Bianchini Kevin J, Curtis Kelly L, Greve Kevin W
University of New Orleans, LA, USA.
Clin Neuropsychol. 2006 Dec;20(4):831-47. doi: 10.1080/13854040600875203.
The purpose of this study was to determine if there is a dose-response relationship between potential monetary compensation and failure on psychological indicators of malingering in traumatic brain injury. 332 traumatic brain injury patients were divided into three groups based on incentive to perform poorly on neuropsychological testing: no incentive; limited incentive as provided by State law; high incentive as provided by Federal law. The rate of failure on five well-validated malingering indicators across these groups was examined. Cases handled under Federal workers compensation laws showed considerably higher rates of failure and diagnosable malingering than cases handled under State law. The findings indicate that monetary compensation associated with workers compensation claims is a major motive for exaggeration and malingering of problems attributed to work-related brain injuries. The clinician's index of suspicion regarding exaggeration and malingering of symptoms and deficits should be much higher in the context of Federal workers compensation claims, particularly in patients who have suffered only mild traumatic brain injury.
本研究的目的是确定在创伤性脑损伤中，潜在金钱补偿与伪装心理指标表现不佳之间是否存在剂量反应关系。332名创伤性脑损伤患者根据在神经心理学测试中表现不佳的诱因被分为三组：无诱因；州法律规定的有限诱因；联邦法律规定的高诱因。研究了这些组中五项经过充分验证的伪装指标的失败率。根据联邦工人赔偿法处理的案件显示出比根据州法律处理的案件更高的失败率和可诊断的伪装率。研究结果表明，与工人赔偿索赔相关的金钱补偿是夸大和伪装与工作相关脑损伤问题的主要动机。在联邦工人赔偿索赔的背景下，临床医生对症状和缺陷夸大及伪装的怀疑指数应该更高，尤其是在仅遭受轻度创伤性脑损伤的患者中。
