اعتبارسنجی روش های تشخیص تمارض متعدد در یک نمونه بزرگ بالینی

The purpose of this study is to further previous research that has shown that common neuropsychological tests can do “double duty” as test of motivation/malingering. Using a large clinical sample of 796 participants, it was found that the nine neuropsychological tests (when used together) were able to correctly identify litigant and nonlitigating groups. Failure on any two of the malingering tests suggested motivational/malingering issues. The groups consisted of mild, moderate, and severe traumatic brain-injured patients; chronic pain, depressed, community controls, and “malingering actors.” Institutionalized and noninstitutionalized patient performance were also examined. This method showed 83% sensitivity and 100% specificity. A 0% false positive rate was found, suggesting good reliability especially in litigating settings. A group of patients for whom this method of motivational assessment might not be appropriate was also identified.

It has long been the authors’ opinion that tests of malingering are (unfortunately) a necessary part of a neuropsychological assessment, and that the validity of the neuropsychological tests used in the profile need to be checked for validity. It has been well reported by other authors (Goebel, 1983; Greiffenstein, Gola, & Baker, 1995; Heaton, Smith, Lehman, & Vogt, 1978; Iverson & Binder, 2000, Meyers & Diep, 2000 and Meyers & Volbrecht, 1998a; Oberg, Udessen, Thomsen, Gade, & Mortensen, 1985) that not all malingerers perform identically on neuropsychological tests. The assessment of malingering has been approached in many ways.