Boone Kyle Brauer, Lu Po
Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.
Clin Neuropsychol. 2003 May;17(2):244-54. doi: 10.1076/clin.17.2.244.16497.
In two litigating patients with histories of severe brain injury (i.e., coma > or =2 days and residual brain imaging abnormalities), noncredible cognitive symptomatology was demonstrated by: (1) "failed" performance on multiple cognitive "effort" tests, (2) noncredible performance on standard neuropsychological instruments, (3) questionable validity of personality inventory profiles, and (4) marked inconsistency in test performance across testing evaluations or marked inconsistency between test scores and activities of daily living documented through surveillance videotapes. Some patients with severe traumatic brain injury show substantial, if not full recovery, and in a litigating context, may feign cognitive symptoms. These cases indicate that tests to verify cognitive effort should be routinely administered to all patients in litigation or who have other motive to feign symptoms, not just patients with mild or questionable brain injury.
在两名有严重脑损伤病史（即昏迷≥2天且残留脑成像异常）的诉讼患者中，不可信的认知症状表现为：（1）在多项认知“努力”测试中“未通过”；（2）在标准神经心理学测试工具上表现不可信；（3）人格问卷剖面图的有效性存疑；（4）不同测试评估之间的测试表现存在明显不一致，或测试分数与通过监控录像记录的日常生活活动之间存在明显不一致。一些重度创伤性脑损伤患者即使没有完全康复，也有显著恢复，在诉讼背景下，可能会假装认知症状。这些案例表明，应常规地对所有处于诉讼中的患者或有其他伪装症状动机的患者进行验证认知努力的测试，而不仅仅是轻度或有可疑脑损伤的患者。
