The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls

Background Individuals with dissociative identity disorder (DID) have complex symptoms consistent with severe traumatic reactions. Clinicians and forensic assessors are challenged by distinguishing symptom exaggeration and feigning from genuine symptoms among these individuals. This task may be aide...

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Autores principales:	Bethany L. Brand, Michelle Barth, Yolanda R. Schlumpf, Hugo Schielke, Sima Chalavi, Eline M. Vissia, Ellert R. S. Nijenhuis, Lutz Jäncke, Antje A. T. S. Reinders
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	sims structured inventory of malingered symptomatology exaggeration malingering simulation trauma dissociation feigning Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/8575f83a605845e8b40c715e128de0ca
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spelling	oai:doaj.org-article:8575f83a605845e8b40c715e128de0ca2021-12-01T14:40:59ZThe utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls2000-806610.1080/20008198.2021.1984048https://doaj.org/article/8575f83a605845e8b40c715e128de0ca2021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/20008198.2021.1984048https://doaj.org/toc/2000-8066Background Individuals with dissociative identity disorder (DID) have complex symptoms consistent with severe traumatic reactions. Clinicians and forensic assessors are challenged by distinguishing symptom exaggeration and feigning from genuine symptoms among these individuals. This task may be aided by administering validity measures. Objective This study aimed to document how individuals with DID score on the Structured Inventory of Malingered Symptomatology (SIMS). The second objective was to compare coached DID simulators and healthy controls to DID patients on the SIMS’s total score and subscales. The third objective was to examine the utility rates of the SIMS in distinguishing simulated DID from clinically diagnosed DID. Method We compared SIMS data gathered from participants from two Dutch sites, one Swiss site and one U.S. site. Sixty-three DID patients were compared to 77 coached DID simulators and 64 healthy controls on the SIMS. A multivariate analysis compared the groups on the SIMS total scores and subscales, and post-hoc Games Howell tests and univariate ANOVAs examined differences between the groups. Utility statistics assessed the accuracy of the SIMS in distinguishing clinical from simulated DID. Results DID simulators scored significantly higher than DID individuals and healthy controls on every SIMS subscale as well as the total score. The majority (85.7%) of the individuals with DID scored above the cut-off, which is typically interpreted as indicative of possible symptom exaggeration. DID individuals scored higher than the healthy controls on every subscale except Low Intelligence, even after controlling for dissociation. The subscales and items most frequently endorsed by the DID group are consistent with symptoms associated with complex trauma exposure and dissociative reactions. The SIMS total score had a sensitivity of 96% but an unacceptably low specificity of 14%. Conclusions The findings indicate that the instrument is not accurate in assessing potential symptom exaggeration or feigning in DID.Bethany L. BrandMichelle BarthYolanda R. SchlumpfHugo SchielkeSima ChalaviEline M. VissiaEllert R. S. NijenhuisLutz JänckeAntje A. T. S. ReindersTaylor & Francis Grouparticlesimsstructured inventory of malingered symptomatologyexaggerationmalingeringsimulationtraumadissociationfeigningPsychiatryRC435-571ENEuropean Journal of Psychotraumatology, Vol 12, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sims structured inventory of malingered symptomatology exaggeration malingering simulation trauma dissociation feigning Psychiatry RC435-571
spellingShingle	sims structured inventory of malingered symptomatology exaggeration malingering simulation trauma dissociation feigning Psychiatry RC435-571 Bethany L. Brand Michelle Barth Yolanda R. Schlumpf Hugo Schielke Sima Chalavi Eline M. Vissia Ellert R. S. Nijenhuis Lutz Jäncke Antje A. T. S. Reinders The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls
description	Background Individuals with dissociative identity disorder (DID) have complex symptoms consistent with severe traumatic reactions. Clinicians and forensic assessors are challenged by distinguishing symptom exaggeration and feigning from genuine symptoms among these individuals. This task may be aided by administering validity measures. Objective This study aimed to document how individuals with DID score on the Structured Inventory of Malingered Symptomatology (SIMS). The second objective was to compare coached DID simulators and healthy controls to DID patients on the SIMS’s total score and subscales. The third objective was to examine the utility rates of the SIMS in distinguishing simulated DID from clinically diagnosed DID. Method We compared SIMS data gathered from participants from two Dutch sites, one Swiss site and one U.S. site. Sixty-three DID patients were compared to 77 coached DID simulators and 64 healthy controls on the SIMS. A multivariate analysis compared the groups on the SIMS total scores and subscales, and post-hoc Games Howell tests and univariate ANOVAs examined differences between the groups. Utility statistics assessed the accuracy of the SIMS in distinguishing clinical from simulated DID. Results DID simulators scored significantly higher than DID individuals and healthy controls on every SIMS subscale as well as the total score. The majority (85.7%) of the individuals with DID scored above the cut-off, which is typically interpreted as indicative of possible symptom exaggeration. DID individuals scored higher than the healthy controls on every subscale except Low Intelligence, even after controlling for dissociation. The subscales and items most frequently endorsed by the DID group are consistent with symptoms associated with complex trauma exposure and dissociative reactions. The SIMS total score had a sensitivity of 96% but an unacceptably low specificity of 14%. Conclusions The findings indicate that the instrument is not accurate in assessing potential symptom exaggeration or feigning in DID.
format	article
author	Bethany L. Brand Michelle Barth Yolanda R. Schlumpf Hugo Schielke Sima Chalavi Eline M. Vissia Ellert R. S. Nijenhuis Lutz Jäncke Antje A. T. S. Reinders
author_facet	Bethany L. Brand Michelle Barth Yolanda R. Schlumpf Hugo Schielke Sima Chalavi Eline M. Vissia Ellert R. S. Nijenhuis Lutz Jäncke Antje A. T. S. Reinders
author_sort	Bethany L. Brand
title	The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls
title_short	The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls
title_full	The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls
title_fullStr	The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls
title_full_unstemmed	The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls
title_sort	utility of the structured inventory of malingered symptomatology for distinguishing individuals with dissociative identity disorder (did) from did simulators and healthy controls
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/8575f83a605845e8b40c715e128de0ca
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The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls

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