Abstract

Performance validity tests are susceptible to false positives from genuine cognitive impairment (e.g., dementia); this has not been explored with the short form of the California Verbal Learning Test II (CVLT-II-SF). In a memory clinic sample, we examined whether CVLT-II-SF Forced Choice Recognition (FCR) scores differed across diagnostic groups, and how the severity of impairment [Clinical Dementia Rating Sum of Boxes (CDR-SOB) or Mini-Mental State Examination (MMSE)] modulated test performance. Three diagnostic groups were identified: subjective cognitive impairment (SCI; n = 85), amnestic mild cognitive impairment (a-MCI; n = 17), and dementia due to Alzheimer’s Disease (AD; n = 50). Significant group differences in FCR were observed using one-way ANOVA; post-hoc analysis indicated the AD group performed significantly worse than the other groups. Using multiple regression, FCR performance was modeled as a function of the diagnostic group, severity (MMSE or CDR-SOB), and their interaction. Results yielded significant main effects for MMSE and diagnostic group, with a significant interaction. CDR-SOB analyses were non-significant. Increases in impairment disproportionately impacted FCR performance for persons with AD, adding caution to research-based cutoffs for performance validity in dementia. Caution is warranted when assessing performance validity in dementia populations. Future research should examine whether CVLT-II-SF-FCR is appropriately specific for best-practice testing batteries for dementia.

摘要

性能效度测试容易受到来自真正认知障碍（例如痴呆）的假阳性的影响；加州语言学习测试 II (CVLT-II-SF) 的简写形式尚未对此进行探讨。在记忆诊所样本中，我们检查了 CVLT-II-SF 强制选择识别 (FCR) 评分是否在诊断组之间存在差异，以及损伤的严重程度如何 [Clinical Dementia Rating Sum of Box (CDR-SOB) 或简易精神状态检查(MMSE)] 调制的测试性能。确定了三个诊断组：主观认知障碍（SCI；n  = 85）、遗忘性轻度认知障碍（a-MCI；n  = 17）和阿尔茨海默病引起的痴呆（AD；n  = 50）。使用单向方差分析观察到 FCR 的显着组差异；事后分析表明，AD 组的表现明显低于其他组。使用多元回归，将 FCR 性能建模为诊断组、严重性（MMSE 或 CDR-SOB）及其相互作用的函数。结果对 MMSE 和诊断组产生了显着的主效应，并具有显着的交互作用。CDR-SOB 分析不显着。损伤的增加不成比例地影响了 AD 患者的 FCR 表现，增加了基于研究的痴呆表现效度的临界值。在评估痴呆人群的表现效度时需要谨慎。未来的研究应检查 CVLT-II-SF-FCR 是否适用于痴呆症最佳实践测试电池。