La utilidad del Inventario Estructurado de Sintomatología Simulada para distinguir a los individuos con Trastorno de Identidad Disociativo (TID) de los simuladores de TID y los controles sanos

TY - JOUR

T1 - La utilidad del Inventario Estructurado de Sintomatología Simulada para distinguir a los individuos con Trastorno de Identidad Disociativo (TID) de los simuladores de TID y los controles sanos

AU - Brand, Bethany L.

AU - Barth, Michelle

AU - Schlumpf, Yolanda R.

AU - Schielke, Hugo

AU - Chalavi, Sima

AU - Vissia, Eline M.

AU - Nijenhuis, Ellert R.S.

AU - Jäncke, Lutz

AU - Reinders, Antje A.T.S.

N1 - Funding Information: This report represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. A.A.T.S. Reinders was supported by the Netherlands Organization for Scientific Research ( www.nwo.nl ), NWO-VENI grant no. 451-07-009. The authors would like to thank all the participants and their therapists. Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - dissociation

KW - exaggeration

KW - feigning

KW - malingering

KW - SIMS

KW - simulation

KW - Structured Inventory of Malingered Symptomatology

KW - trauma

UR - http://www.scopus.com/inward/record.url?scp=85119480123&partnerID=8YFLogxK

U2 - 10.1080/20008198.2021.1984048

DO - 10.1080/20008198.2021.1984048

M3 - Article

C2 - 34868478

AN - SCOPUS:85119480123

SN - 2000-8198

VL - 12

JO - European journal of psychotraumatology

JF - European journal of psychotraumatology

IS - 1

M1 - 1984048

ER -