[Response distortion or symptom severity? Symptom description by psychiatric patients and sociomedical assessment subjects].

BACKGROUND

Psychiatric disorders are the most frequent cause for premature retirement; however, trying to verify claims of performance deficits due to psychiatric disorders without the actual existence of the latter in sociomedical assessments is problematic. For this reason, differentiation between actual psychiatric disorders with real presence of symptoms and simulated or aggravated symptoms is of importance in sociomedical assessments. In recent years, symptom validity tests (SVT) have been increasingly utilized in psychiatric/psychological assessments; however, knowledge of the validity of these tests and the relation to symptom severity is still lacking.

OBJECTIVE

This study aimed to compare the validity of different SVTs depending on symptom severity (Structured Inventory of Malingered Symptomatology (SIMS), Word Memory Test (WMT), Symptom Checklist-90-R (SCL-90‑R), Minnesota Multiphasic Personality Inventory‑2 (MMPI-2)).

MATERIAL AND METHODS

Clinically treated inpatient psychiatric patients (n = 30) were compared with subjects of sociomedical assessments (n = 29) regarding their tendency to simulate or aggravate symptoms.

RESULTS

It could be shown that the WMT and the SIMS both failed in the differentiation between psychiatric patients and subjects of sociomedical assessments, regarding description of symptoms or (un)restricted performance motivation. Furthermore, 20% of psychiatric patients were classified as false positive in WMT. The results of the SIMS were significantly related to the severity of psychiatric symptoms in SCL-90‑R, therefore the severity of symptoms was assessed rather than the response distortion.

CONCLUSION

The results underline the importance of further research on SVTs in sociomedical assessments, especially regarding symptom severity and response distortion.