Abstract

The current study examined characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a sample of 110 patients at an adult neuropsychology clinic. Subjects with especially high or low suspicion of invalid reporting were identified based on clinician-completed questions. SIMS elevation rates were examined at different cutoffs and between these groups and were correlated with other indicators of validity. High rates of SIMS elevations were found at the standard cutoff (>14) for the total sample (45.5%), low suspicion cases (24.4%), and high suspicion cases (95.7%). Other indicators of invalidity were low (secondary gain = 8.5%, clinical suspicion of exaggeration in interview M = 2.37/5, medical records concerning for invalidity = 2.4%, mixed/poor performance validity = 6.1%). Elevations correlated with clinician concern for over-reporting in interview, subject-reported cognitive concern (r = −.610) and psychological measures (BDI-II r = −.602, PROMIS r = −.409) but not with neuropsychological memory tests or performance validity measures (all p > .23). The SIMS should be interpreted with caution, as elevations appeared largely related to cognitive concern and psychiatric distress rather than true malingering. A cutoff of > 16 could be used in neuropsychological populations, although this is still of modest specificity.

摘要

目前的研究在成人神经心理学诊所的 110 名患者样本中检查了伪装症状学结构化清单 (SIMS) 的特征。根据临床医生完成的问题确定对无效报告的高度怀疑或高度怀疑的受试者。在不同的截止点和这些组之间检查 SIMS 升高率，并与其他有效性指标相关。在总样本 (45.5%)、低疑似病例 (24.4%) 和高疑似病例 (95.7%) 的标准截止值 (>14) 处发现 SIMS 升高率较高。其他无效指标较低（二次增益 = 8.5%，临床怀疑访谈中夸大事实 M = 2.37/5，与无效有关的医疗记录 = 2.4%，混合/差绩效效度 = 6.1%）。r = -.610）和心理测量（BDI-II r = -.602，PROMIS r = -.409），但不包括神经心理记忆测试或性能有效性测量（所有p > .23）。应谨慎解释 SIMS，因为升高似乎主要与认知问题和精神困扰有关，而不是真正的装病。> 16 的截止值可用于神经心理学人群，尽管这仍然具有适度的特异性。