Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Arch Clin Neuropsychol. 2012 Mar;27(2):190-5. doi: 10.1093/arclin/acr119. Epub 2012 Jan 25.
The measurement of effort is now considered to be an important component of neuropsychological assessment. In addition to stand-alone measures, built-in, or embedded measures of effort have been derived for a limited number of standard neurocognitive tests. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used brief battery, employed as a core diagnostic tool in dementia and as a neurocognitive screening battery or tracking/outcome measure in a variety of other disorders. An effort index (EI) for the RBANS has been published previously (Silverberg, N. D., Wertheimer, J. C., & Fichtenberg, N. L. 2007. An EI for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical Neuropsychology, 21 (5), 841-854), but it has been reported to result in high false positive rates when applied to patients with "true" amnesia (e.g., Alzheimer's disease). We created a new effort scale (ES) for the RBANS based on the observation of patterns of free recall and recognition performance in amnesia versus inadequate effort. The RBANS ES was validated on a sample of patients with amnestic disorders and a sample of mild traumatic brain injury participants who failed a separate measure of effort. The sensitivity and specificity of the new ES was compared with the previously published EI. Receiver-operating characteristic analyses demonstrated much better sensitivity and specificity of the ES, with a marked reduction in false positive errors. Application and limitations of the RBANS ES, including indications for its use, are discussed.
现在，努力程度的测量被认为是神经心理学评估的一个重要组成部分。除了独立的测量方法外，还为少数标准神经认知测试衍生出了内置或嵌入式的努力程度测量方法。重复性成套神经心理状态测验（RBANS）是一种广泛使用的简短测验，被用作痴呆症的核心诊断工具，以及各种其他疾病的神经认知筛查测验或跟踪/预后测量工具。之前已经发表了 RBANS 的努力指数（EI）（Silverberg, N. D., Wertheimer, J. C., & Fichtenberg, N. L. 2007. An EI for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical Neuropsychology, 21 (5), 841-854），但当应用于“真正”健忘症（例如阿尔茨海默病）患者时，它被报告会导致高假阳性率。我们根据遗忘症与努力不足患者的自由回忆和识别表现模式，为 RBANS 创建了一个新的努力量表（ES）。我们在一组遗忘症患者和一组未能通过单独的努力测量的轻度创伤性脑损伤参与者样本上验证了 RBANS ES。新 ES 的敏感性和特异性与之前发表的 EI 进行了比较。接受者操作特征分析表明 ES 的敏感性和特异性要好得多，假阳性错误明显减少。讨论了 RBANS ES 的应用和局限性，包括其使用的适应症。
