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.
摘要：
在临床神经心理学评估过程中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,很少有研究认为多发性硬化症（pwMS）患者的表现是不可信的。PwMS经常经历一个或多个已知影响数据有效性的因素，包括严重的神经认知障碍，心理困扰/心理干扰，和次要收益。本案例系列旨在说明这些因素与pwMS中的性能有效性测试之间的潜在关系。IRB批准的包含pwMS的数据库中有6例被广泛用于神经心理学评估，确定了至少涉及上述因素之一的学术医疗中心。背景,神经心理学测试数据，并回顾了各自的临床考虑因素.有趣的是,没有发现诊断为严重神经认知障碍的pwMS具有不可信的表现，在没有明显心理困扰的情况下，也没有任何表现不可信的患者。考虑到不可信性能的可变性和影响pwMS性能有效性的多种因素，强烈建议临床医生考虑采用心理测量学上合适的方法来评估pwMS中认知数据的有效性。其他研究旨在阐明基本利率，机制产生，评估pwMS中不可信性能的方法势在必行。
