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

Psychol Trauma. 2019 Jul;11(5):477-485. doi: 10.1037/tra0000382. Epub 2018 Jul 19.

Abstract

Objective: The first objective was to understand how individuals with complex dissociative disorders (CDD) score on the Trauma Symptom Inventory-2 (TSI-2). These individuals have high elevations on many psychological measures' validity and clinical scales because of the severe traumatic reactions they experience; thus, creating a challenge for clinicians who seek to determine whether these individuals are exaggerating reported symptoms. The second objective was to compare coached CDD simulators to CDD profiles on the TSI-2s clinical and validity scales. The third objective was to examine the utility rates of the TSI-2s Atypical Response Scale (ATR) in distinguishing feigned CDD from clinical CDD.

Method: This study compared 39 CDD inpatients to 51 coached CDD simulators on the TSI-2. A profile analysis compared the CDD group and coached simulators on the TSI-2 scales, and post hoc 1-way analysis of covariances (ANCOVAS) examined significant differences between the groups.

Results: The CDD patients elevated on most of the TSI-2 clinical scales and factors. There were significant differences between CDD patients' and CDD simulators' TSI-2 profiles, with simulators failing to endorse some of the co-occurring symptoms common in CDD. The ATR correctly classified only 60-73% of participants and its specificity scores were low.

Conclusions: 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 (c) 2019 APA, all rights reserved).

MeSH terms

  • Adolescent
  • Adult
  • Diagnosis, Differential
  • Dissociative Disorders / diagnosis*
  • Factitious Disorders / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Simulation
  • Psychiatric Status Rating Scales
  • Young Adult