Chouinard M J, Rouleau I
Laboratoire de Neuroscience de la Cognition, Université du Québec à Montréal, Hôpital Notre-Dame, Montréal, Quebec, Canada.
J Int Neuropsychol Soc. 1997 Nov;3(6):545-52.
We tested the validity of the 48-Pictures Test, a 2-alternative forced-choice recognition test, in detecting exaggerated memory impairments. This test maximizes subjective difficulty, through a large number of stimuli and shows minimal objective difficulty. We compared 17 suspected malingerers to 39 patients with memory impairments (6 amnesic, 15 frontal lobe dysfunctions, 18 other etiologies), and 17 normal adults instructed to simulate malingering on three memory tests: the 48-Pictures Test, the Rey Auditory Verbal Learning Test (RAVLT), and the Rey Complex Figure Test (RCFT). On the 48-Pictures Test, the clinical groups showed good recognition performance (amnesics: 85%; frontal dysfunction: 94%; other memory impairments: 97%), whereas the two simulator groups showed a poor performance (suspected malingerers: 62% correct; volunteer simulators 68% correct). The two other tests did not show a high degree of discrimination between the clinical groups and the simulator groups, except in 2 measures: the 2 simulator groups tended to show a performance decrement from the last recall trial to immediate recognition of the RAVLT and also performed better than the clinical groups on the immediate recall of the RCFT. A discriminant analysis with the latter 2 measures and the 48-Pictures Test correctly classified 96% of the participants. These results suggest that the 48-Pictures Test is a useful tool for the detection of possible simulated memory impairment and that when combined to the RAVLT recall-recognition difference score and to the immediate recall score on the RCFT can provide strong evidence of exaggerated memory impairment.
我们测试了48图测试（一种二选一强制选择识别测试）在检测夸大记忆损伤方面的有效性。该测试通过大量刺激使主观难度最大化，且客观难度最小。我们将17名疑似诈病者与39名记忆损伤患者（6名失忆症患者、15名额叶功能障碍患者、18名其他病因患者）以及17名被指示在三项记忆测试中模拟诈病的正常成年人进行了比较：48图测试、雷伊听觉词语学习测试（RAVLT）和雷伊复杂图形测试（RCFT）。在48图测试中，临床组表现出良好的识别能力（失忆症患者：85%；额叶功能障碍患者：94%；其他记忆损伤患者：97%），而两个模拟组表现较差（疑似诈病者：正确率62%；志愿者模拟者：正确率68%）。除了两项指标外，其他两项测试在临床组和模拟组之间没有表现出高度的区分度：两个模拟组在RAVLT的最后一次回忆试验到即时识别中往往表现出成绩下降，并且在RCFT的即时回忆方面也比临床组表现更好。使用后两项指标和48图测试进行的判别分析正确分类了96%的参与者。这些结果表明，48图测试是检测可能的模拟记忆损伤的有用工具，并且当与RAVLT回忆 - 识别差异分数以及RCFT上的即时回忆分数相结合时，可以为夸大的记忆损伤提供有力证据。
