Can the Trauma Symptom Inventory-2 distinguish coached simulators from dissociative disorder patients?

Abstract

It is important to understand how CDD individuals score on the TSI-2 so that their results can be recognized and meaningfully interpreted. The TSI-2 may not be a useful measure for distinguishing feigned CDD from CDD. (PsycINFO Database Record

Detecting Negative Response Bias Within the Trauma Symptom Inventory–2 (TSI-2): a Review of the Literature

“…These findings are consistent with the fact that dissociative symptoms often overlap with the tendency to overreport bizarre and eccentric symptoms (Merckelbach et al, 2017). Therefore, to determine the credibility of a given presentation, Palermo and Brand (2019) suggested that the TSI-2 should be used in conjunction with established symptom validity tests (SVTs), such as the SIRS-2 Trauma Index or the MMPI-2 F p scale, given its incremental utility. In fact, previous studies have shown that these measures are effective at differentiating between genuine complex dissociative disorders and feigned symptoms (Brand & Chasson, 2015;Brand et al, 2014Brand et al, , 2016.…”

“…In addition to evaluating internal consistency and temporal stability during instrument development, subsequent research also examined the TSI-2's concurrent, discriminant, construct, and criterion validity. However, recent studies (Palermo & Brand, 2019) have shown that the ATR scale, when used to distinguish coached simulators from patients with dissociative disorders-and using a cutoff of ≥ 15-underperforms compared to the Infrequency-Psychopathology (F p ) scale of the MMPI-2 (Butcher et al, 1989). In fact, the overall diagnostic power (ODP; percent of the sample correctly classified as having or not having the condition of interest) was 60% for the TSI-2 ATR scale, and 83% for the MMPI F p scale (Brand & Chasson, 2015).…”

“…Finally, Palermo and Brand (2019) examined the TSI-2 profile of individuals with complex dissociative disorders (CDDs). Given the relationship between exposure to severe trauma and the presence of CDD (Brand & Stadnik, 2013;Foote et al, 2008;Rodewald et al, 2011;Saxe et al, 2002), the authors hypothesized that patients with CDD would have scores comparable or higher than patients with PTSD.…”

“…Moreover, ODP declined as the cutoff increased, indicating that even if sensitivity and specificity were sacrificed, a high false positive rate persisted. Results suggests that the ATR is more efficient at separating credible from non-credible profiles among individuals with PTSD symptoms (i.e., 89.5%; Weiss & Rosenfeld, 2017), and trauma histories (i.e., 93.8%;Filone & DeMatteo, 2017) rather than CDD (Palermo & Brand, 2019). Of course, these findings must be replicated before definitive population-specific recommendations can be issued.…”

“…The TSI-2 was developed in light of the fact that the first version of the TSI (Briere, 1995) was unable to detect instances when PTSD symptoms were over-reported, grossly exaggerated, or fully fabricated (Palermo & Brand, 2019). The TSI-2 consists of 136 items to which an examinee is asked to rate the frequency of their symptoms, condition, or behavior within the six-month period prior to the assessment.…”