The Self-Report Symptom Inventory as an Instrument for Detecting Symptom Over-Reporting

Abstract

Abstract. The recently developed Self-Report Symptom Inventory (SRSI) intends to provide an alternative approach to the detection of symptom over-reporting. Unlike other measures, the SRSI includes both non-existent symptoms (i.e., pseudosymptoms) and genuine symptoms. Previous research using the German SRSI showed that people who exaggerate their complaints over-endorse both types of symptoms. In the current simulation experiment, we tested whether the Dutch and English SRSI are effective in identifying over-reporting by comparing SRSI scores of an honest group ( n = 51) with those of two experimental simulator groups (pain, n = 54; anxiety, n = 53). The pain and anxiety simulators endorsed significantly more genuine symptoms and pseudosymptoms than honest participants (ηp2 = .50 and ηp2 = .30, respectively). Furthermore, pain and anxiety over-reporters specifically over-endorsed symptoms corresponding to their simulation instructions (Cohen’s ds > 0.77). Using the recommended cut-off score, the SRSI detected 48% of pain over-reporters and 73% of anxiety over-reporters, with areas under the curve (AUC) ranging from .88 to .91. These results indicate that the SRSI is a promising tool for identifying over-reporting, but further research with clinical samples is needed.

Verifiability and Symptom Endorsement in Genuine, Exaggerated, and Malingered Pain

“…Thus, no differences were found between truth tellers and malingerers, nor exaggerators and malingerers in terms of genuine symptoms and pseudosymptoms. These findings are unusual, considering repeated findings that support malingerers' "over-the-top" strategy of endorsing symptoms (Boskovic, Merckelbach, et al, 2019;Merten et al, 2016). In this study, however, it was shown that, although both exaggerators and malingerers exhibited over-reporting, this tendency was slightly stronger among exaggerators, who had an underlying genuine condition that led to a significant difference only between exaggerators and truth tellers.…”

“…In this project, we followed a between-groups design using a simulation paradigm, meaning that participants received instructions in the form of vignettes to simulate a certain condition. Both the SRSI and the VA have been used in simulation design studies (see Boskovic et al, 2017;Boskovic, Dibbets, et al, 2019;Boskovic, Merckelbach, et al, 2019).…”

“…The first two items address understanding the instructions, whereas the remaining items tap into good health and mental abilities. Participants who over-report symptoms are expected to endorse a lower number of these items than honest subjects (see Boskovic, Merckelbach, et al, 2019;Merten et al, 2016). Our truth tellers (M = 2.87, SD = 1.67) endorsed a significantly higher number of these items than both exaggerators (M = 1.57, SD = 1.92) and malingerers (M = 1.49, SD = 1.75; F(2, 166) = 11.64, p < .001, η p 2 = .12).…”

“…Detection Rate SRSI Previous research (Boskovic, Merckelbach, et al, 2019) proposed that the appropriate SRSI cutoff point for pain-related complaints is more than six pseudosymptoms endorsed. By employing this cutoff to our data, 47.6% of exaggerators (n = 30) and 40% of malingerers (n = 16) were correctly classified as over-reporters.…”

“…Whereas the first one assesses underperformance (i.e., poor effort) on cognitive tests, the latter one assesses over-endorsement of symptoms (Merten & Merckelbach, 2013;Merten, Merckelbach, Giger, & Stevens, 2016). The idea behind the SRSVTs is that individuals who exaggerate genuine or fabricate nonexistent symptoms are inclined to over-report their poor health claims (Boskovic, Merckelbach, Merten, Hope, & Jelicic, 2019). Thus, SRSVTs heavily rely on bizarre or atypical symptoms that are unlikely to be experienced by genuine patients.…”