Independent Practice, Algiers Neurobehavioral Resource, LLC, New Orleans, LA, USA.
Clin Neuropsychol. 2022 Aug;36(6):1244-1264. doi: 10.1080/13854046.2020.1840633. Epub 2020 Dec 10.
The purpose of this paper is to determine whether negative validity test findings should be used in the Bayesian aggregate along with positive test findings for the determination of malingering as the condition of interest (COI). Evidence-based diagnostic methods for conditions in neuropsychology and medicine were reviewed for comparison with their use in cases of malingering. Logical and Bayesian analyses of these cases were applied. A case study showed that negative validity test findings did not indicate "good effort". Deception about illness is fundamentally different from other constructs/diseases in evidence-based medicine and neuropsychology. This is because deception involves a deliberate process that may involve coaching, claimant research, and/or focusing the deception on one aspect (e.g., slowness) as opposed to other neurocognitive problems (e.g., memory). Comparatively, other conditions in medicine and neuropsychology are unlikely to be manipulated by the patient. The assertion by Frederick (2015) and Black, Necrason, and Omasta (2016) that both positive and negative validity test findings must be used together in the aggregate does not stand up to this comparative scrutiny. The fundamental assumption by these authors that a negative test finding concerning malingering represents "good effort" is flawed; it simply represents lack of evidence of malingering, which cannot be construed as evidence of lack of malingering. We recommend that in forensic determination of malingering, negative validity test findings should not be used in a Bayesian aggregation. This conclusion is consistent with current practices in the field.
本文旨在探讨在贝叶斯综合分析中,是否应将负效价测试结果与正效价测试结果一起用于确定伪装为关注条件(COI)的情况。为了与伪装病例的应用进行比较,对神经心理学和医学中的基于证据的诊断方法进行了审查。对这些病例进行了逻辑和贝叶斯分析。一项案例研究表明,负效价测试结果并不能表明“良好的努力”。关于疾病的欺骗与循证医学和神经心理学中的其他构建/疾病从根本上不同。这是因为欺骗涉及一个刻意的过程,可能涉及指导、申请人研究,和/或将欺骗集中在一个方面(例如,缓慢)而不是其他神经认知问题(例如,记忆)上。相比之下,医学和神经心理学中的其他病症不太可能被患者操纵。弗雷德里克(2015)和布莱克、内克拉森和奥马斯塔(2016)的断言,即正效价和负效价测试结果必须一起在综合分析中使用,这种说法并不能经得起这种比较性的审查。这些作者的基本假设是,关于伪装的负测试结果代表“良好的努力”,这是有缺陷的;它只是代表缺乏伪装的证据,不能被解释为缺乏伪装的证据。我们建议,在法医确定伪装时,不应在贝叶斯综合分析中使用负效价测试结果。这一结论与该领域的现行做法一致。