Abstract

Objective: Social Security Disability is a common external incentive in neuropsychological evaluations. This study determined base rates of invalidity when patients referred for routine clinical evaluations have Social Security Disability as an external incentive. Method: Patients (n = 242) were grouped as validly or invalidly performing based on the use of multiple performance validity tests. Frequency analyses were then conducted. Results: As a whole, 46.0% of clinically referred patients with Social Security Disability as an external incentive produced invalid data. When divided by disability pursuit status, 58.6% of individuals already receiving Social Security Disability, 44.6% of individuals actively seeking Social Security Disability, and 39.3% of individuals considering seeking Social Security Disability produced invalid data. By comparison, only 8.5% of clinically referred patients without known external incentives produced invalid data. Conclusions: Beyond establishing base rates, these data indicate that the external incentive, not necessarily the evaluation setting, increases the rate of invalidity, as obtained base rates mirror those observed in independent medical examinations. In addition, this study highlights that even patients who report that they are considering but have not committed themselves to pursuing an external incentive frequently invalidate testing.

摘要

目的：社会保障残疾是神经心理学评估中常见的外部诱因。本研究确定了转介进行常规临床评估的患者将社会保障残疾作为外部诱因时的基本无效率。方法： 根据使用多项性能有效性测试，将患者 ( n = 242) 分组为有效或无效执行。然后进行频率分析。结果：总体而言，46.0% 的临床转诊社会保障残疾患者作为外部激励产生了无效数据。按残疾追求状态划分时，58.6% 的已经获得社会保障残疾的个人、44.6% 的积极寻求社会保障残疾的个人和 39.3% 正在考虑寻求社会保障残疾的个人产生了无效数据。相比之下，在没有已知外部激励的情况下，只有 8.5% 的临床转诊患者产生了无效数据。结论：除了建立基本比率之外，这些数据表明外部激励（不一定是评估设置）会增加无效率，因为获得的基本比率反映了独立体检中观察到的情况。此外，这项研究强调，即使是报告他们正在考虑但尚未承诺追求外部激励的患者也经常使测试无效。