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).