دقت طبقه بندی آزمون حافظه تمارض در افراد در معرض سموم زیست محیطی و صنعتی گزارشی: نتایج یک تجزیه و تحلیل گروه های شناخته شده

This study used a known-groups design to examine the classification accuracy of the Test of Memory Malingering in detecting cognitive malingering in patients claiming cognitive deficits due to exposure to environmental and industrial toxins. Thirty-three patients who met Slick et al. criteria for Malingered Neurocognitive Dysfunction were compared to 17 toxic exposure patients negative for evidence of malingering, 14 TBI patients and 22 memory disorder patients, both groups without incentive. The original cutoffs (<45) for Trial 2 and Retention demonstrated perfect specificity (0% false positive error rate) and impressive sensitivity (>50%). These findings indicate the TOMM can be used with confidence as an indicator of negative response bias in cases of cognitive deficits attributed to exposure to alleged neurotoxic substances.

The problem of malingering has been relatively neglected in cases of alleged toxic exposure (Bianchini et al., 2003). Nonetheless, it is an issue of some importance given that exposure often occurs in a compensable context. Bianchini et al. (2003) demonstrated that malingering does occur in toxic exposure and illustrated the conservative application of empirically based detection techniques and their use within Slick, Sherman, and Iverson (1999) system for the diagnosis of Malingered Neurocognitive Dysfunction (MND). The survey data of Mittenberg, Patton, Canyock, and Condit (2002) suggest that the prevalence of malingering in alleged cases of neurotoxic chemical-related disease is about 30%. The work of van Hout and colleagues (van Hout, Schmand, Wekking, & Deelman, 2006; van Hout, Schmand, Wekking, Hageman, & Deelman, 2003) suggests a similar range. Appropriate assessment of patients claiming cognitive impairment due to toxic exposure requires the assessment of potential malingering and the development of scientifically based techniques with which to identify malingering patients.