Edens J F, Otto R K, Dwyer T
Department of Mental Health Law & Policy, University of South Florida, Tampa 33612, USA.
J Am Acad Psychiatry Law. 1999;27(3):387-96.
The Structured Inventory of Malingered Symptomatology (SIMS) is one of a number of recently developed instruments designed to identify persons exaggerating and/or fabricating psychiatric and cognitive symptomatology. Preliminary analog research indicated that the SIMS showed some promise as a screening device for identifying malingerers. This study examined the utility of the SIMS for identifying malingerers and, more importantly, its ability to distinguish truly symptomatic persons from persons fabricating symptomatology. In a sample of 197 participants who completed the SIMS and Symptom Checklist-90-Revised (SCL-90-R) under both honest and malingering instructional sets, sensitivity and specificity rates were generally high for the SIMS Total score and subscales. However, moderate correlations with the SCL-90-R were obtained in this sample, and specificity rates were lowest among a subset of participants reporting clinically significant levels of distress; both findings raise concerns regarding the potential for high false positive rates among clinical populations. Implications for clinical forensic practice are discussed and recommendations for future research are offered.
伪装症状结构化量表(SIMS)是近期开发的旨在识别夸大和/或伪造精神及认知症状者的多种工具之一。初步的模拟研究表明,SIMS作为识别伪装者的筛查工具显示出一定前景。本研究考察了SIMS在识别伪装者方面的效用,更重要的是,考察了其区分真正有症状者与伪造症状者的能力。在197名参与者的样本中,他们在诚实和伪装指导语下完成了SIMS和症状自评量表-90修订版(SCL-90-R),SIMS总分及分量表的敏感性和特异性率总体较高。然而,该样本中SIMS与SCL-90-R的相关性中等,且在报告有临床显著痛苦水平的参与者子集中特异性率最低;这两个发现都引发了对临床人群中高假阳性率可能性的担忧。文中讨论了对临床法医实践的影响,并给出了未来研究的建议。