De Boer Adam B, Phillips Matthew S, Barwegen Kearston C, Obolsky Maximillian A, Rauch Andrew A, Pesanti Stephen D, Tse Phoebe Ka Yin, Ovsiew Gabriel P, Jennette Kyle J, Resch Zachary J, Soble Jason R
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL USA.
Department of Neurology, University of Illinois College of Medicine, Chicago, IL USA.
Psychol Inj Law. 2023;16(1):61-72. doi: 10.1007/s12207-022-09467-9. Epub 2022 Nov 3.
The utility of symptom (SVT) and performance (PVT) validity tests has been independently established in neuropsychological evaluations, yet research on the relationship between these two types of validity indices is limited to circumscribed populations and measures. This study examined the relationship between SVTs on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and PVTs in a mixed neuropsychiatric setting. This cross-sectional study included data from 181 diagnostically and demographically diverse patients with neuropsychiatric conditions referred for outpatient clinical neuropsychological evaluation at an academic medical center. All patients were administered a uniform neuropsychological battery, including the MMPI-2-RF and five PVTs (i.e., Dot Counting Test; Medical Symptom Validity Test; Reliable Digit Span; Test of Memory Malingering-Trial 1; Word Choice Test). Nonsignificant associations emerged between SVT and PVT performance. Although the Response Bias Scale was most predictive of PVT performance, MMPI-2-RF SVTs generally had low classification accuracy for predicting PVT performance. Neuropsychological test performance was related to MMPI-2-RF SVT status only when overreporting elevations were at extreme scores. The current study further supports that SVTs and PVTs measure unique and dissociable constructs among diverse patients with neuropsychiatric conditions, consistent with literature from other clinical contexts. Therefore, objective evidence of symptom overreporting on MMPI-2-RF SVTs cannot be interpreted as definitively indicating invalid performance on tests of neurocognitive abilities. As such, clinicians should include both SVTs and PVTs as part of a comprehensive neuropsychological evaluation as they provide unique information regarding performance and symptom validity.
症状效度测试（SVT）和表现效度测试（PVT）在神经心理学评估中的效用已得到独立确立，但关于这两种效度指标之间关系的研究仅限于特定人群和测量方法。本研究在混合神经精神疾病环境中考察了明尼苏达多相人格问卷-2-修订版（MMPI-2-RF）上的SVT与PVT之间的关系。这项横断面研究纳入了181名诊断和人口统计学特征各异的神经精神疾病患者的数据，这些患者被转介到一家学术医疗中心进行门诊临床神经心理学评估。所有患者都接受了一套统一的神经心理学测试，包括MMPI-2-RF和五项PVT（即点数测试；医学症状效度测试；可靠数字广度；记忆伪装测试-试验1；单词选择测试）。SVT与PVT表现之间未发现显著关联。尽管反应偏差量表对PVT表现的预测性最强，但MMPI-2-RF的SVT在预测PVT表现时通常分类准确率较低。只有当过度报告的分数处于极端水平时，神经心理学测试表现才与MMPI-2-RF的SVT状态相关。当前研究进一步支持，在不同的神经精神疾病患者中，SVT和PVT测量的是独特且可分离的结构，这与其他临床背景的文献一致。因此，MMPI-2-RF的SVT上症状过度报告的客观证据不能被明确解释为神经认知能力测试表现无效。因此，临床医生应将SVT和PVT都纳入全面的神经心理学评估中，因为它们提供了关于表现和症状效度的独特信息。
