Publication: Prevalence of Symptom Overreporting in the Structured Inventory of Malingered Symptomatology (SIMS) in Clinical Patients: A Meta- Analysis
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Date
2024-10-03
Authors
Puente López, Esteban ; Pina, David ; Dandachi-FitzGerald, Brechje ; Giromini, Luciano ; López Nicolás, Rubén ; Nieto Cañaveras, María Dolores ; Merten, Thomas
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Publisher
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DOI
https://doi.org/10.70478/psicothema.2025.37.18
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info:eu-repo/semantics/article
Description
Abstract
Antecedentes: Los fallos en las pruebas de validez de síntomas (puntuar por encima del punto de corte establecido) pueden producirse en
diversos contextos y situaciones, incluidos los entornos clínicos rutinarios. Hasta la fecha, ningún metaanálisis se ha centrado en la tasa
de fallos del Inventario Estructurado de Simulación de Síntomas (SIMS) en evaluaciones clínicas. Método: Se realizó un meta-análisis
de efectos aleatorios binomial-normal para estimar la tasa de fallos combinada del SIMS entre pacientes con un diagnóstico clínico que
fueron evaluados en un entorno no forense. Resultados: Se incluyeron 34 estudios y 40 muestras (n = 8844). La puntuación media total
del SIMS fue de 15.9 (DE = 5.2). La tasa global estimada de fallo de la SIMS fue del 36% (IC del 95%: 30%-43%; I2 = 96.6%, p < .001).
Conclusiones: Existe una elevada tasa de fallo en el SIMS en poblaciones de pacientes clínicos; sin embargo, estos resultados positivos no
son necesariamente falsos positivos. El reto metodológico de diferenciar los verdaderos de los falsos positivos es vital y debería dictar tanto
la planificación cuidadosa de futuros estudios como la circunspección en la interpretación de las tasas de fallo de las pruebas de validez en
las evaluaciones clínicas
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 (SD = 5.2). The estimated overall failure rate of SIMS was 36% (95% CI: 30%–43%; I2 = 96.6%, p < .001). Conclusions: There is an elevated failure rate on the SIMS in clinical patient populations; however, these positive results are not necessarily false 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.
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 (SD = 5.2). The estimated overall failure rate of SIMS was 36% (95% CI: 30%–43%; I2 = 96.6%, p < .001). Conclusions: There is an elevated failure rate on the SIMS in clinical patient populations; however, these positive results are not necessarily false 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.
Citation
Puente-López, E., Pina, D., Dandachi-FitzGerald, B., Giromini, L., López-Nicolás, R., Nieto-Cañaveras, M. D., & Merten, T. (2025). Prevalence of symptom overreporting in the Structured Inventory of Malingered Symptomatology (SIMS) in clinical patients: A meta-analysis. Psicothema, 37(2), 74-85. https://doi.org/10.70478/psicothema.2025.37.18
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