New and Improved? A Comparison of the Original and Revised Versions of the Structured Interview of Reported Symptoms

Abstract

The current study evaluated the accuracy of the Structured Interview of Reported Symptoms, Second Edition (SIRS-2) in a criterion-group study using a sample of forensic psychiatric patients and a community simulation sample, comparing it to the original SIRS and to results published in the SIRS-2 manual. The SIRS-2 yielded an impressive specificity rate (94.3%) that exceeded that obtained using the original SIRS scoring method (92.0%) and approached that observed in the SIRS-2 normative data (97.5%). However, changes in scoring resulted in markedly lower sensitivity rates of the SIRS-2 (36.8% among forensic patients and 66.7% among simulators) compared with the SIRS (47.4% and 75.0%, respectively). The removal of the Total Score from the SIRS-2 further hindered identification of feigning. Analyses also evaluated the additive value of the new RS-Total and MT Index scales in the SIRS-2. Implications of these results for forensic psychologists are discussed.

Utility of the Structured Interview of Reported Symptoms (SIRS-2) in detecting feigned adult attention-deficit/hyperactivity disorder

“…Sensitivity was generally higher than that observed for the SIRS' second edition, ranging from .60 if "Indeterminate" cases were considered not to be feigning and .86 if those with an "Indeterminate" classification were counted towards the "Feigning" cases. This is in line with previous research reporting significant decrements in sensitivity when the SIRS-2 is compared to its predecessor (Brand et al, 2014;Green et al, 2013;Tarescavage & Glassmire, 2016;Tylicki et al, 2018). As approximately 30% of adults with ADHD were wrongfully accused of feigning; however, specificity of the original SIRS was unacceptably low (.24 to .67).…”

“…Specificity of the SIRS-2, on the other hand, was high. These findings extend upon recent studies reporting significantly reduced sensitivity when the SIRS and SIRS-2 are compared (Brand et al, 2014;Green et al, 2013;Tarescavage & Glassmire, 2016;Tylicki et al, 2018). Additionally, they are in line with the developer's cautions (Rogers et al, 2010) which draw attention to the distinction between the detection of feigned mental disorders versus feigned cognitive complaints.…”

“…As measures of classification accuracy, including estimates of sensitivity and specificity, necessitate a dichotomous classification of either "genuine" or "feigning" (see Green et al, 2013), participants classified as "Indeterminate-General" and "Indeterminate-Evaluate" were combined with the "Genuine" responding group to determine accuracy of classification using the SIRS-2 decision model. This yielded a sensitivity of .19 and a specificity of .93.…”

“…The primary goal of these changes was the reduction of false-positive classifications. Yet the comparison of both SIRS editions strongly suggests that the SIRS-2's improved specificity comes at the cost of meaningfully reduced sensitivity among forensic psychiatric patients and disability claimants, as well as individuals presenting with symptoms of Dissociative Identity Disorder (Brand, Tursich, Tzall, & Loewenstein, 2014;Green, Rosenfeld, & Belfi, 2013;Tarescavage & Glassmire, 2016;Tylicki et al, 2018). While the newly introduced RS Total Score (please refer to Method Section for descriptions of the scales and indices) appears to serve its intended purpose in reducing false-positive rates (Green et al, 2013), the value of the new MT Index and SS Index has been called into question (Green et al, 2013;Tarescavage & Glassmire, 2016).…”

Does the R-PAS Meet Standards for Forensic Use? Considerations with Introducing a New Rorschach Coding System

“…Recent research suggests, however, that these relatively minor revisions have resulted in a test that performs quite differently from its predecessor. Green, Rosenfeld, and Belfi (2012), for example, found that although the specificity rates remained impressive, the sensitivity rates were remarkably lower with the SIRS-2.…”