Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Slingedael Korsakoff Center, Lelie Care Group, Rotterdam, The Netherlands.
Appl Neuropsychol Adult. 2020 Nov-Dec;27(6):549-557. doi: 10.1080/23279095.2019.1576180. Epub 2019 Mar 8.
Performance validity tests (PVTs) and Symptom validity tests (SVTs) are developed to identify people that present false or exaggerated symptoms. Although a key factor of both types of tests includes relative insensitivity to cognitive disorders, the direct effects of amnesia have been poorly studied. Therefore, a sample of 20 patients diagnosed with Korsakoff Amnesia (KA) through neuropsychological assessment and 20 healthy comparisons (HC) were administered the Test of Memory Malingering (TOMM), the Structured Inventory of Malingered Symptomatology (SIMS), and the newly developed Visual Association Test - Extended (VAT-E). Our results show that KA patients scored systematically lower on the TOMM and VAT-E, while performance on the SIMS was comparable with healthy comparisons. Some KA patients were regarded as underperformers based on the TOMM and VAT-E, suggesting limitations in applying these instruments in severe amnesia. There was a strong interdependence of PVTs in logistic regression. We conclude that the TOMM and VAT-E are not fully robust against severe memory disorders and show a serious risk of false positives. Complete neuropsychological profile analysis is needed, and PVTs should be interpreted with caution in patients with suspected amnesia.
性能有效性测试（PVTs）和症状有效性测试（SVTs）是为了识别那些表现出虚假或夸大症状的人而开发的。虽然这两种测试的一个关键因素都包括对认知障碍相对不敏感，但遗忘症的直接影响还没有得到很好的研究。因此，通过神经心理学评估诊断为科萨科夫遗忘症（KA）的 20 名患者和 20 名健康对照（HC）接受了记忆伪装测试（TOMM）、伪装症状的结构化清单（SIMS）和新开发的视觉联想测试-扩展版（VAT-E）的测试。我们的结果表明，KA 患者在 TOMM 和 VAT-E 上的得分系统较低，而在 SIMS 上的表现与健康对照组相当。一些 KA 患者根据 TOMM 和 VAT-E 被认为表现不佳，这表明在严重的遗忘症中应用这些工具存在局限性。逻辑回归显示 PVTs 之间存在很强的相互依存关系。我们得出结论，TOMM 和 VAT-E 对严重的记忆障碍不是完全稳健的，并且存在严重的假阳性风险。需要进行完整的神经心理学分析，并且在怀疑有遗忘症的患者中应谨慎解释 PVTs。
