Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada.
Jefferson Neurobehavioral Group, New Orleans, LA, USA.
Appl Neuropsychol Adult. 2022 Nov-Dec;29(6):1425-1439. doi: 10.1080/23279095.2021.1884555. Epub 2021 Feb 25.
This study was designed to evaluate the classification accuracy of the recently introduced forced-choice recognition trial to the Hopkins Verbal Learning Test - Revised (FCR) as a performance validity test (PVT) in a clinical sample. Time-to-completion (T2C) for FCR was also examined.
Forty-three students were assigned to either the control or the experimental malingering (MAL) condition. Archival data were collected from 52 adults clinically referred for neuropsychological assessment. Invalid performance was defined using MAL status, two free-standing PVTs and two validity composites.
Among students, FCR ≤11 or T2C ≥45 seconds was specific (0.86-0.93) to invalid performance. Among patients, an FCR ≤11 was specific (0.94-1.00), but relatively insensitive (0.38-0.60) to non-credible responding0. T2C ≥35 s produced notably higher sensitivity (0.71-0.89), but variable specificity (0.83-0.96). The T2C achieved superior overall correct classification (81-86%) compared to the accuracy score (68-77%). The FCR provided incremental utility in performance validity assessment compared to previously introduced validity cutoffs on Recognition Discrimination.
Combined with T2C, the FCR has the potential to function as a quick, inexpensive and effective embedded PVT. The time-cutoff effectively attenuated the low ceiling of the accuracy scores, increasing sensitivity by 19%. Replication in larger and more geographically and demographically diverse samples is needed before the FCR can be endorsed for routine clinical application.
本研究旨在评估最近引入的霍普金斯词语学习测验修订版(Hopkins Verbal Learning Test - Revised,HVLT-R)中的迫选再认测验(Forced-choice recognition trial,FCR)作为一种临床样本中的表现效度测验(Performance validity test,PVT)的分类准确性。还检查了 FCR 的完成时间(Time-to-completion,T2C)。
43 名学生被分配到对照组或实验性诈病(Malingering,MAL)组。从 52 名临床转介进行神经心理评估的成年人中收集档案数据。无效表现使用 MAL 状态、两个独立的 PVT 和两个有效性综合指标来定义。
在学生中,FCR≤11 或 T2C≥45 秒对无效表现具有特异性(0.86-0.93)。在患者中,FCR≤11 是特异性的(0.94-1.00),但相对不敏感(0.38-0.60)到不可信的反应。T2C≥35 秒可产生显著更高的敏感性(0.71-0.89),但特异性(0.83-0.96)可变。T2C 的整体正确分类(81-86%)优于准确性得分(68-77%)。与先前介绍的识别辨别有效性截止值相比,FCR 在表现有效性评估中提供了额外的效用。
与 T2C 结合使用,FCR 有可能成为一种快速、廉价且有效的嵌入式 PVT。时间截止有效地降低了准确性得分的低上限,使敏感性提高了 19%。在 FCR 可用于常规临床应用之前,需要在更大、更具地理和人口统计学多样性的样本中进行复制。