Hurtubise Jessica, Baher Tabarak, Messa Isabelle, Cutler Laura, Shahein Ayman, Hastings Maurissa, Carignan-Querqui Marilou, Erdodi Laszlo A
Department of Psychology, University of Windsor, Windsor, Canada.
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
Appl Neuropsychol Child. 2020 Oct-Dec;9(4):337-354. doi: 10.1080/21622965.2020.1719409. Epub 2020 Feb 21.
This study was designed to examine the classification accuracy of verbal fluency (VF) measures as performance validity tests (PVT). Student volunteers were assigned to the control ( = 57) or experimental malingering ( = 24) condition. An archival sample of 77 patients with TBI served as a clinical comparison. Among students, FAS T-score ≤29 produced a good combination of sensitivity (.40-.42) and specificity (.89-.95). Animals T-score ≤31 had superior sensitivity (.53-.71) at .86-.93 specificity. VF tests performed similarly to commonly used PVTs embedded within Digit Span: RDS ≤7 (.54-.80 sensitivity at .93-.97 specificity) and age-corrected scaled score (ACSS) ≤6 (.54-.67 sensitivity at .94-.96 specificity). In the clinical sample, specificity was lower at liberal cutoffs [animals T-score ≤31 (.89-.91), RDS ≤7 (.86-.89) and ACSS ≤6 (.86-.96)], but comparable at conservative cutoffs [animals T-score ≤29 (.94-.96), RDS ≤6 (.95-.98) and ACSS ≤5 (.92-.96)]. Among students, VF measures had higher signal detection performance than previously reported in clinical samples, likely due to the absence of genuine impairment. The superior classification accuracy of animal relative to letter fluency was replicated. Results suggest that existing validity cutoffs can be extended to cognitively high functioning examinees, and emphasize the importance of population-specific cutoffs.
本研究旨在检验言语流畅性（VF）测量作为效标效度测试（PVT）的分类准确性。将学生志愿者分配至对照组（n = 57）或实验性诈病组（n = 24）。选取77例创伤性脑损伤（TBI）患者的存档样本作为临床对照。在学生中，FAS T分数≤29时，敏感性（0.40 - 0.42）和特异性（0.89 - 0.95）的组合良好。动物流畅性T分数≤31时，特异性为0.86 - 0.93，敏感性更高（0.53 - 0.71）。VF测试的表现与数字广度中常用的PVT相似：倒序数字广度（RDS）≤7（敏感性为0.54 - 0.80，特异性为0.93 - 0.97）以及年龄校正量表分数（ACSS）≤6（敏感性为0.54 - 0.67，特异性为0.94 - 0.96）。在临床样本中，宽松临界值下特异性较低[动物流畅性T分数≤31（0.89 - 0.91）、RDS≤7（0.86 - 0.89）和ACSS≤6（0.86 - 0.96）]，但在保守临界值下相当[动物流畅性T分数≤29（0.94 - 0.96）、RDS≤6（0.95 - 0.98）和ACSS≤5（0.92 - 0.96）]。在学生中，VF测量的信号检测性能高于先前临床样本中的报告，可能是由于不存在真正的损伤。动物流畅性相对于字母流畅性的更高分类准确性得到了重复验证。结果表明，现有的效度临界值可扩展至认知功能较高的受测者，并强调了针对特定人群的临界值的重要性。
