Department of Veteran Affairs, Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Appl Neuropsychol Adult. 2023 Jan-Feb;30(1):83-90. doi: 10.1080/23279095.2021.1910951. Epub 2021 May 4.
There is a need to develop performance validity tests (PVTs) that accurately identify those with severe cognitive decline but also remain sensitive to those suspected of invalid cognitive testing. The TOMM1 Discrepancy Index (TDI) attempts to address both of these issues. Veterans diagnosed with dementia ( = 251) were administered TOMM1 and the MSVT in order to develop the TDI (TOMM1 percent correct minus MSVT Free Recall percent correct). Cut offs based on the dementia sample were then used to identify those in the non-dementia sample ( = 1,226) suspected of invalid test performance ( = 401). Combining TOMM1 and the TDI in the dementia sample greatly reduced the false positive rate (specificity = 0.97) at a cut off of 28 points or less on the TDI. Those suspected of invalid testing were identified at much higher rates (sensitivity = 0.75) compared to the MSVT genuine memory impairment profile (GMIP, sensitivity = 0.49). By utilizing a neurologically plausible pattern of scores across two PVTs, the TDI correctly classified those with dementia and identified a large percentage with invalid test performance. PVTs utilizing a complex pattern of performance may help reduce one's ability to fabricate cognitive deficits.
需要开发性能有效性测试（PVT），以准确识别那些认知严重下降的人，同时也能对那些被怀疑认知测试无效的人保持敏感。TOMM1 差异指数（TDI）试图解决这两个问题。为了制定 TDI（TOMM1 正确百分比减去 MSVT 自由回忆正确百分比），给被诊断为痴呆症的退伍军人（ = 251）进行了 TOMM1 和 MSVT 测试。然后根据痴呆症样本的截止值来识别非痴呆症样本（ = 1,226）中那些被怀疑测试无效的人（ = 401）。在痴呆症样本中，将 TOMM1 和 TDI 结合使用，大大降低了假阳性率（特异性=0.97），TDI 截定点为 28 分或更低。与 MSVT 真正记忆损伤谱（GMIP，敏感性=0.49）相比，被怀疑测试无效的人的识别率要高得多（敏感性=0.75）。通过利用两种 PVT 之间神经上合理的分数模式，TDI 正确地识别了痴呆症患者，并确定了很大一部分测试无效的患者。利用复杂的表现模式的 PVT 可能有助于减少人们编造认知缺陷的能力。
