Argosy University Seattle, American School of Professional Psychology, 2601 A. Elliott Avenue, WA 98105, USA.
Clin Neuropsychol. 2011 Feb;25(2):287-301. doi: 10.1080/13854046.2010.538436.
A wide variety of cognitive measures, particularly memory measures, have been studied for their ability to detect suspect effort, or biased responding on neuropsychological assessment instruments. However, visual spatial measures have received less attention. The purpose of this study was to evaluate the classification accuracy of several commonly used visual spatial measures, including the Judgment of Line Orientation Test, the Benton Facial Recognition Test, the Hooper Visual Organization Test, and the Rey Complex Figure Test-Copy and Recognition trials. Participants included 491 consecutive referrals who participated in a comprehensive neuropsychological assessment and met study criteria. Participants were divided into two groups identified as either unbiased responding (UR, N = 415) or biased responding (BR, N = 30) based on their performance on two measures of effort. The remaining participants (N = 46) had discrepant performance on the symptom validity measures and were excluded from further analysis. The groups differed significantly on all measures. Additionally, receiver operating characteristic (ROC) analysis indicated all of the measures had acceptable classification accuracy, but a measure combining scores from all of the measures had excellent classification accuracy. Results indicated that various cut-off scores on the measures could be used depending on the context of the evaluation. Suggested cut-off scores for the measures had sensitivity levels of approximately 32-46%, when specificity was at least 87%. When combined, the measures suggested cut-off scores had sensitivity increase to 57% while maintaining the same level of specificity (87%). The results were discussed in the context of research advocating the use of multiple measures of effort.
已经研究了各种认知测试，尤其是记忆测试，以评估其检测可疑努力或神经心理评估工具中存在偏差反应的能力。然而，视觉空间测试受到的关注较少。本研究的目的是评估几种常用的视觉空间测试的分类准确性，包括线条定向判断测试、本顿面部识别测试、霍普视觉组织测试和 Rey 复杂图形测试的复制和识别试验。参与者包括 491 名连续转诊患者，他们参加了全面的神经心理评估并符合研究标准。参与者根据他们在两项努力测试中的表现分为无偏差反应（UR，N=415）和有偏差反应（BR，N=30）两组。其余（N=46）名参与者在症状有效性测试中表现不一致，因此被排除在进一步分析之外。两组在所有测试中均存在显著差异。此外，接收者操作特征（ROC）分析表明，所有测试均具有可接受的分类准确性，但将所有测试的分数组合在一起的测试具有极好的分类准确性。结果表明，根据评估的具体情况，可以使用各种测试的不同截断分数。建议的测试截断分数具有约 32-46%的敏感性水平，特异性至少为 87%。当组合使用时，这些测试的建议截断分数的敏感性提高到 57%，同时保持相同的特异性（87%）。结果在提倡使用多种努力测试的研究背景下进行了讨论。
