Soble Jason R, Finley John-Christopher A, Phillips Matthew S, Abalos Steven A, Valencia Victor A, Jennette Kyle J, Pliskin Neil H
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL.
Department of Neurology, University of Illinois College of Medicine, Chicago, IL.
J Psychiatr Pract. 2025 Jul 1;31(4):201-208. doi: 10.1097/PRA.0000000000000865.
This study validated embedded symptom validity tests (SVT) in the Beck Depression (BDI-II) and Beck Anxiety (BAI) Inventories that are sensitive to psychiatric symptom overreporting in an outpatient clinical population referred for attention-deficit/hyperactivity disorder diagnostic evaluation.
Cross-sectional data from 623 consecutive neuropsychological referrals were analyzed. The sample comprised young-to-middle-aged community-dwelling adults, was predominantly female (61%), and 44% non-Hispanic white, 25% Hispanic, 16% non-Hispanic black, 10% Asian, and 5% other race/ethnicity.
BDI-II ≥ 26 (33% to 86% sensitivity/90% specificity) and BAI ≥ 16 (38% to 82% sensitivity/90% specificity) were optimal cut-scores for detecting potential symptom overreporting. Scores exceeding the cutoffs on both the BDI-II and BAI SVTs should be counted as a single elevation, because these tests captured redundant aspects of overreporting. However, the BDI-II SVT was the stronger symptom overreporting indicator and should be prioritized as the more accurate test when BDI-II/BAI SVT discrepancies occur.
BDI-II and BAI embedded SVTs can detect possible symptom overreporting among diagnostically diverse outpatients undergoing attention-deficit/hyperactivity disorder evaluations. These SVTs are not intended to replace well-validated SVTs, but screen for symptom overreporting and identify patients who may require further assessment without incurring additional time, costs, or burden, as they are embedded in brief, routinely administered self-report measures.
本研究验证了贝克抑郁量表（BDI-II）和贝克焦虑量表（BAI）中的嵌入式症状效度测试（SVT），这些测试对因注意力缺陷多动障碍诊断评估而转诊的门诊临床人群中精神症状过度报告敏感。
分析了来自623例连续神经心理学转诊病例的横断面数据。样本包括居住在社区的中青年成年人，以女性为主（61%），44%为非西班牙裔白人，25%为西班牙裔，16%为非西班牙裔黑人，10%为亚洲人，5%为其他种族/族裔。
BDI-II≥26（敏感性33%至86%/特异性90%）和BAI≥16（敏感性38%至82%/特异性90%）是检测潜在症状过度报告的最佳临界分数。BDI-II和BAI的SVT分数超过临界值应计为单一升高，因为这些测试捕捉了过度报告的冗余方面。然而，BDI-II的SVT是更强的症状过度报告指标，当BDI-II/BAI的SVT出现差异时，应优先将其作为更准确的测试。
BDI-II和BAI嵌入式SVT可以在接受注意力缺陷多动障碍评估的不同诊断门诊患者中检测可能的症状过度报告。这些SVT并非旨在取代经过充分验证的SVT，而是用于筛查症状过度报告，并识别可能需要进一步评估的患者，而不会产生额外的时间、成本或负担，因为它们嵌入在简短的、常规实施的自我报告测量中。
