Kirk Neurobehavioral Health, Louisville, CO, USA.
Department of Physical Medicine & Rehabilitation, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
Appl Neuropsychol Child. 2020 Oct-Dec;9(4):292-306. doi: 10.1080/21622965.2020.1750118. Epub 2020 May 6.
Growing recognition and concerns of non-credible performance in pediatric populations have led clinicians to investigate the utility of performance and symptom validity tests (PVT/SVTs) among children and adolescents. Yet current research has indicated that a minority of clinicians routinely utilize a free-standing PVT in pediatric neuropsychological evaluations. The current article investigates the rationale for using PVT/SVTs, and the impact that failure of such exams have on other neurocognitive tests. A review of common adult PVTs and their appropriateness for use with specific pediatric clinical populations is presented, as well as empirical evidence for evaluating embedded validity indicators. The limited literature on SVTs with youth is also reviewed and provides additional insight into symptom exaggeration. There are various reasons children would provide noncredible performance, many of which are different from adults. A review of how the clinician should handle this behavior in pediatric evaluations is provided and what patient populations may present with a higher base rate of failure. Finally, various approaches are offered on how to explain these results to children and their caregivers.
越来越多的人认识到并关注到儿科人群中不可信的表现，这促使临床医生研究在儿童和青少年中使用表现和症状效度测试（PVT/SVT）的效用。然而，目前的研究表明，少数临床医生在儿科神经心理评估中常规使用独立的 PVT。本文探讨了使用 PVT/SVT 的基本原理，以及此类考试失败对其他神经认知测试的影响。本文还介绍了常见的成人 PVT 及其在特定儿科临床人群中的适用性，以及评估嵌入式有效性指标的实证证据。对青少年 SVT 的有限文献进行了回顾，并对症状夸大提供了更多的见解。儿童提供不可信表现的原因有很多，其中许多与成年人不同。本文还回顾了临床医生在儿科评估中应如何处理这种行为，以及哪些患者群体可能表现出更高的失败率。最后，还提供了各种方法来向儿童及其照顾者解释这些结果。
