena,1, Judith Rosmalenb a University Medical Center Groningen, Psychiatry, Groningen, The Netherlands b University Medical Center Groningen, Psychiatry & Internal Medicine, Groningen, The Netherlands Aim: Patients with Medically Unexplained Symptoms (MUS) often feel stigmatized, which may possibly be related to healthcare professionals' (negative) attitudes and/or prejudices towards this patient group. In this study we aim to explore healthcare professionals' attitudes towards working with MUS-patients. Methods: Currently, 33 psychiatrists (in training), 40 occupational medicine specialists and 39 children's physicians participated. All participants were asked to answer the question: ‘What is the first word that comes into your mind when you think about patients with MUS?’. Data were collected during lectures about MUS, using an online, anonymous, tool. Since this study is ongoing, more data will be collected in various professional groups. Results: The most frequently mentioned word (including synonyms) was ‘difficult’ (7.9%; n = 9), followed by ‘complex’ (7.1%; n = 8). Overall, 39.8% (n = 45) of all words had a negative connotation, such as ‘complicated’, ‘whining’, and ‘exhausting’. Only 6.1% (n = 7) oneword descriptions had a positive connotation, such as ‘important’ 109 and ‘interesting’. Other words (52.2%; n = 59) were neutral, such as ‘fibromyalgia’, and ‘unclear’. More results will be presented in due time, as well as results per profession. Conclusion: Negative attitudes and/or prejudices may hamper the healthcare professional's ability to provide the best possible care for MUS-patients. Therefore, prejudices deserve attention in medical education and training. doi:10.1016/j.jpsychores.2019.03.032 SID183 Posttraumatic stress and motivators of refugee aid volunteers and fulltime employees Ekaterini Georgiadoua, Theresa Grimmb, Yesim Erimb,1 a Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Klinik für Psychiatrie und Psychotherapie - Klinikum Nürnberg, Nürnberg, Germany b University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, (FAU), Department of Psychosomatic Medicine and Psychotherapy, Erlangen, Germany Aim: Since 2015 about 1.3 million asylum seekers were documented in Germany. A huge group of volunteers (VAD) engaged in support activities for them, like accompanying them to official departments, teaching them the language etc. On the other side, municipalities and different state departments hired new employees as full-time aid workers (FAD). We surveyed the motivation for helping activities and the specific stressors in refugee aid. Methods: This is a cross-sectional questionnaire survey. Depression was measured with Patient Health Questionnaire (PHQ), traumatic events and posttraumatic stress with the Essen Trauma Inventory (ETI). Results: A total number of 111 aid workers participated, 39 (35.1%) were Volunteering Aid Workers and 72 (64.9%) Fulltime Aid Workers (FAD). 30.6% of aid workers have own immigration background; 12.8% of VAD vs. 40.3% of FAD. VAD reported religious motivation in first place, FAD vocational motivation, but also charity motives in about 70%. Depression (PHQ-9 ≥ 10) was measured in 9.0%; in 11.8% of the VAD vs. in 8.5% of the FAD. Traumatic events were reported in 91% in the sample vs. 24% in the German general population. None of the VAD but 5.1% of the FAD fulfilled the psychometric requirements of a PTSD. Conclusion: FAD and VAD both present risk factors for mental disorders. They should be supported by regular preventive screenings and trainings for resilient mental health. doi:10.1016/j.jpsychores.2019.03.033 SID28 The development of a patient-reported outcome measure for real-time symptom assessment in a population with functional urologic complaints—A focus group study Alexandra Herrewegha,1, Lisa Vorkb, Eline Eurelingsc, Carsten Leuec, Joanna Kruimelb, Gommert van Koeveringea, Desiree Vrijensa a Maastricht University Medical Center+, Urology, Maastricht, The Netherlands b Maastricht University Medical Center+, Gastroenterology and Hepatology, Maastricht, The Netherlands c Maastricht University Medical Center+, Psychiatry and Medical Psychology, Maastricht, The Netherlands 110 Abstracts Aim: In the current diagnostic process for overactive bladder syndrome (OAB), biased retrospective questionnaires are often used. There is a need for a new assessment tool that embraces the heterogeneity of the OAB complex. A momentary assessment tool, the Experience Sampling Method (ESM) is promising, capturing random repetitive measurements during the day in the context of daily life and is capable to measure potential contextual triggers and psychological aspects. A focus group study was set up to evaluate which items should be implemented in a urological ESM. Methods: Focus group interviews were arranged, to assess the suitability and comprehensibility of a newly developed urological patient-reported outcome measurement (PROM), “Uromate.” “Uromate” was created based on ESM literature. A multidisciplinary expert meeting was conducted to gain consensus on item relevance. Results: The initial ESM questionnaire contained 58 items, but was eventually reduced to 39 items after focus group sessions and expert meeting. Thirty-seven items are repeated questions, including three gender-dependent items. Two items are one-time questions about the use of incontinence material. Additionally, a morning questionnaire was included. Depending on the symptom pattern, a minimum of 26 items and a maximum of 36 items will be repeatedly assessed with “Uromate.” Conclusion: There is a need for a modern assessment tool for OAB which overcomes the limitations of today's retrospective questionnaires. Therefore, a urological ESM tool, the “Uromate,” is being developed as a PROM, following the FDA PROM development guidelines, to measure real-time symptoms in the context of daily life. doi:10.1016/j.jpsychores.2019.03.034 SID134 On aggravating depressive symptomatology a study using the assessment of depression inventory (ADI) Machteld van Leeuwen1, Jos de Jonghe, Jordy Muller, Winy Grent, Tjerk Schoemaker, Sascha Meyer Noord West Ziekenhuis, Medical Psychology, Alkmaar, The Netherlands Aim: The Assessment of Depression Inventory (ADI) is a self-rating questionnaire of 39 items Embedded in the ADI are three standalone validity scales to detect the variables of random responding, feigning, and reliability (Mogge et al., 2008). This study aims to validate the feigning and depression scales of the ADI's Dutch version. Methods: This cross-sectional observational study included 499 participants, including referrals in a medico-legal or disability claim context (n = 151), outpatients with an established psychiatric diagnosis, fibromyalgia or chronic back pain patients (n = 156), instructed malingerers (n = 60) and healthy control subjects (n = 152). Symptom validity tests (GWMT, SIMS, AKTG, RDS) and depression questionnaires (BDI-II-NL, HADS) were used for correlation and to help classify respondents into groups of probable or no response bias. Results: The feigning- (α =0.841) and depression scale (α =0.955) showed high internal consistency. The ADI-feigning scale correlated strongly with the SIMS (r = 0.741, p b .001, n = 207). Scores differed between Slick-positive or -negative groups. The ADI-feigning scale effectively distinguished between probable response bias cases, healthy controls and non-aggravating patients, showing high sensitivity (0.850) and specificity (0.878) rates. The optimal cutoff score was ≥10. A cutoff score of 37 was established for moderate depression and 43 for severe depression. Conclusion: The Dutch version of the ADI shows to be a promising symptom validity test with good psychometric properties, indicated by high internal consistency and concurrent validity for both the feigning and depression scales. The ADI may be efficient and effective neuropsychological tool, especially in settings where both depressive complaints and malingering are common occurrences. doi:10.1016/j.jpsychores.2019.03.035 SID136 The visual association test – Extended: detecting non-credible memory performance Sascha Meyera,1, Rudolf Pondsb a University Maastricht, Psychiatry and Neuropsychology, MHeNS, Maastricht, The Netherlands b Maastricht Universitair Medisch Centrum, Medical Psychology, Maastricht, The Netherlands Aim: The results of neuropsychological tests may be distorted by patients who exaggerate or fabricate memory deficits. This may lead to an incorrect diagnosis. Prevalence of such non-credible performance for patients referred to memory clinics of general hospitals is estimated to be 6.5%. Performance validity tests (PVT) can be used to detect noncredible performance. The aim of our two studies was to validate such a test, i.e. the newly developed Visual Association Test Extended (VAT-E). Methods: In study 1, we compared VAT-E total scores of healthy controls (n = 226), patients with amnestic mild cognitive impairment (a-MCI) (n = 76), patients with Alzheimer's disease (AD) (n = 26), and persons instructed to feign memory deficit (n = 29). In study 2, we compared litigating patients classified as Malingering of Neurocognitive Dysfunction (MND) (n = 26) or non-MND (n = 67). Results: Results showed that the VAT-E differentiated patients with a-MCI (specificity 93% -100%) or patients with AD (specificity 92% 100%) from persons instructed to feign (sensitivity 86% - 100%). Furthermore, the VAT-E differentiated MND from non-MND (sensitivity 54%, specificity 97%). Conclusion: The VAT-E may be a useful PVT based on the ability to differentiate between those with a genuine memory impairment, persons instructed to feign memory impairment, and a group suspected of malingering cognitive deficits. doi:10.1016/j.jpsychores.2019.03.036 SID143 Genuine and deceitful symptom reporting in psychosomatic patients A study in a medico-legal or disability claim setting Tjerk Schoemakera,1, Jos de Jonghea, Anne-Ava Stevensa, Rudolf Pondsb a Noord West Ziekenhuis, Medical Psychology, Alkmaar, The Netherlands b Maastricht Universitair Medisch Centrum, Medical Psychology, Maastricht, The Netherlands Aim: Symptom or performance validity testing has become a major theme in contemporary neuropsychological research, motivated by the growing consensus that such assessments are an essential part of neuropsychological evaluations (Bush et al., 2005). The present study aimed to investigate the prevalence of response bias and its effects on regular cognitive tests and self-rating scales in a medico-legal and disability claim context.