Background: Individuals with dissociative identity disorder (DID) experience severe and broad-ranging symptoms which can be associated with elevations on measures designed to detect feigning and/or malingering. Research is needed to determine how to distinguish genuine DID from simulated DID on assessment measures and validity scales. Objective: This study examined whether the Miller Forensic Assessment of Symptoms Test (M-FAST), a screening measure of malingering, could differentiate between individuals with DID and DID simulators. Method: Thirty-five individuals with clinical, validated DID were compared to 88 individuals attempting to simulate DID on the M-FAST. A MANCOVA compared the two groups on total M-FAST score and subscales. Univariate ANCOVA's examined differences between the groups. A series of logistic regressions were conducted to determine whether group status predicted the classification of malingering. Utility statistics evaluated how well the M-FAST discerned clinical and simulated DID.Results: The M-FAST correctly classified 82.9% of individuals with DID as not malingering when using the suggested cut-off score of six. However, utilizing a cut-off score of seven correctly classified 93.6% of all participants and maintained adequate sensitivity (.96) but demonstrated increased specificity (.89). Conclusions: The M-FAST shows promise in distinguishing genuine DID when the cut-off score is increased to seven. This study adds to the growing body of literature identifying tests that can adequately distinguish clinical from simulated DID. Clinical Impact StatementWhile the M-FAST performed well at classifying malingering among those attempting to simulate dissociative identity disorder (DID), it correctly classified approximately only 83% of individuals diagnosed with DID as not malingering, indicating that a cut-off score of 6 on the M-FAST performs poorly with this population. However, by increasing the cut-off score to 7, the M-FAST improved substantially such that most individuals with DID were classified correctly, while still maintaining high sensitivity. These results suggest that a cut-off score of 7 may be indicated for individuals with DID.
Objective: Women veterans are disproportionately affected by intimate partner violence (IPV). Within the civilian literature, intimate partner stalking (IPS) is a common, uniquely deleterious form of IPV; the present study seeks to prospectively examine the psychological effects of IPS among women veterans. Method: Women veterans (n = 266) were recruited using the KnowledgePanel, a probability-based survey panel; participants completed surveys at time 1 (T1) and at time 2 (T2) follow-up 18 months later. Women responded to questionnaires assessing IPV and IPS experiences, and symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety. Results: At T1, 54.5% of women reported lifetime IPV, of whom 64.1% reported IPS; at T2, 49.2% reported past-year IPV, of whom 7.6% experienced past-year IPS. Bivariately, women in the T1 IPS group reported higher T2 PTSD, depression, and anxiety symptoms than the T1 IPV only and no IPV groups. In a multivariate model, there remained indirect effects of T1 IPS on T2 PTSD symptoms, when other forms of violence (i.e., T1 and T2 IPV, MST, IPS) were controlled. Conclusions: When added to models including other forms of IPV, women who experienced IPS reported increased risk for PTSD symptoms, which predicted heightened PTSD symptoms over time. Providers treating women veterans should assess for experiences of IPS as an additional form of IPV and address PTSD to prevent the development of subsequent comorbid psychopathology. Clinical Impact StatementPrior research indicates that women veterans are disproportionately affected by intimate partner violence (IPV). However, despite civilian research reporting deleterious effects of intimate partner stalking (IPS), there is limited research examining IPS among women veterans. To address this literature gap, our study prospectively explores associations among IPV, IPS, and their negative effects. The findings suggest that IPS contributes to symptom severity. Clinicians should consider inquiring about IPS victimization experiences when assessing for IPV among women veterans in order to inform treatment methods.
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