Diagnostic utility of the Structured Inventory of Malingered Symptomatology (SIMS) in detecting feigned cognitive impairment in older adults.

IF 2.6 3区心理学 Q2 CLINICAL NEUROLOGY

Clinical Neuropsychologist Pub Date : 2026-07-21 DOI:10.1080/13854046.2026.2702531

Marie Kompasova, Lenka Kramska, Ales Bartos

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引用次数: 0

Abstract

Objective: The primary aim of this study was to evaluate the diagnostic utility of the Structured Inventory of Malingered Symptomatology (SIMS) in detecting feigned cognitive impairment, specifically through self-reported cognitive and neurological symptoms, among older adults.

Method: The study was carried out at the University Hospital Kralovske Vinohrady in Prague, Czech Republic. The study included 172 participants: 56 patients with cognitive impairment (33 patients with MCI and 23 patients with dementia), 54 healthy elderly volunteers as a simulation group, and 62 healthy elderly honest responders. SIMS was used as the primary research tool. Cognitive performance was evaluated using the RBANS and the MoCA. Emotional status and functional abilities were measured using the GDS-15, BAI, and FAQ.

Results: Our results support the utility of SIMS in older adults, as the instrument significantly distinguished feigned symptoms from genuine cognitive impairment. At the proposed cutoff score of > 20, the SIMS Total Score yielded 100% sensitivity and specificity. For the AM scale, sensitivity reached 89% and specificity 98% (cutoff > 7), while the NI scale achieved 87% sensitivity and 96% specificity (cutoff > 6). AUC values for these scales exceeded .959.

Conclusions: The primary contribution of this work is the introduction of revised cutoff scores specifically tailored for older adults (Total Score > 20, AM > 7, NI > 6, AF > 6, p > 2, and LI > 2). These adjusted criteria minimize the risk of false-positive results while extending the potential applications of SIMS within both clinical and forensic settings.

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结构量表的诊断效用的伪装症状（SIMS）在检测假性认知障碍的老年人。

目的：本研究的主要目的是评估结构化症状量表（SIMS）在检测假性认知障碍方面的诊断效用，特别是通过老年人自我报告的认知和神经症状。方法：研究在捷克共和国布拉格克拉洛夫斯克大学医院进行。该研究包括172名参与者：56名认知障碍患者（33名轻度认知障碍患者和23名痴呆症患者），54名健康老年志愿者作为模拟组，62名健康老年人诚实应答者。SIMS是主要的研究工具。使用rban和MoCA评估认知表现。采用GDS-15、BAI和FAQ对情绪状态和功能能力进行测量。结果：我们的研究结果支持SIMS在老年人中的效用，因为该仪器可以显著区分假装的症状和真正的认知障碍。在建议的临界值为bbbb20时，SIMS总分的敏感性和特异性均为100%。对于AM量表，灵敏度达到89%，特异性达到98%（截止> 7），而NI量表的灵敏度为87%，特异性为96%（截止> 6）。这些尺度的AUC值超过0.959。结论：这项工作的主要贡献是引入了专门为老年人量身定制的修订截止评分（Total Score >0, AM bbb7, NI bbb6, AF bbb6, p >2和LI >2）。这些调整后的标准最大限度地降低了假阳性结果的风险，同时扩大了SIMS在临床和法医环境中的潜在应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuropsychologist 医学-临床神经学

CiteScore

8.40

自引率

12.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.