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Considerations regarding noncredible performance in the neuropsychological assessment of patients with multiple sclerosis: A case series
Applied Neuropsychology: Adult ( IF 1.4 ) Pub Date : 2021-09-11 , DOI: 10.1080/23279095.2021.1971229
Victoria Sanborn 1 , John Lace 2 , John Gunstad 1, 3 , Rachel Galioto 2, 4
Affiliation  

Abstract

Determining the validity of data during clinical neuropsychological assessment is crucial for proper interpretation, and extensive literature has emphasized myriad methods of doing so in diverse samples. However, little research has considered noncredible presentation in persons with multiple sclerosis (pwMS). PwMS often experience one or more factors known to impact validity of data, including major neurocognitive impairment, psychological distress/psychogenic interference, and secondary gain. This case series aimed to illustrate the potential relationships between these factors and performance validity testing in pwMS. Six cases from an IRB-approved database containing pwMS referred for neuropsychological assessment at a large, academic medical center involving at least one of the above-stated factors were identified. Backgrounds, neuropsychological test data, and clinical considerations for each were reviewed. Interestingly, no pwMS diagnosed with major neurocognitive impairment was found to have noncredible performance, nor was any patient with noncredible performance in the absence of notable psychological distress. Given the variability of noncredible performance and multiplicity of factors affecting performance validity in pwMS, clinicians are strongly encouraged to consider psychometrically appropriate methods for evaluating validity of cognitive data in pwMS. Additional research aiming to elucidate base rates of, mechanisms begetting, and methods for assessing noncredible performance in pwMS is imperative.



中文翻译:

关于多发性硬化症患者神经心理学评估中不可信表现的考虑:病例系列

摘要

在临床神经心理学评估期间确定数据的有效性对于正确解释至关重要,大量文献强调了在不同样本中这样做的无数方法。然而,很少有研究考虑多发性硬化症 (pwMS) 患者的不可信表现。PwMS 通常会经历一种或多种已知影响数据有效性的因素,包括主要的神经认知障碍、心理困扰/心因性干扰和继发性增益。本案例系列旨在说明这些因素与 pwMS 性能有效性测试之间的潜在关系。确定了来自 IRB 批准的包含 pwMS 的数据库中的 6 个案例,这些案例在涉及至少一个上述因素的大型学术医疗中心进行神经心理学评估。背景, 审查了神经心理学测试数据和每个临床考虑因素。有趣的是,没有发现被诊断患有严重神经认知障碍的 pwMS 表现不可信,也没有发现任何在没有明显心理困扰的情况下表现不可信的患者。鉴于不可信表现的可变性和影响 pwMS 表现有效性的因素的多样性,强烈鼓励临床医生考虑使用心理测量学上适当的方法来评估 pwMS 中认知数据的有效性。旨在阐明 pwMS 中不可信性能的基本速率、产生机制和评估方法的额外研究势在必行。没有发现被诊断为主要神经认知障碍的 pwMS 具有不可信的表现,也没有发现任何在没有明显心理困扰的情况下具有不可信表现的患者。鉴于不可信表现的可变性和影响 pwMS 表现有效性的因素的多样性,强烈鼓励临床医生考虑使用心理测量学上适当的方法来评估 pwMS 中认知数据的有效性。旨在阐明 pwMS 中不可信性能的基本速率、产生机制和评估方法的额外研究势在必行。没有发现被诊断为主要神经认知障碍的 pwMS 具有不可信的表现,也没有发现任何在没有明显心理困扰的情况下具有不可信表现的患者。鉴于不可信表现的可变性和影响 pwMS 表现有效性的因素的多样性,强烈鼓励临床医生考虑使用心理测量学上适当的方法来评估 pwMS 中认知数据的有效性。旨在阐明 pwMS 中不可信性能的基本速率、产生机制和评估方法的额外研究势在必行。强烈鼓励临床医生考虑使用心理测量学上适当的方法来评估 pwMS 中认知数据的有效性。旨在阐明 pwMS 中不可信性能的基本速率、产生机制和评估方法的额外研究势在必行。强烈鼓励临床医生考虑使用心理测量学上适当的方法来评估 pwMS 中认知数据的有效性。旨在阐明 pwMS 中不可信性能的基本速率、产生机制和评估方法的额外研究势在必行。

更新日期:2021-09-11
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