ABSTRACT

Objective: The validity of neuropsychological test performance has scarcely been studied in patients with substance use disorders (SUD), despite the possibility that some SUD individuals may distort their performance for compensation seeking (e.g., work leave, permanent or total disability, or the designation of services such as sheltered housing). Thus, the aim of the present study is to determine: (i) the possible utility of the Test of Memory Malingering (TOMM) in detecting invalid test results among SUD patients, and (ii) the percentage of individuals that underperform the TOMM among SUD patients seeking compensation.

Method: Seventy-seven patients (59 men and 18 women) with SUD in outpatient treatment with an age range between 20 and 59 years were divided into two groups: SUD patients without compensation seeking (n = 41), and SUD patients with compensation seeking (n = 36). Participants performed a neuropsychological assessment with measures of processing speed, working memory, inhibition, verbal memory, cognitive flexibility, and decision-making, that also included the TOMM.

Results: Our results demonstrate that there were no significant differences on TOMM performance between the two groups. Only one participant underperformed the TOMM (1.3% of the sample). Results showed cognitive impairment in the sample, but no differences between the groups on the different neuropsychological measures.

Conclusions: This constitutes the first study to explore the capacity of a forced-choice test to detect invalid test results in an SUD population. There was a high performance on the TOMM among the SUD participants of our study despite their cognitive impairment, indicating adequate effort in their neuropsychological test performance. Further, these findings suggest that the probability of showing invalid neuropsychological performance among SUD compensation seeking patients is much lower than what has been found in other populations, such as in mild brain injury patients.

摘要

目的: 尽管某些 SUD 个体可能会因寻求补偿（例如，工作假、永久性或完全残疾，或指定服务，例如庇护所）。因此，本研究的目的是确定：(i) 记忆欺骗测试 (TOMM) 在检测 SUD 患者无效测试结果方面的可能效用，以及 (ii) 在 SUD 中表现低于 TOMM 的个体百分比寻求赔偿的患者。

方法: 77 例（男 59 例，女 18 例）的门诊 SUD 患者，年龄在 20 至 59 岁之间，分为两组：不寻求补偿的 SUD 患者（n = 41）和寻求补偿的 SUD 患者(n = 36)。参与者通过处理速度、工作记忆、抑制、语言记忆、认知灵活性和决策制定的措施进行了神经心理学评估，其中还包括 TOMM。

结果：我们的结果表明，两组之间的 TOMM 性能没有显着差异。只有一名参与者的表现低于 TOMM（占样本的 1.3%）。结果显示样本中存在认知障碍，但在不同的神经心理学指标上，各组之间没有差异。

结论：这是第一项探索强制选择测试在 SUD 人群中检测无效测试结果的能力的研究。尽管有认知障碍，我们研究的 SUD 参与者在 TOMM 上的表现仍然很高，这表明他们在神经心理学测试表现方面付出了足够的努力。此外，这些发现表明，寻求 SUD 补偿的患者出现无效神经心理表现的可能性远低于其他人群，例如轻度脑损伤患者。