ABSTRACT

Objective: The base rate of neuropsychological performance invalidity in electrical injury, a clinically-distinct and frequently compensation-seeking population, is not well established. This study determined the base rate of performance invalidity in a large electrical injury sample, and examined patient characteristics, injury parameters, and neuropsychological test performance based on validity status.

Method: This cross-sectional study included data from 101 patients with electrical injury consecutively referred for post-acute neuropsychological evaluation. Eighty-five percent of the sample was compensation-seeking. Multiple performance validity tests (PVTs) were administered as part of standard clinical evaluation. For patients with four or more PVTs, valid performance was operationalized as less than or equal to one PVT failure and invalid performance as two or more failures.

Results: Frequency analysis revealed 66% (n = 67) had valid performance while 29% (n = 29) demonstrated probable invalid performance; the remaining 5% (n = 5) had indeterminate validity. No significant differences in demographics or injury parameters emerged between validity groups (0 vs. 1 vs. ≥2 PVT failures). In contrast, the electrical injury group with invalid performance performed significantly worse across tests of processing speed and executive abilities than those with valid performance (ps< .05, η_p² = .19-.25).

Conclusions: The current study is the first to establish the base rate of neuropsychological performance invalidity in electrical injury survivors using empirical methods and current practice standards. Patient and clinical variables, including compensation-seeking status, did not differ between validity groups; however, neuropsychological test performance did, supporting the need for multi-method, objective performance validity assessment.

摘要

目的：电损伤是一个临床上不同且经常寻求补偿的人群，其神经心理学性能无效的基本率尚未确定。本研究确定了大型电损伤样本中的基本性能无效率，并根据有效性状态检查了患者特征、损伤参数和神经心理学测试性能。

方法：这项横断面研究包括 101 名连续转诊进行急性神经心理学评估的电损伤患者的数据。百分之八十五的样本是寻求补偿的。多项绩效有效性测试 (PVT) 作为标准临床评估的一部分进行管理。对于具有 4 个或更多 PVT 的患者，有效表现被定义为小于或等于 1 个 PVT 失败，无效表现被定义为两个或多个失败。

结果：频率分析显示 66% ( n = 67) 的表现有效，而 29% ( n = 29) 表现出可能无效的表现；其余 5% ( n = 5) 的有效性不确定。有效性组之间的人口统计学或损伤参数没有显着差异（0 对 1 对 ≥ 2 PVT 失败）。相比之下，在处理速度和执行能力测试中，表现无效的电击损伤组的表现明显低于表现有效的电伤组 ( p s< .05, η _p ²  = .19-.25)。

结论：目前的研究是第一个使用经验方法和现行实践标准确定电伤幸存者神经心理行为无效率的基础研究。患者和临床变量，包括寻求补偿的状态，在有效性组之间没有差异；然而，神经心理学测试表现确实如此，支持多方法、客观的表现有效性评估的需要。