Zakzanis Konstantine K, Gammada Emnet, Jeffay Eliyas
Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada.
Appl Neuropsychol Adult. 2012;19(2):98-107. doi: 10.1080/09084282.2011.644099.
The present study examined the relationship between multiple neuropsychological symptom validity tests (SVTs) and psychological presentation. More formally, we set out to determine if performance on neuropsychological SVTs was related to psychological symptom credibility and which specific neuropsychological SVTs were most associated with noncredible psychological presentation. Archival records from 106 litigating examinees were utilized in this study. Our results illustrate that neuropsychological SVTs are modestly related to psychological symptom credibility and that specific neuropsychological SVTs are variably associated to this end. We conclude that when multiple, but not independent, neuropsychological SVTs are employed within the context of a neuropsychological examination, they do have clinical utility as it relates to credibility of psychological presentation and these constructs do share variance reciprocally in clinically meaningful ways. When independently employed, however, the observed relationship is modest at best. Hence, to place clinical opinion on firmer scientific grounds within the context of a neuropsychological examination, multiple cognitive SVTs, in hand with psychological test instruments that include validity indexes, are essential to derive opinion that is based on science rather than faith in the instance of litigation when an incentive to manifest disability for the sake of an external reward holds probable.
本研究考察了多种神经心理学症状效度测试(SVT)与心理表现之间的关系。更确切地说,我们着手确定神经心理学SVT的表现是否与心理症状可信度相关,以及哪些特定的神经心理学SVT与不可信的心理表现最为相关。本研究使用了106名参与诉讼的受测者的档案记录。我们的结果表明,神经心理学SVT与心理症状可信度有一定关联,并且特定的神经心理学SVT在这方面的关联程度各不相同。我们得出结论,在神经心理学检查中使用多种但并非独立的神经心理学SVT时,它们在与心理表现可信度相关方面确实具有临床效用,并且这些构念确实以临床上有意义的方式相互共享方差。然而,当单独使用时,观察到的关系充其量只是适度的。因此,为了在神经心理学检查的背景下将临床意见置于更坚实的科学基础上,多种认知SVT与包含效度指标的心理测试工具一起,对于得出基于科学而非主观判断的意见至关重要,尤其是在诉讼情况下,当存在为了外部奖励而伪装残疾的动机时。