Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra (FPCEUC), Coimbra, Portugal.
Crim Behav Ment Health. 2023 Oct;33(5):330-341. doi: 10.1002/cbm.2306. Epub 2023 Aug 8.
There are numerous scales for screening cognitive performance and thus identification of any potential deficits, but in spite of the vulnerability of the prison population to such problems, there has been no adequate validation of screening tools specifically for use with prisoners or others in the criminal justice system.
To validate the Montreal Cognitive Assessment (MoCA) for use with prisoners.
100 adult prisoners in one Portuguese prison were randomly invited by clinicians to take part in this study. A same size sample of community-living adult non-offenders of similar age was selected from the MoCA's normative study database in Portugal. For both groups, the key inclusion criterion was fluency in the Portuguese language. All participants completed the Mini Mental State Examination (MMSE) and the MoCA, both in Portuguese translation. Cronbach's alpha coefficient was calculated as an index of internal consistency and Pearson's r correlations calculated. Group performances were compared using independent samples t-test. Covariance analysis (ANCOVA) was computed with level of education as covariate. To measure the magnitude of the effect, was used. A receiver operating characteristics curve analysis was computed to evaluate the discriminatory accuracy of MoCA and MMSE.
The MoCA showed a 'reasonable' internal consistency index (α = 0.75) as well as positive and significant correlations with the MMSE. As a cognitive measure, however, the MoCA showed consistently superior psychometric properties and higher discriminatory accuracy (MoCA = 89%) than the MMSE (65%). According to the Youden index, the optimal cut-off point for the MoCA is below 24 points, whereas for the MMSE, it is below 27.
The MoCA is a valid cognitive screening tool for use with prisoners. Further validations against detailed cognitive evaluation would be a useful next step.
有许多量表可用于筛查认知表现，从而发现任何潜在的缺陷，但尽管监狱人口容易出现这些问题，但还没有针对囚犯或刑事司法系统中的其他人员进行适当验证的筛查工具。
验证蒙特利尔认知评估（MoCA）在囚犯中的适用性。
葡萄牙一所监狱的 100 名成年囚犯被临床医生随机邀请参加这项研究。从 MoCA 在葡萄牙的正态研究数据库中选择了相同数量的年龄相似的社区居住成年非罪犯作为对照组。两组的主要纳入标准是流利的葡萄牙语。所有参与者都完成了简易精神状态检查（MMSE）和葡萄牙语翻译的 MoCA。Cronbach's alpha 系数被计算为内部一致性的指标，Pearson's r 相关系数被计算。使用独立样本 t 检验比较两组的表现。协方差分析（ANCOVA）计算了教育程度作为协变量。使用效应量 来衡量效应的大小。计算了受试者工作特征曲线分析，以评估 MoCA 和 MMSE 的判别准确性。
MoCA 显示出“合理”的内部一致性指数（α=0.75），并且与 MMSE 呈正相关且显著相关。然而，作为认知测量工具，MoCA 显示出始终优于 MMSE 的心理测量特性和更高的判别准确性（MoCA=89%）。根据 Youden 指数，MoCA 的最佳截断点低于 24 分，而 MMSE 的最佳截断点低于 27 分。
MoCA 是一种适用于囚犯的有效的认知筛查工具。进一步对详细认知评估的验证将是下一步有用的工作。
