■在法医背景下寻求残疾赔偿的创伤性脑损伤患者中,神经心理损害的恶意是常见的。迫切需要探索不同合作水平下神经心理学评估结果的差异。
■共有420名患有严重创伤性脑损伤的参与者被归类为恶意组,部分合作小组,并根据二项式强制选择数字记忆测试完成合作组。韦克斯勒成人智力量表,事件相关的潜在成分,随后应用症状自评量表90评估参与者的心理状况。
■在二项式强制选择数字记忆测试和韦克斯勒成人智力量表中,较低的P3振幅,同时在症状自评量表90中得分高于其他两组。有恶意倾向的参与者的实际智商大多在正常和边缘伤害之间,他们经常在症状检查表90中报告整体评分升高。合作指数(定义为积极症状困扰指数与全球严重程度指数的比率,CI)被提出并验证为症状清单90的嵌入式有效性指标,受试者工作特征(ROC)曲线下面积为0.938。当CI值为1.28时,CI在区分恶意与非恶意方面具有最高的分类能力。结合CI和P3振幅,用于疾病诊断的ROC曲线下面积进一步达到0.952。
■在法医背景下的任何非最佳努力都会导致心理学评估结果的意外偏差。CI是充当症状清单90的嵌入有效性指示符的潜在候选者。CI和P3振幅的组合可以帮助识别严重创伤性脑损伤后参与者的恶意行为。
UNASSIGNED: Malingering of neuropsychological damage is common among traumatic brain injury patients pursuing disability compensation in forensic contexts. There is an urgent need to explore differences in neuropsychological assessment outcomes with different levels of cooperation.
UNASSIGNED: A total of 420 participants with severe traumatic brain injury were classified into malingering group, partial cooperation group, and complete cooperation group according to the Binomial forced-choice digit memory test. The Wechsler Adult Intelligence Scale, event-related potential component, and Symptom Checklist 90 were applied subsequently to assess the psychological status of participants.
UNASSIGNED: Participants in the malingering group presented lower scores in the binomial forced-choice digit memory test and the Wechsler Adult Intelligence Scale, lower P3 amplitude, and simultaneously higher scores in the Symptom Checklist 90 than the other two groups. The actual intelligence quotient of participants with malingering tendencies ranged mostly between normal and marginal damage, and they often reported elevated whole scale scores in the Symptom Checklist 90. The Cooperation Index (defined as the ratio of positive symptom distress index to global severity index, CI) was proposed and validated to function as an embedded validity indicator of the Symptom Checklist 90, and the area under the receiver operating characteristic (ROC) curve was 0.938. When valued at 1.28, CI has the highest classification ability in differentiating malingering from non-malingering. Combined with the CI and P3 amplitude, the area under the ROC curve for malingering diagnosis further reached 0.952.
UNASSIGNED: Any non-optimal effort in a forensic context will lead to unexpected deviation in psychology evaluation results. CI is a potential candidate to act as an embedded validity indicator of the Symptom Checklist 90. The combination of CI and P3 amplitude can help to identify malingering in participants after severe traumatic brain injury.