A Study of the SIRS with severely traumatized patients.

Clinical research has revealed that traumatized patients often elevate feigning indicators on psychological measures, which raises the possibility that traumatization and concomitant dissociation may lead to misclassifications of malingering. Within the domain of feigned mental disorders, the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) is a well established measure with excellent reliability and validity across clinical and forensic settings. Although recent studies have demonstrated its effectiveness with outpatient posttraumatic stress disorder (PTSD) samples, the SIRS usefulness with severely traumatized patients remains to be investigated. In this study, we recruited traumatized patients for a within-subjects simulation design in which we asked feigners to convincingly portray themselves as examinees claiming total disabilities. When compared to standard instructions, feigned presentations produced substantial effect sizes. Although the standard SIRS classifications produced moderately high sensitivities (M = .82), the false-positive rates were problematic. To minimize false-positives, we constructed a Trauma Index (TI) from 3 primary SIRS scales that appeared unaffected by severe trauma. Implementation of the TI substantially reduced false-positive rates (M = .09).

Use of the SIRS in compensation cases: an examination of its validity and generalizability.

The Structured Interview of Reported Symptoms (SIRS; Rogers et al., Structured interview of reported symptoms (SIRS) and professional manual, 1992) is a well-validated psychological measure for the assessment of feigned mental disorders (FMD) in clinical, forensic, and correctional settings. Comparatively little work has evaluated its usefulness in compensation and disability contexts. The present study examined SIRS data from 569 individuals undergoing forensic neuropsychiatric examinations for the purposes of workers' compensation, personal injury, or disability proceedings. Using bootstrapping comparisons, three primary groups were identified: FMD, feigned cognitive impairment (FCI), genuine-both (GEN-Both) that encompasses both genuine disorders (GEN-D) and genuine-cognitive presentation (GEN-C). Consistent with the SIRS main objective, very large effect sizes (M Cohen's d = 1.94) were observed between FMD and GEN-Both groups. Although not intended for this purpose, moderate to large effect sizes (M d = 1.13) were found between FCI and GEN-Both groups. An important consideration is whether SIRS results are unduly affected by common diagnoses or clinical conditions. Systematic comparisons were performed based on common disorders (major depressive disorder, PTSD, and other anxiety disorders), presence of a cognitive disorder (dementia, amnestic disorder, or cognitive disorder NOS), or intellectual deficits (FSIQ < 80). Generally, the magnitude of differences on the SIRS primary scales was small and nonsignificant, providing evidence of the SIRS generalizability across these diagnostic categories. Finally, the usefulness of the SIRS improbable failure-revised (IF-R) scale was tested as a FCI screen. Although it has potential in ruling out genuine cases, the IF-R should not be used as a feigning screen.

Feigned neurocognitive deficit: taxon or dimension?

The purpose of this study was to explore the latent structure of feigned neurocognitive deficit. Scores on the Test of Memory Malingering (TOMM), Letter Memory Test (LMT), and Victoria Symptom Validity Test (VSVT) served as indicators in a taxometric investigation of 527 compensation-seeking adults using three taxometric procedures -- mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent-mode factor analysis (L-Mode). All three procedures showed evidence of dimensional latent structure. The fact that feigned neurocognitive symptomatology is ordered along a continuum rather than bifurcating into distinct categories has important implications for theory, research, and clinical practice.

Malingering as a categorical or dimensional construct: the latent structure of feigned psychopathology as measured by the SIRS and MMPI-2.

The 6 nonoverlapping primary scales of the Structured Interview of Reported Symptoms (SIRS) were subjected to taxometric analysis in a group of 1,211 criminal and civil examinees in order to investigate the latent structure of feigned psychopathology. Both taxometric procedures used in this study, mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV), produced dimensional results. A subgroup of participants (n = 711) with valid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols were included in a second round of analyses in which the 6 nonoverlapping primary scales of the SIRS and the Infrequency (F), Infrequency-Psychopathology (Fp), and Dissimulation (Ds) scales of the MMPI-2 served as indicators. Again, the results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingering-honest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one. The theoretical and clinical practice implications of these findings are discussed.

Damages and rewards: assessment of malingered disorders in compensation cases.

The assessment of malingering poses unique challenges to forensic practitioners in compensation cases and disability determinations. Beyond malingering itself, false claims can be presented regarding both the source of genuine symptoms and their injurious effects on work and social functioning. The article examines how contextually based psychological factors can affect clients' presentation in compensation cases. Important distinctions between different types of response style (e.g. malingering, feigning, and secondary gain) are presented. In addition, empirically validated detection strategies provide a clinical framework for the assessment of feigned disorders. With an emphasis on compensation cases and clinically relevant disorders, the effectiveness of these detection strategies is considered for specific psychological measures.