Structured Interview Of Reported Symptoms Research Articles

A simulation study on the utility of the Structured Interview of Reported Symptoms-Second Edition (SIRS-2) in Taiwan Region adults

ABSTRACT The Structured Interview of Reported Symptoms (SIRS) and its revised edition (SIRS-2) are frequently used in forensic psychological evaluations for assessing response style. The present research investigated the utility of this instrument in Taiwan Region adults. In a simulation design, 143 nonclinical volunteers were randomly assigned to either simulating or honest-responding groups. Results indicated that the primary scales of the Chinese SIRS-2 possessed acceptable internal consistency and generated large to very large effect sizes (1.39–2.17) in differentiating simulators and genuine respondents. The convergent validity of the Chinese SIRS-2 was supported by the correlations of its scales with the Chinese MMPI-2 validity scales. Confirmatory factor analysis results showed a one-factor model. The decision models of both the SIRS and SIRS-2 resulted in few to no false positives, while the SIRS had greater sensitivity than the SIRS-2. The SIRS-2 total score generated discrimination rates comparable to the published manual in detecting feigning or honest responding. Results supported the use of the Chinese SIRS-2 in Taiwan Region adults. However, as the research methodology inflates both effect sizes and specificity estimates, further research is needed to examine the clinical utility of the Chinese SIRS-2.

The association between clinicians' initial judgments of feigning and outcomes on symptom validity measures among pretrial forensic psychiatric inpatients

Research suggests the use of validated symptom validity tests to detect feigning is imperative to increase accuracy over unaided clinical judgment, especially in forensic settings. This study examined performance on the Miller Forensic Assessment of Symptoms (M-FAST) and Structured Interview of Reported Symptoms (SIRS) during 297 assessments of forensic inpatients. The risk of being identified as feigning on the M-FAST or SIRS was similar for those who were referred for evaluation of feigning compared to those who were not, but individuals with malingering designations prior to the evaluation scored significantly higher than those without on the M-FAST and several SIRS subscales. Findings support the importance of utilizing objective methods of data collection.

"Comparability of Structured Interview of Reported Symptoms (SIRS) and Structured Interview of Reported Symptoms-Second Edition (SIRS-2) classifications with external response bias criteria": Correction to Tylicki et al. (2018).

Reports an error in "Comparability of Structured Interview of Reported Symptoms (SIRS) and Structured Interview of Reported Symptoms-Second Edition (SIRS-2) classifications with external response bias criteria" by Jessica L. Tylicki, Dustin B. Wygant, Anthony M. Tarescavage, Richard I. Frederick, Elizabeth A. Tyner, Robert P. Granacher and Martin Sellbom (Psychological Assessment, 2018[Sep], Vol 30[9], 1144-1159). In the article there was a minor error in the note to Table 8 in which d₇ was defined as genuine vs. feigning. However, d₇ actually reflects the effect size for indeterminate-general vs. feigning. (The following abstract of the original article appeared in record 2018-04164-001.) Rogers, Sewell, and Gillard (2010) released a revised version of the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992), the SIRS-2, which introduced several new scales, indices, and a new classification model with the overall goal of improving its classification of genuine versus feigned presentations. Since the release of the SIRS-2, several concerns have been raised regarding the quality of the SIRS-2 development and validation samples and the method used to calculate classification accuracy estimates. To further explore issues related to the clinical utility of the SIRS-2, the current study examined associations of the SIRS and SIRS-2 with the Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008/2011) validity scales in separate samples of disability claimants and criminal defendants. Results indicate that the SIRS-2 reduced the number of feigning classifications. Additional analyses suggest that the Modified Total Index and Supplementary Scale Index do not assess the test-taking strategy that Rogers and colleagues (2010) intended the indices to capture. External data indicates that evaluees reclassified on the SIRS-2 in nonfeigning categories exhibited feigned symptoms of psychopathology. Indeed, we found that SIRS-identified feigners showed significant evidence of overreporting on the Minnesota Multiphasic Personality Inventory-2-Restructured Form validity scales, regardless of their SIRS-2 classification. The current study highlights the overall weakness in clinical utility of the SIRS-2. Implications of these results for both clinical and forensic settings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Comparability of Structured Interview of Reported Symptoms (SIRS) and Structured Interview of Reported Symptoms-Second Edition (SIRS-2) classifications with external response bias criteria.

Rogers, Sewell, and Gillard (2010) released a revised version of the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992), the SIRS-2, which introduced several new scales, indices, and a new classification model with the overall goal of improving its classification of genuine versus feigned presentations. Since the release of the SIRS-2, several concerns have been raised regarding the quality of the SIRS-2 development and validation samples and the method used to calculate classification accuracy estimates. To further explore issues related to the clinical utility of the SIRS-2, the current study examined associations of the SIRS and SIRS-2 with the Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008/2011) validity scales in separate samples of disability claimants and criminal defendants. Results indicate that the SIRS-2 reduced the number of feigning classifications. Additional analyses suggest that the Modified Total Index and Supplementary Scale Index do not assess the test-taking strategy that Rogers and colleagues (2010) intended the indices to capture. External data indicates that evaluees reclassified on the SIRS-2 in nonfeigning categories exhibited feigned symptoms of psychopathology. Indeed, we found that SIRS-identified feigners showed significant evidence of overreporting on the Minnesota Multiphasic Personality Inventory-2-Restructured Form validity scales, regardless of their SIRS-2 classification. The current study highlights the overall weakness in clinical utility of the SIRS-2. Implications of these results for both clinical and forensic settings are discussed. (PsycINFO Database Record

Supplemental Material for Comparability of Structured Interview of Reported Symptoms (SIRS) and Structured Interview of Reported Symptoms–Second Edition (SIRS-2) Classifications With External Response Bias Criteria

Supplemental Material for Comparability of Structured Interview of Reported Symptoms (SIRS) and Structured Interview of Reported Symptoms–Second Edition (SIRS-2) Classifications With External Response Bias Criteria

A pilot study on the Chinese Minnesota Multiphasic Personality Inventory-2 in detecting feigned mental disorders: Simulators classified by using the Structured Interview of Reported Symptoms.

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is often used in forensic psychological/psychiatric assessment. This was a pilot study on the utility of the Chinese MMPI-2 in detecting feigned mental disorders. The sample consisted of 194 university students who were either simulators (informed or uninformed) or controls. All the participants were administered the Chinese MMPI-2 and the Structured Interview of Reported Symptoms-2 (SIRS-2). The results of the SIRS-2 were utilized to classify the participants into the feigning or control groups. The effectiveness of eight detection indices was investigated by using item analysis, multivariate analysis of covariance (MANCOVA), and receiver operating characteristic (ROC) analysis. Results indicated that informed-simulating participants with prior knowledge of mental disorders did not perform better in avoiding feigning detection than uninformed-simulating participants. In addition, the eight detection indices of the Chinese MMPI-2 were effective in discriminating participants in the feigning and control groups, and the best cut-off scores of three of the indices were higher than those obtained from the studies using the English MMPI-2. Thus, in this sample of university students, the utility of the Chinese MMPI-2 in detecting feigned mental disorders was tentatively supported, and the Chinese Infrequency Scale (ICH), a scale developed specifically for the Chinese MMPI-2, was also supported as a valid scale for validity checking.

Likelihood of obtaining Structured Interview of Reported Symptoms (SIRS) and SIRS-2 elevations among forensic psychiatric inpatients with screening elevations on the Miller Forensic Assessment of Symptoms Test.

The Miller Forensic Assessment of Symptoms Test (M-FAST) was designed as a screening measure for feigned psychiatric symptoms. When M-FAST Total Scores are elevated (raw score ≥6), the test manual recommends follow-up with a more comprehensive measure of feigning, such as the widely used and researched Structured Interview of Reported Symptoms (SIRS) or the revised version of the test (SIRS-2). The purpose of the current study was to evaluate how often M-FAST screening elevations are associated with subsequent elevations on the SIRS or SIRS-2. The sample included archival data from 100 forensic psychiatric inpatients who obtained M-FAST Total Score elevations ≥6 during screening and were subsequently administered the SIRS (that was also rescored using SIRS-2 criteria). Among examinees who elevated the M-FAST over the recommended cutoff, 66.0% met standard SIRS feigning criteria, 42% met SIRS-2 criteria for feigning, and 81.0% obtained at least 1 SIRS/SIRS-2 elevation in the Probable Feigning range or higher. These results are consistent with the M-FAST manual guidelines, which support the use of the ≥6 M-FAST cutoff score to screen for potential feigning (but not as an independent marker of feigning). A higher M-FAST cutoff score of ≥16 was associated with subsequently meeting full SIRS criteria for feigning in 100.0% of protocols. Because the SIRS criteria were designed to have very low false positive rates, these findings indicate that more confident assertions about feigning can be made when elevations reach this level on the MFAST. (PsycINFO Database Record

Differences between Structured Interview of Reported Symptoms (SIRS) and SIRS-2 sensitivity estimates among forensic inpatients: A criterion groups comparison.

The Structured Interview of Reported Symptoms (SIRS) underwent a major revision in 2010 yielding the SIRS-2. The new test has since been criticized for several potential problems, particularly in terms of its sensitivity to feigned psychopathology. For this reason, the purpose of this study was to examine the concordance between SIRS and SIRS-2 classifications and sensitivity estimates in an archival sample of 263 criminal defendants (215 males, 48 females) who were admitted to a high-security state psychiatric hospital for restoration of competency to stand trial. In a subgroup of 39 presumed feigning patients who elevated 1 or more collateral measures of feigning (primarily the M-FAST) at conservative cutoffs, we found marked discrepancies between the sensitivity of the SIRS (.87) and SIRS-2 (.54). The marked differences in sensitivity were partially explained by a global interpretation discordance rate of 47%, with discordance primarily resulting from SIRS-based feigning cases being classified as indeterminate on the SIRS-2. Follow-up analyses of intercorrelations and percentile distributions indicated that the new SIRS-2 scales may lack utility in the assessment of feigning because of problems relating to the construct validity of the scales and their interpretive cutoffs. Future directions in research and clinical practice are discussed, with added emphasis on the significant limitations of archival pretrial forensic samples for identifying presumed genuine groups necessary to calculate specificity estimates (which were meaningfully higher for the SIRS-2 in this sample). Overall, the primary clinical implication is that feigning should remain a strong consideration in SIRS-2 cases yielding an indeterminate classification. (PsycINFO Database Record

The Relationship Between Psychiatric and Cognitive Symptom Feigning Among Forensic Inpatients Adjudicated Incompetent to Stand Trial.

The accurate assessment of feigning is an important component of forensic assessment. Two potential strategies of feigning include the fabrication/exaggeration of psychiatric impairments and the fabrication/exaggeration of cognitive deficits. The current study examined the relationship between psychiatric and cognitive feigning strategies using the Structured Interview of Reported Symptoms and Test of Memory Malingering among 150 forensic psychiatric inpatients adjudicated incompetent to stand trial. A greater number of participants scored within the feigning range on the Structured Interview of Reported Symptoms than on the Test of Memory Malingering. Relative risk ratios indicated that individuals shown to be feigning cognitive deficits were 1.68 times more likely to feign psychiatric symptoms than those not shown to be feigning cognitive deficits. Likewise, individuals shown to be feigning psychiatric deficits were 1.86 times more likely to feign cognitive deficits than those not shown to be feigning psychiatric symptoms. Overall, findings suggest that psychiatric feigning and cognitive feigning are related, but can be employed separately as feigning strategies. Therefore, clinicians should consider evaluating for both feigning strategies in forensic assessments where cognitive and psychiatric symptoms are being assessed.

Measures of Symptom Exaggeration for Mental Health Disorders: A Systematic Review.

Introduction .- Measures that help detect exaggeration of symptoms can be valuable for informing more accurate diagnoses and aid in treatment and case management. We completed a systematic review to identify measures that assess symptom exaggeration in mental health disorders. Methods .- Eligible studies assessed exaggeration of symptoms with a psychometrically validated measure in patients presenting with a mental health disorder. We searched MEDLINE and PsycINFO from inception to June 2013 for relevant studies. To determine study eligibility, reviewers screened title and abstracts of identified citations, and reviewed full texts of all potentially eligible citations. Data extractors completed data abstraction of eligible studies. Results .- Of 8435 unique citations, 105 studies consisting of 112 cohorts were eligible, and we identified 36 unique, validated measures assessing exaggeration of symptoms. The most frequently used measures were symptom validity indicators embedded in the Minnesota Multiphasic Personality Inventory (MMPI-2) (n=48, 46%), the Structured Interview of Reported Symptoms (SIRS) (n=12, 11%), and the Personality Assessment Inventory (PAI) (n=11, 10%). Most studies (n=96; 91%) failed to test reliability of their measure of symptom exaggeration. The symptom validity indicators in the MMPI/MMPI-2 and the SIRS both showed moderate to high internal consistency, range 0.47 to 0.85 and 0.48 to 0.95, respectively. Conclusions .- Multiple measures assessing symptom exaggeration have been used in patients with mental health disorders. The symptom validity indicators of the MMPI/MMPI-2 are the most widely used measures to assess symptom exaggeration. Assessment and reporting of reliability is poor across studies; we require further assessment of psychometric properties for existing measures of symptom exaggeration.

An examination of the association between psychopathy and dissimulation using the MMPI-2-RF validity scales.

This investigation sought to determine whether individuals high on psychopathic traits are better able than those low on such traits to avoid detection when feigning psychopathology in the context of a forensic psychological evaluation. Study 1 tested whether individuals high on psychopathy were better able than those low on psychopathy to avoid detection by the Minnesota Multiphasic Personality Inventory 2-Restructured Form's (MMPI-2-RF; Ben-Porath, Y. S., & Tellegen, A., 2008, Minnesota Multiphasic Personality Inventory-2 Restructured Form: Manual for administration, scoring and interpretation, Minneapolis, MN: University of Minnesota Press.) overreporting (F-r, Fp-r) and underreporting (L-r and K-r) validity scales, when undergraduate students were asked to feign good, feign bad, or respond honestly. Study 2 aimed to replicate and extend the overreporting (F-r and Fp-r) analyses in a forensic pretrial sample, in which individuals were classified as malingering or not malingering using the Structured Interview of Reported Symptoms (SIRS; Rogers, R., Bagby, R. M., & Dickens, S. E., 1992, Structured Interview of Reported Symptoms. Tampa, FL, Psychological Assessment Resources.). Combined results indicated that psychopathy did not affect the utility of the MMPI-2-RF validity scales in detecting overreporting. The underreporting analyses indicated that psychopathy did not affect the utility of L-r; however, callous-aggressive (or "meanness") psychopathy traits moderated the utility of K-r in detecting those feigning psychological adjustment, such that K-r was better able to detect individuals high on, rather than low on, psychopathy when underreporting. These results are promising in terms of evidence that individuals high on psychopathic traits are not any better than individuals low on these traits in feigning during psychological evaluations.

The Detection of Feigning Using Multiple PAI Scale Elevations

Archival data were collected from 98 male inmates at a psychiatric inpatient unit to examine the utility of the Multiscale Feigning Index (MFI) as a proposed feigning index for the Personality Assessment Inventory (PAI). MFI was compared with existing PAI feigning indices, Malingering (MAL), Negative Impression Management (NIM), and Rogers Discriminant Function (RDF), using performance on the Structured Interview of Reported Symptoms (SIRS) as the feigning criterion. Regression analyses revealed that MFI was a stronger predictor of SIRS outcome than NIM, MAL, and RDF. In addition, NIM, MAL, and RDF did not add substantial incremental validity to MFI in predicting SIRS outcome. Receiver operating characteristic analyses revealed sensitivity of 68.89% and specificity of 94.34% at an MFI cutoff of more than 76, which compared favorably with the utility of NIM, MAL, and RDF.

The Utility of the Structured Interview of Reported Symptoms in a Sample of Individuals With Intellectual Disabilities

The challenges of accurate forensic assessment are aggravated when evaluatees have intellectual disabilities. Few studies have addressed the efficacy of forensic assessment in samples diagnosed with an intellectual disability, and those that have typically focus on measures of cognitive effort rather than on feigned psychiatric symptoms. This study focuses on the applicability of the original and revised versions of the Structured Interview of Reported Symptoms (SIRS) in a sample of participants with genuine intellectual disabilities. The SIRS was administered to 43 individuals diagnosed with intellectual disabilities, all of whom were asked to respond honestly. A considerable proportion of these respondents were misclassified as feigning psychiatric symptoms. These misclassifications were most frequent when the respondents had comorbid psychiatric diagnoses. The updated scoring algorithm of the SIRS-2 generated a rate of misclassifications that was substantially lower but that still exceeded published normative data. The implications for forensic assessment are discussed.

The Structured Interview of Reported Symptoms 2nd Edition (SIRS-2): The New Benchmark towards the Assessment of Malingering

The assessment of malingering is one of the most challenging tasks practicing forensic psychologists commonly encounter in their work. The Structured Interview of Reported Symptoms (SIRS), originally released in 1992, has come to be regarded as a psychometric benchmark for the assessment of malingering. This article reports on some of the features contained in its second edition (now known as the SIRS-2). Key developments include various scale indexes, a tabulated decision model for the interpretation of test results, and a mechanism to enhance test item security.

The negative distortion scale: a new PAI validity scale

The personality assessment inventory (PAI) includes three scales to address negative feigning, but none have proved successful under all circumstances, especially with forensic populations. Using psychiatric inpatients, a new validity scale was developed for individuals presenting with higher levels of psychopathology, as often is the case with forensic patients. Items with extreme response frequencies were identified from within PAI's eight clinical scales that address psycho-pathology; from these a negative distortion scale (NDS) was constructed. To evaluate efficacy of the NDS, the structured interview of reported symptoms (SIRS) was used as a criterion measure for malingering. The NDS was found to effectively discriminate suspected malingerers, and it added incremental validity to existing PAI validity measures.

Recent Developments in Acute Pancreatitis

The incidence of acute pancreatitis (AP) has been increasing worldwide, but the major etiologies remain gallstones and alcohol. Several studies have reported that smoking is an independent risk factor for developing AP. Classification of AP has traditionally used the categories of mild and severe disease. However, a new intermediate category of moderately severe AP has been described with intermediate characteristics including a high incidence of local complications but a low mortality. Assessment criteria that can serve as early predictors of AP severity are often complex and not sufficiently accurate. However, several recently described criteria that rely on criteria such as the body mass index, physical findings, and simple laboratory measurements could prove useful if validated in large prospective studies. Many issues related to the therapy of AP are still unresolved. Although preliminary studies support the importance of early volume expansion for the treatment of acute pancreatitis, optimization of the amount and type of fluids will require further studies. Similarly, preliminary studies suggest that enteral nutrition might benefit patients with AP and could even be useful early in the course of disease. However, the timing and type of fluids as well as the intestinal infusion site require further study. Finally, issues related to the prophylactic use of antibiotics in patients with severe AP have not been resolved. While the process of clinical investigation moves slowly, progress has been made in clinical studies of AP.

Malingering in a correctional setting: the use of the Structured Interview of Reported Symptoms in a jail sample

The ability to detect malingering in the correctional setting is of paramount importance. The burgeoning jail and prison population combined with statutory requirements for the provision of mental health treatment require that only those most in need receive these services. Several structured assessments have been developed to assist in the identification of individuals more likely to be feigning psychiatric symptoms. Prior to the development of these specialized assessments, subscales of standard psychological tests were used as an indicator of assessment attitudes, for both malingering and other dissimulation. At the Sacramento County (CA) Jail, the Structured Interview of Reported Symptoms (SIRS) is routinely administered when clinicians feel there is a possibility that an inmate receiving psychiatric services may be feigning or exaggerating his/her symptoms. Our study examined data from these evaluations of inmates in conjunction with other clinical data (e.g., psychiatric diagnosis, educational level) to determine those factors most associated with malingering in jail inmates. Our results indicate that the prevalence of malingering in our sample was quite high: over 66% were found to be malingering based on the scoring criteria for the SIRS. Inmates diagnosed with Antisocial Personality Disorder were no more likely to feign symptoms than inmates without this diagnosis. Inmates designated as malingering in their charts were no more likely to be found malingering on the SIRS, suggesting that they may have adopted an effective strategy.

The Utility of the MMPI-2 Criminal Offender Infrequency (Fc) Scale in the Detection of Malingering in Criminal Defendants

Recognizing that nonmalingering criminal subjects often elevate both the Infrequency (F) and Infrequency Psychopathology (Fp) scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Megargee (2004) developed the Criminal Offender Infrequency (Fc) scale, which includes items infrequently endorsed by criminal offenders. This study compared MMPI-2 F, F(p), Fb and Fc elevations of criminal defendants who classified as malingering or not malingering using the Structured Interview of Reported Symptoms (SIRS). Results of Logistic Regression Analyses suggested that the Fc scale performed better than F(p) and Fb, and at least as good as F in the detection of malingering in this forensic sample. Sensitivity, Specificity, Positive and Negative Predictive Validity Values for F, Fp and Fc are provided.

Utility of the Structured Inventory of Malingered Symptomatology (SIMS) and the Assessment of Depression Inventory (ADI) in screening for malingering among outpatients seeking to claim disability

A sample of 56 disability seekers were administered the Structured Interview of Reported Symptoms (SIRS), the Structured Inventory of Malingered Symptomatology (SIMS), and the Assessment of Depression Inventory (ADI). Individuals were classified as honest or suspected malingerers based on their SIRS scores. Additionally, 60 individuals from the community completed the SIMS and the ADI honestly or as if they were malingering depression. Both malingering groups had significantly higher mean scores on the SIMS total and ADI feigning scales than both honest groups. The scores of the malingering groups did not significantly differ. The utility of various cut-off scores on these scales is presented and discussed. In the clinical sample, previously recommended SIMS total cut-off scores (>14 or >16) had excellent sensitivity, but low specificity. Conversely, the recommended ADI feigning cut-off score (>13) had excellent specificity, but low sensitivity. Increasing the SIMS total cut-off score to >19 and decreasing the ADI feigning cut-off score to >9 may improve their utility in screening for malingering among outpatients seeking to claim disability.

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.