Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston, MA, USA.
Behav Res Methods. 2019 Jun;51(3):1102-1116. doi: 10.3758/s13428-018-01195-w.
Severe developmental deficits in face recognition ability (developmental prosopagnosia, or DP) have been vigorously studied over the past decade, yet many questions remain unanswered about their origins, nature, and social consequences. A rate-limiting factor in answering such questions is the challenge of recruiting rare DP participants. Although self-reported experiences have long played a role in efforts to identify DPs, much remains unknown about how such self-reports can or should contribute to screening or diagnosis. Here, in a large, population-based web sample, we investigated the effectiveness of self-report, used on its own, as a screen to identify individuals who will ultimately fail, at a conventional cutoff, the two types of objective tests that are most commonly used to confirm DP diagnoses: the Cambridge Face Memory Test (CFMT) and the famous faces memory test (FFMT). We used a highly reliable questionnaire (alpha = .91), the Cambridge Face Memory Questionnaire (CFMQ), and revealed strong validity via high correlations of .44 with the CFMT and .52 with the FFMT. However, cutoff analyses revealed that no CFMQ score yielded a clinical-grade combination of sensitivity and positive predictive value in enough individuals to support using it alone as a DP diagnostic or screening tool. This result was replicated in an analysis of data from the widely used PI20 questionnaire, a 20-question self-assessment of facial recognition similar in form to the CFMQ. We therefore recommend that screens for DP should, wherever possible, include objective as well as subjective assessment tools.
在过去的十年中，人们对严重的面部识别能力发育缺陷（发育性面孔失认症，或 DP）进行了深入研究，但关于其起源、本质和社会后果仍有许多问题尚未得到解答。回答这些问题的一个限制因素是难以招募到罕见的 DP 参与者。尽管自我报告的经验长期以来一直是识别 DP 患者的努力的一部分，但对于此类自我报告如何或应该有助于筛选或诊断，人们仍知之甚少。在这里，我们在一个大型的基于人群的网络样本中，研究了自我报告作为一种筛选工具的有效性，单独使用时，它是否可以用来识别最终会在常规截止值下无法通过两种最常用于确认 DP 诊断的客观测试的个体：剑桥面孔记忆测试（CFMT）和著名面孔记忆测试（FFMT）。我们使用了一种高度可靠的问卷（alpha =.91），即剑桥面孔记忆问卷（CFMQ），并通过与 CFMT 的高相关性.44 和与 FFMT 的高相关性.52 揭示了其强大的有效性。然而，截止值分析显示，没有任何 CFMQ 分数能够在足够多的个体中产生具有临床意义的敏感性和阳性预测值的组合，无法支持单独使用它作为 DP 诊断或筛选工具。这一结果在对广泛使用的 PI20 问卷数据的分析中得到了复制，PI20 问卷是一种 20 个问题的自我评估，形式上与 CFMQ 相似，用于评估面孔识别能力。因此，我们建议 DP 的筛选应尽可能包括客观和主观评估工具。
