VA North Texas Healthcare System, Dallas, TX, USA.
Arch Clin Neuropsychol. 2020 Jul 24;35(5):562-575. doi: 10.1093/arclin/acaa008.
The number of women veterans seeking Veterans Health Administration services has substantially increased over the past decade. Neuropsychology remains an understudied area in the examination of gender differences. The present study sought to delineate similarities and differences in men and women veterans presenting for neuropsychological evaluation in terms of demographics, referral, medical conditions, effort, and outcome diagnosis.
A database collected from an outpatient VA neuropsychology clinic from 2013 to 2019 was analyzed (n = 232 women, 2642 men). Additional analyses examined younger (n = 836 men, 155 women) and older (n = 1805 men, 77 women) age cohorts.
Women veterans were younger and more educated than men, whereas men had higher prevalence of vascular risk factors. Both groups were most often referred from mental health clinics and memory was the most common referral question. Although men performed worse on performance validity measures, clinicians rated women as evidencing poorer effort on a cumulative rating based on formal and embedded performance validity measures, behavioral observations, and inconsistent test patterns. Older women reported more depressive symptoms than older men and were more commonly diagnosed with depression.
This exploratory study fills a gap in the understanding of gender differences in veterans presenting for neuropsychological evaluations. Findings emphasize consideration for the intersection of gender with demographics, medical factors, effort, and psychological symptoms by VA neuropsychologists. A better understanding of relationships between gender and these factors may inform neuropsychologists' test selection, interpretation of behavioral observations, and diagnostic considerations to best treat women veterans.
在过去的十年中，寻求退伍军人事务部服务的女性退伍军人人数大幅增加。神经心理学仍然是性别差异研究中一个研究不足的领域。本研究旨在根据人口统计学、转诊、医疗状况、努力程度和结果诊断，描述男女退伍军人在接受神经心理评估时的相似点和不同点。
分析了 2013 年至 2019 年期间从退伍军人事务部门诊神经心理学诊所收集的数据库（n=232 名女性，2642 名男性）。其他分析还检查了年龄较小（n=836 名男性，155 名女性）和年龄较大（n=1805 名男性，77 名女性）的队列。
女性退伍军人比男性退伍军人年轻，受教育程度更高，而男性退伍军人血管危险因素的患病率更高。这两个群体最常从心理健康诊所转诊，而记忆是最常见的转诊问题。尽管男性在表现有效性测量上的表现较差，但临床医生根据正式和嵌入式表现有效性测量、行为观察和不一致的测试模式，基于累积评分评定女性表现出较差的努力程度。老年女性比老年男性报告更多的抑郁症状，更常被诊断为抑郁症。
这项探索性研究填补了理解退伍军人接受神经心理评估时性别差异方面的空白。研究结果强调了退伍军人事务部神经心理学家考虑性别与人口统计学、医疗因素、努力程度和心理症状的交叉点。更好地了解性别与这些因素之间的关系，可以为神经心理学家选择测试、解释行为观察以及做出诊断考虑以更好地治疗女性退伍军人提供信息。
