The effects of symptom overreporting on PTSD treatment outcome

Abstract

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 psycho-education. 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