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The effects of symptom overreporting on PTSD treatment outcome
Agnes van Minnen1,2, Birgit van Dalen2, Eline M Voorendonk1,2
1Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.
Background:
It is often assumed that individuals with posttraumatic stress disorder (PTSD) who overreport their symptoms should be excluded from trauma-focused treatments.
Objective:
To investigate the effects of a brief, intensive trauma-focused treatment programme for individuals with PTSD who are overreporting symptoms.
Methods:
Individuals (n = 205) with PTSD participated in an intensive trauma-focused treatment programme consisting of EMDR and prolonged exposure (PE) therapy, physical activity and psycho-education. Assessments took place at pre- and post-treatment (Structured Inventory of Malingered Symptomatology; SIMS, Clinician Administered PTSD Scale for DSM-5; CAPS-5).
Results:
Using a high SIMS cut-off of 24 or above, 14.1% (n = 29) had elevated SIMS scores (i.e. 'overreporters'). The group of overreporters showed significant decreases in PTSD-symptoms, and these treatment results did not differ significantly from other patients. Although some patients (35.5%) remained overreporters at post-treatment, SIMS scores decreased significantly during treatment.
Conclusion:
The results suggest that an intensive trauma-focused treatment not only is a feasible and safe treatment for PTSD in general, but also for individuals who overreport their symptoms.
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