Symptom Validity Testing in Somatoform and Dissociative Disorders: A Critical Review

Merten, Thomas; Merckelbach, Harald

doi:10.1007/s12207-013-9155-x

Cited by 78 publications

(46 citation statements)

References 109 publications

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“…Almost two-thirds of the sample scored above the cutoff for the exaggeration scale. One could speculate that dissociative psychopathology causes symptom exaggeration, but Merten and Merckelbach's (2013) review points out that the reverse-intentional symptom exaggeration is conducive to reported dissociative symptoms-might be as plausible. For example, Kong, Allen, and Glisky (2008) evaluated interidentity memory transfer in DID patients and control participants instructed to simulate/malinger symptoms of DID.…”

Section: Commentmentioning

confidence: 99%

The trauma model of dissociation: Inconvenient truths and stubborn fictions. Comment on Dalenberg et al. (2012).

Lynn

Lilienfeld

Merckelbach

et al. 2014

Psychological Bulletin

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129

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Dalenberg et al. (2012) argued that convincing evidence (a) supports the longstanding trauma model (TM), which posits that early trauma plays a key role in the genesis of dissociation; and (b) refutes the fantasy model (FM), which posits that fantasy proneness, suggestibility, cognitive failures, and other variables foster dissociation. We review evidence bearing on Dalenberg et al.'s 8 predictions and find them largely wanting in empirical support. We contend that the authors repeat errors committed by many previous proponents of the TM, such as attributing a central etiological role to trauma in the absence of sufficient evidence. Specifically, Dalenberg et al. leap too quickly from correlational data to causal conclusions, do not adequately consider the lack of corroboration of abuse in many studies, and underestimate the relation between dissociation and false memories. Nevertheless, we identify points of agreement between the TM and FM regarding potential moderators and mediators of dissociative symptoms (e.g., family environment, biological vulnerabilities) and the hypothesis that dissociative identity disorder is a disorder of self-understanding. We acknowledge that trauma may play a causal role in dissociation but that this role is less central and specific than Dalenberg et al. contend. Finally, although a key assumption of the TM is dissociative amnesia, the notion that people can encode traumatic experiences without being able to recall them lacks strong empirical support. Accordingly, we conclude that the field should now abandon the simple trauma-dissociation model and embrace multifactorial models that accommodate the diversity of causes of dissociation and dissociative disorders.Keywords: dissociation, dissociative disorder, dissociative identity disorder, trauma, sociocognitive modelThe notion that people dissociate to cope with trauma has its roots in the writings of Janet (1889/1973). This trauma model (TM) remains influential among some clinical scholars (e.g., Dalenberg et al., 2012), who contend that trauma is the key player in the genesis of dissociation. Nevertheless, as we discuss later, advocates of the TM have often neglected to articulate trauma's precise role in the cause of dissociation. Critics of the TM (e.g., Giesbrecht, Lynn, Lilienfeld, & Merckelbach, 2008, 2010Lynn, Lilienfeld, Merckelbach, Giesbrecht, & van der Kloet, 2012;Pope & Hudson, 1995) Correspondence concerning this article should be addressed to Steven Jay Lynn, Psychology Department, Binghamton University (SUNY), Binghamton, NY 13902. E-mail: stevenlynn100@gmail.com This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.Psychological Bulletin © 2014 American Psychological Association 2014 0033-2909/14/$12.00 DOI: 10.1037/a0035570 896 etiology of dissociation and dissociative disorders. 1 An early alternative to the TM, the sociocognitive model (SCM; Lili...

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Section: Commentmentioning

confidence: 99%

The trauma model of dissociation: Inconvenient truths and stubborn fictions. Comment on Dalenberg et al. (2012).

Lynn

Lilienfeld

Merckelbach

et al. 2014

Psychological Bulletin

Self Cite

129

130

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“…There is no empirical evidence for this assumption, and the opposite idea-intentional feigning eventually contributing to somatoform symptoms-can be defended equally forcefully (Merten & Merckelbach, 2013; see also Rogers, Jackson, & Kaminski, 2005).…”

Section: Correlations With Clinical Scales and Other Svtsmentioning

confidence: 99%

The Structured Inventory of Malingered Symptomatology (SIMS): A Systematic Review and Meta-Analysis

Impelen

Merckelbach

Jelícic

et al. 2014

The Clinical Neuropsychologist

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130

102

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We meta-analytically reviewed studies that used the Structured Inventory of Malingered Symptomatology (SIMS) to detect feigned psychopathology. We present weighted mean diagnostic accuracy and predictive power indices in various populations, based on 31 studies, including 61 subsamples and 4009 SIMS protocols. In addition, we provide normative data of patients, claimants, defendants, nonclinical adults, and various experimental feigners, based on 41 studies, including 125 subsamples and 4810 SIMS protocols. We conclude that the SIMS (1) is able to differentiate well between instructed feigners and honest responders; (2) generates heightened scores in groups that are known to have a raised prevalence of feigning (e.g., offenders who claim crime-related amnesia); (3) may overestimate feigning in patients who suffer from schizophrenia, intellectual disability, or psychogenic non-epileptic seizures; and (4) is fairly robust against coaching. The diagnostic power of the traditional cut scores of the SIMS (i.e., > 14 and > 16) is not so much limited by their sensitivity—which is satisfactory—but rather by their substandard specificity. This, however, can be worked around by combining the SIMS with other symptom validity measures and by raising the cut score, although the latter solution sacrifices sensitivity for specificity.

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“…Against this backdrop, a wide array of tests has been developed that intend to provide an indication of the credibility of symptom reports. When employing these instruments, empirically based cut-offs aid in determining whether symptoms are likely to be genuine or not (Merten & Merckelbach, 2013). A reasonably high diagnostic accuracy can be obtained when multiple detection tests are combined.…”

Section: Introductionmentioning

confidence: 99%

“…That is, faking bad may compromise the integrity of clinical data underlying evaluations with regard to diagnosis or therapy progress (Dandachi-FitzGerald et al, 2011;Merten & Merckelbach, 2013;Rosen, 2006), and sometimes it may even impact judicial decisions about competency to stand trial or criminal responsibility (Van Oorsouw & Merckelbach, 2010).…”

Section: Introductionmentioning

confidence: 99%

Antisocial features and “faking bad”: A critical note

Niesten

Nentjes

Bernstein

2015

International Journal of Law and Psychiatry

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Symptom Validity Testing in Somatoform and Dissociative Disorders: A Critical Review

Cited by 78 publications

References 109 publications

The trauma model of dissociation: Inconvenient truths and stubborn fictions. Comment on Dalenberg et al. (2012).

The trauma model of dissociation: Inconvenient truths and stubborn fictions. Comment on Dalenberg et al. (2012).

The Structured Inventory of Malingered Symptomatology (SIMS): A Systematic Review and Meta-Analysis

Antisocial features and “faking bad”: A critical note

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