SIMS: symptom simulation test

Some people try to trick the psychologist into issuing a diagnosis that interests them based on the simulation of symptoms. We talk about a serious problem and one against which psychologists are often helpless.: In their actions they rely on the patient’s honesty. Now, what can they do to not be deceived?

Deception can be an art, so its detection is a real challenge for specialists. Therefore, they are necessary Specific measuring instruments that unmask this type of “fictitious” patients.

In this sense, and with the aim of detecting patterns of falsification and exaggeration of symptoms, the Structured Inventory of Simulation of Symptoms (SIMS) has been developed. Thanks to it, the simulation hypothesis can be contrasted and increase the reliability, validity and precision of psychological assessment.

Symptom credibility

It is the responsibility of the psychologist judge the accuracy and reliability of any source that may influence the outcome of the evaluation and, when possible, corroborate the information. Thus, you must consider the possibility that the person who has come to the consultation is moving into the realm of deception. Sometimes, family and friends can be more reliable than the patient himself. Especially in cases that present with anosognosia.

The problem: the symptoms or testimonies given by these people cannot be the subject of a major investigation, if only because of the amount of resources that such an investigation would demand. Therefore, one must choose explore what can be analyzed: the symptoms and findings and the patient’s clinical picture. Thus, the possible feigning of illness can be determined, according to scientific and diagnostic criteria.

What does SIMS consist of?

The purpose of SIMS is to detect the simulation of psychopathological and neuropsychological symptoms. It is an evaluation instrument made up of 75 dichotomous response items (true or false). In addition, it is made up of 5 scales, with 15 items each:

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Psychosis. Unusual or extravagant psychotic symptoms, atypical of the real pathology. Its sweeping area of symptom simulation is psychopathology. “I think the government has installed video cameras on traffic signs to spy on me.” “N“or there is nothing I can do, other than taking medication, that will have any effect on the voices I hear.”Neurological impairment. Illogical or very atypical neurological symptoms. Your symptom simulation sweep area is the physical. “Walking is very difficult for me, due to my balance problems.”Amnestic disorders. Symptoms related to memory disorders. For example, “The biggest problem I have is my memory.” either “I have difficulty remembering the day of the week”. Its sweeping area of symptom simulation is cognitive.Low intelligence. Exaggeration of the intellectual deficit, through failure regarding general knowledge questions. Just like the previous one. Its sweeping area of symptom simulation is cognitive. “The capital of Italy is Hungary” either “A week is made up of 6 days.”Affective disorders. Atypical symptoms of depression and anxiety. Your symptom simulation sweep area is the. Psychopathological. For example, “I rarely laugh” or “I cry very rarely.”

To establish simulation or not, cut-off points are provided on each scale. Thus, the score in each of them allows us to detect the symptoms that present atypically; or the way in which the person being evaluated tries to falsify a specific disorder. This It allows us to know both the degree of suspicion of simulation and the areas in which it occurs.

Application time

Its application time is very short, about 10 or 15 minutes. Thanks to this, it can be used as a screening test or identification of clinical signs quickly and effectively; or as part of a more extensive, complete and exhaustive test battery. Furthermore, it can be applied in different contexts and adapts to different conditions and needs of clinical, labor, medical-legal and/or forensic nature.

Who simulates symptoms?

Malingering of symptoms is more common in individuals involved in a criminal investigation or civil litigation. As well as in the course of insurance disability or workers’ compensation claims.. However, this test is also useful to detect shoplifters who pretend to be kleptomaniacs, in order to avoid being prosecuted or use it as a mitigating circumstance in court.