Prevalence of Symptom Overreporting in the Structured Inventory of Malingered Symptomatology (SIMS) in Clinical Patients: A Meta-Analysis.

Résumé

BACKGROUND: Failure on symptom validity tests may occur in a variety of contexts and situations, including routine clinical settings. To date, no meta-analysis has targeted the failure rate of the Structured Inventory of Malingered Symptomatology (SIMS) in clinical assessments, nor the factors that may moderate this rate.METHOD: We used a binomial-normal random-effects meta-analysis to estimate the pooled failure rate of SIMS among patients with a clinical diagnosis who were evaluated in a non-forensic setting.RESULTS: 34 studies and 40 samples were included. The total sample size was 8844 patients. The mean total SIMS score was 15.9 ( 5.2). The estimated overall failure rate of SIMS was 36% (95% CI: 30%-43%; = 96.6%, < .001).CONCLUSIONS: There is an elevated failure rate on the SIMS in clinical patient populations; however, these positive results are not necessarily positives. The methodological challenge to tell true and false positives apart appears to be of primary importance and should dictate both careful planning of future studies and circumspection when interpreting rates of validity test failure in clinical assessments.