The effects of symptom overreporting on PTSD treatment outcome

European Journal of Psychotraumatology

Agnes van Minnen, Birgit van Dalen, Eline M. Voorendonk, Anouk Wagenmans & Ad de Jongh


Background: It is often assumed that individuals with posttraumatic stress disorder (PTSD) who overreport their symptoms should be excluded from trauma-focused treatments.

Objective: To investigate the effects of a brief, intensive trauma-focused treatment programme for individuals with PTSD who are overreporting symptoms.

Methods: Individuals (n = 205) with PTSD participated in an intensive trauma-focused treatment programme consisting of EMDR and prolonged exposure (PE) therapy, physical activity and psychoeducation. Assessments took place at pre- and post-treatment (Structured Inventory of Malingered Symptomatology; SIMS, Clinician Administered PTSD Scale for DSM-5; CAPS-5).

Results: Using a high SIMS cut-off of 24 or above, 14.1% (n = 29) had elevated SIMS scores (i.e., “overreporters”). The group of overreporters showed significant decreases in PTSD-symptoms, and these treatment results did not differ significantly from other patients.  Although some patients (35.5%) remained overreporters at post-treatment, SIMS scores decreased significantly during treatment.

Conclusion: The results suggest that an intensive trauma-focused treatment not only is a feasible and safe treatment for PTSD in general, but also for individuals who overreport their symptoms.

Keywords: malingering; treatment outcome; trauma-focused treatment; symptom overreporting; intensive treatment

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