The SIMS Screening Test: Are These Symptoms Real?

Did you ever fake being sick when you were a child to get out of school? Well, not just children do this. Keep reading to learn about adults who fake symptoms.
The SIMS Screening Test: Are These Symptoms Real?

Last update: 20 April, 2019

Some patients try to manipulate their psychologists into diagnosing them with a particular condition by faking symptoms. This is a serious problem that many psychologists have to deal with. At the end of the day, they don’t have any recourse because their actions rely on the patient’s honesty. So what can they do to avoid falling for this kind of trick? One tool at their disposal is the SIMS screening test.

Deceit is an art, which makes identifying it a true challenge for specialists. They need specific evaluation tools to help them unmask lying patients.

That’s where the Structured Inventory of Malingered Symptomology (SIMS) screening test comes in. Researchers developed it to detect when patients lie and exaggerate their symptoms. Thanks to SIMS, psychologists can discover if their patients are lying, thus increasing the validity and accuracy of psychological testing.

Credibility of symptoms

Psychologists have the responsibility of judging the accuracy and trustworthiness of anything that can influence the result of a psychological evaluation. Whenever possible, they should corroborate the information they have. Psychologists always have to consider the possibility that their patient might be lying to them. Sometimes, the patient’s family and friends are more trustworthy than the patient themselves, especially if they’re suffering from anosognosia.

The problem is that psychologists don’t have the time or resources to research what their patients share with them. Thus, they have to explore what’s within their reach: the patient’s symptoms and medical history. They can use scientific and diagnostic criteria to determine if the patient is faking their symptoms or not.

A woman with a psychologist.

How does the SIMS screening test work?

The end goal of the SIMS screening test is to detect fake psychopathological and neuropsychological symptoms. It consists of a total of 75 true-or-false items divided into five levels, each containing fifteen items:

  • Psychosis. Rare or over the top psychotic symptoms, atypical of real pathologies. Patients in this level engage in psychopathological malingering. “I think the government installed video cameras in the traffic lights to spy on me.” “Only medication silences the voices I hear inside my head.”
  • Neurological decline. Illogical or atypical neurological symptoms. Patients in this category engage in physical malingering. “Walking is really hard for me due to my balance problems.”
  • Amnesia. Symptoms related to memory disorders. For example, “I have a lot of memory problems” or “I have a hard time remembering the days of the week.” Patients in this category engage in cognitive malingering.
  • Low intelligence. This is when patients exaggerate their intellectual capacity by giving the wrong answers to obvious questions. For example, “The capital of Italy is Hungary” or “There are six days in a week.”
  • Affective disorders. Atypical depression and anxiety symptoms. Patients who fall into this category display fake psychopathological symptoms. For example, “I rarely laugh” or “I almost never cry.”

To tell if someone is faking it or not, the psychologist assigns points to each level. The number of points in each level allows them to identify the patient’s atypical symptomology or how they’re trying to fake a disorder. The SIMS screening test helps to understand the degree to which the patient is faking it, as well as the areas where they’re doing it.

How long does the SIMS screening test take?

This screening test takes about 10-15 minutes. Thanks to this instrument, health professionals can sift through medical history in a fast and effective way. They can also use the more extensive version of it. The test can be applied to different contexts and adapts to different conditions and needs.

The SIMS screening test.

Who fakes symptoms?

Individuals who are in involved in criminal investigations or in civil court are more likely to fake symptoms. Some people who collect disability checks also tend to lie about their symptoms. Nevertheless, this test is also useful to find petty thieves who steal from stores and then justify themselves by claiming to be kleptomaniacs to avoid any kind of jail or court time.

In conclusion, faking symptoms isn’t technically considered a psychiatric illness. However, if you discover that a patient is consciously and deliberately deceiving you during the SIMS screening test or other diagnostic exams, make sure that you make a note of it in their file.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.