Evaluating the gold standard: A review and meta-analysis of the Structured Interview of Reported Symptoms.

Abstract

The Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) is often touted as the gold standard of measures of feigning. This label likely arises in part out of the impressive accuracy rates reported in the extensive validation research that preceded its publication. However, since its publication, researchers not only have continued to investigate the measure's utility but have expanded the study of the SIRS to include novel populations, different study methodologies, and abbreviated versions. The current review examines 26 studies using the SIRS to identify feigning, evaluating both its effectiveness at differentiating feigners from genuine responders and the potential impact of moderating variables. Meta-analyses revealed that research published since the initial validation studies demonstrate higher sensitivity but lower specificity rates than those reported in the SIRS manual. Studies in which feigners were composed of simulators yielded higher classification rates than studies sampling actual suspected malingerers. Furthermore, genuine patient samples were significantly more likely than nonclinical samples to be misclassified as feigning. Abbreviated versions of the SIRS also demonstrated equivalent accuracy with the standard measure. The implications of these findings for clinical practice are discussed.

The Structured Inventory of Malingered Symptomatology (SIMS): A Systematic Review and Meta-Analysis

“…The SIRS consists of 172 questions that cover multiple strategies to detect feigned psychopathology, such as absurd symptoms, unlikely combinations of symptoms, reported versus observed symptoms, and abnormal severity of symptoms. The SIRS has been well studied; the metaanalysis by Green and Rosenfeld (2011) yielded a sensitivity (i.e., the likelihood of a positive SVT result in feigners) of .49 and a specificity (i.e., likelihood of a negative SVT result in honest responders) of .95 for the SIRS.…”

“…The majority of known-groups studies employed the SIRS as sole external criterion, but this instrument possesses suboptimal sensitivity. Because of this, groups of honest responders may contain a substantial proportion of false negatives (i.e., feigners who are erroneously classified as honest responders; on average 51%; Green & Rosenfeld, 2011). This may lead to an overestimation of the sensitivity of the SIMS (because the SIMS is not faulted for failing to label false negatives of the SIRS as hits) and an underestimation of specificity (as the SIMS is considered to be incorrect when it does identify false negatives of the SIRS as hits).…”

Detecting malingering mental illness in forensics: Known-Group Comparison and Simulation Design with MMPI-2, SIMS and NIM

“…The SIRS uses multiple strategies to detect feigned psychopathology, such as absurd symptoms, unlikely combinations of symptoms, discrepancies between reported and observed symptoms and referred abnormal severity of symptoms. The SIRS has been well studied; a meta-analysis ( Green & Rosenfeld, 2011 ) yielded a sensitivity (i.e., the likelihood of a positive symptom validity test, SVT result in feigners) of 0.49 and a specificity (i.e., likelihood of a negative SVT result in honest responders) of 0.95. The efficacy of SIRS in classifying KGC groups for the validation of the three tests we used in the present study has been shown for NIM ( Rogers et al, 1998 ; Mogge & LePage, 2004 ; Bocaccini, Murrie & Duncan, 2006 ; Gaines et al, 2007 ), SIMS ( Lewis, Simcox & Berry, 2002 ; Edens, Poytress & Watkins-Clay, 2007 ; Vitacco et al, 2007 ; Clegg, Fremouw & Mogge, 2009 ) and MMPI-2 ( Bocaccini, Murrie & Duncan, 2006 ; Toomey, Kucharski & Duncan, 2009 ; Barber-Rioja et al, 2009 ).…”

Clinical Guide to Mental Disability Evaluations

“…Psychologists should not rely solely on information available in the tests' manuals, but should remain abreast of research about the applications of these scales across populations and settings (Alwes et al 2008;Green and Rosenfeld 2011;Jelicic et al 2011;Vitacco et al 2007Vitacco et al , 2008Weiss et al 2011). The evaluating or consulting psychologist must be familiar with each instrument's capacities both to fail to detect feigning, and to misclassify genuinely impaired evaluees as probable malingerers.…”