Arnold Ginger, Boone Kyle Brauer, Lu Po, Dean Andy, Wen Johnny, Nitch Steve, McPherson Susan
Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, CA 90509, USA.
Clin Neuropsychol. 2005 Feb;19(1):105-20. doi: 10.1080/13854040490888567.
Past studies indicate that patients with incentive to fake neuropsychological symptoms are likely to have lower finger tapping scores than credible patients. The present study builds upon past research by investigating finger tapping performance for seven groups: (a) noncredible patients (as determined by failed psychometric and behavioral criteria), and patients with (b) closed head injury, (c) dementia, (d) mental retardation, (e) psychosis, or (f) depression, and (g) healthy older controls. Results showed that men tapped faster than women, requiring that groups be divided by gender. Noncredible male and female patients tapped slower than their comparison group counterparts. Dominant hand score proved to be more sensitive to noncredible performance than other scores (nondominant, sum of both hands, difference between dominant and nondominant), especially for women. Sensitivity, specificity, and positive and negative predictive value tables are presented. With specificity set at 90% for the comparison groups combined, a dominant hand cutoff score of </=35 for men yielded 50% sensitivity, while a score of </=28 yielded 61% sensitivity for women. Specificity values for specific cutoff scores varied significantly across the comparison groups, indicating that cutoffs should be adjusted for the particular differential diagnosis. In conclusion, results indicate that when using finger tapping scores to detect noncredible performance: (a) Dominant hand performance is more sensitive, and (b) cutoffs should be selected based on gender and claimed diagnosis.
以往的研究表明，有动机伪装神经心理学症状的患者，其手指敲击得分可能低于可信的患者。本研究在以往研究的基础上，调查了七组患者的手指敲击表现：（a）不可信患者（由心理测量和行为标准判定），以及患有（b）闭合性颅脑损伤、（c）痴呆、（d）智力障碍、（e）精神病、（f）抑郁症的患者，和（g）健康的老年对照组。结果显示，男性的敲击速度比女性快，因此需要按性别对组进行划分。不可信的男性和女性患者的敲击速度均比其对照组对应人员慢。优势手得分被证明比其他得分（非优势手、双手得分总和、优势手与非优势手之差）对不可信表现更敏感，尤其是对女性。文中给出了敏感性、特异性以及阳性和阴性预测值表。将对照组合并后的特异性设定为90%时，男性优势手截断分数≤35时敏感性为50%，而女性分数≤28时敏感性为61%。特定截断分数的特异性值在各对照组之间差异显著，这表明截断分数应根据特定的鉴别诊断进行调整。总之，结果表明，在使用手指敲击得分来检测不可信表现时：（a）优势手表现更敏感，且（b）应根据性别和声称的诊断来选择截断分数。
