Niesten Isabella J M, Müller Wenke, Merckelbach Harald, Dandachi-FitzGerald Brechje, Jelicic Marko
Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
Psychol Inj Law. 2017;10(4):368-384. doi: 10.1007/s12207-017-9303-9. Epub 2017 Nov 11.
Is presenting patients with moral reminders prior to psychological testing a fruitful deterrence strategy for symptom over-reporting? We addressed this question in three ways. In study 1, we presented individuals seeking treatment for ADHD complaints ( = 24) with moral primes using the Mother Teresa Questionnaire and compared their scores on an index of symptom over-reporting (i.e., the Structured Inventory of Malingered Symptomatology, SIMS) with those of unprimed patient controls ( = 27). Moral primes slightly decreased SIMS scores, but the effect was not significant. In study 2, we took a different approach to activate moral categories: we recruited individuals seeking treatment for ADHD complaints and asked some of them to sign a moral contract (i.e., prime; = 19) declaring that they would complete the tests in an honest way and compared their scores on the SIMS and standard clinical scales measuring self-reported psychopathology with those of unprimed patient controls ( = 17). Again, we found no convincing evidence that moral cues suppress symptom over-reporting. In study 3, we gave individuals from the general population ( = 132) positive, negative, or neutral moral primes and implicitly induced them to feign symptoms, after which they completed a brief validated version of the SIMS and an adapted version of the b Test (i.e., an underperformance measure). Again, primes did not affect over-reporting tendencies. Taken together, our findings illustrate that moral reminders are not going to be useful in clinical practice. Rather, they point towards the importance of studying contextual and individual difference factors that guide moral decision-making in patients and may be modified to discourage symptom over-reporting.
在心理测试前向患者提供道德提醒,对于抑制症状过度报告而言,是一种有效的威慑策略吗?我们通过三种方式来探讨这个问题。在研究1中,我们使用特蕾莎修女问卷向寻求多动症治疗的个体(n = 24)呈现道德启动刺激,并将他们在症状过度报告指标(即伪装症状结构量表,SIMS)上的得分与未接受启动刺激的患者对照组(n = 27)进行比较。道德启动刺激略微降低了SIMS得分,但效果并不显著。在研究2中,我们采用了不同的方法来激活道德范畴:我们招募了寻求多动症治疗的个体,并要求其中一些人签署一份道德契约(即启动刺激;n = 19),声明他们将诚实地完成测试,并将他们在SIMS和测量自我报告精神病理学的标准临床量表上的得分与未接受启动刺激的患者对照组(n = 17)进行比较。同样,我们没有发现令人信服的证据表明道德线索会抑制症状过度报告。在研究3中,我们给普通人群中的个体(n = 132)呈现积极、消极或中性的道德启动刺激,并暗中诱导他们伪装症状,之后他们完成了一份简短的经过验证的SIMS版本和一份改编版的b测试(即一项表现不佳测量)。同样,启动刺激并未影响过度报告倾向。综合来看,我们的研究结果表明,道德提醒在临床实践中并无用处。相反,它们指出了研究情境和个体差异因素的重要性,这些因素指导患者的道德决策,并且可能被调整以抑制症状过度报告。