Malingering of psychiatric disorders in neuropsychological evaluations: Divergence of cognitive effort measures and psychological test validity indicators

2021 ◽  
Vol 36 (6) ◽  
pp. 1231-1231
Author(s):  
Naomi R Kaswan ◽  
Ryan C Thompson ◽  
Yelena Markiv ◽  
Aubrey Deenen ◽  
Haig V Pilavjian ◽  
...  

Abstract Objective Literature supports the use of the Delis-Kaplan Executive Function System Trail Making Test Conditions 4/2 ratio (TMT 4/2) and Stroop Color Word Test Word Reading (WR) as embedded validity indicators (EVIs) with adults (Erdodi et al., 2018; Guise et al., 2012) and the Wechsler Abbreviated Scale of Intelligence, 2nd Edition Matrix Reasoning (MR) as an EVI with children (Sussman et al., 2017). This study assessed the utility of these measures as EVIs in healthy children, compared to the Test of Memory Malingering Trial 1 (TOMM1 < 45; Perna & Loughan, 2013) and Reliable Digit Span (RDS). Method Participants (n = 99, 68.7% male, Mage = 11.9) completed baseline neuropsychological evaluations for sport participation, including the aforementioned measures. Receiver operator characteristic curve analysis was used to determine whether TMT 4/2, MR, and WR accurately categorized valid performance. Results TMT 4/2 yielded adequate sensitivity (0.83–1.00) but poor specificity (0.07–0.09) when predicting TOMM1 and RDS pass/fail performances. MR yielded adequate sensitivity (1.00) and specificity (0.92) when predicting RDS pass/fail performance and adequate specificity (0.92) and poor sensitivity (0.18) when predicting TOMM1 pass/fail performance. The only EVI that produced better than chance accuracy was MR when predicting RDS pass/fail performance (area under the curve [AUC] = 0.98). All participants failed the WR cutoff, suggesting poor specificity. Conclusion Results suggest that MR was the only EVI that achieved minimally acceptable specificity (≥0.90) in children. MR performed adequately when detecting valid performances but variably when detecting invalid performances; therefore, MR may be used alongside well-established performance validity tests with children but not independently.


2017 ◽  
Vol 41 (S1) ◽  
pp. s812-s812
Author(s):  
A. Giamarelou ◽  
P. Polychronopoulos ◽  
M. Skokou ◽  
L. Messinis ◽  
P. Gourzis

IntroductionFrontotemporal dementia (FTD) encompasses a group of clinical features that include personality and behavior changes (disinhibition, social isolation, antisocial behavior, compulsion) and executive dysfunction (poor planning, loss of judgment and loss of insight). These features may lead to an incorrect diagnosis of a primary psychiatric disorder.ObjectivesTo emphasize the difficulties in making a clinical distinction between early frontotemporal dementia and other psychiatric diseases.MethodsWe describe 11 patients who suffered from FTD, while initially had diagnosed with primary psychiatric disorders. The correct diagnosis was achieved by psychiatric and neuropsychological evaluations (WAIS SCALE, ACE-R, MMSE), neuroimaging studies (MRI 7/11, SPECT 8/11) and applying the international consensus criteria for FTD.ResultsAll patients (5 males and 6 females) were initially diagnosed with psychiatric disorders: schizophrenia (2/11), bipolar disorders (4/11), depression (5/11), schizoaffective disorder (1/11), somatization disorder (1/11), personality disorders (2/11), malingering (1/11), alcohol dependence (1/11), while 5 patients had more than one diagnosis. The age of onset varied from 19 to 53 years old. Final diagnosis of FTD was delayed on average 6,5 years from the onset of symptoms.ConclusionClinicians should be familiar with the clinical entity of FTD and its difficult distinction from other psychiatric disorders. A possible hospitalization of a patient with FTD in a psychiatric department and the social impact that it brings may be avoided. On the other hand, the proper care of FTD patients (pharmacological and psychosocial) improves the quality of life of patients and their caregivers.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2005 ◽  
Vol 50 (13) ◽  
pp. 851-856 ◽  
Author(s):  
Paul A Kurdyak ◽  
William H Gnam

Objectives: With the release of data from the Canadian Community Health Survey: Mental Health and Weil-Being (Cycle 1.2), researchers have, for the first time, information on several psychiatric disorders from a nationally representative sample of Canadians residing in households. This survey used the Composite International Diagnostic Interview (CIDI) to identify persons with one or more psychiatric disorders. In this paper, our primary purpose was to evaluate the evidence supporting the validity of the CIDI—that is, the extent to which the depression diagnoses generated by the CIDI reflect true cases of depression. Method: We conducted a critical review of the CIDI, focusing on the depression module. Results: Reliability studies indicate that the CIDI performs reliably, as measured by interrater reliability. However, the use of different versions of the CIDI and the occasional exclusion of the Depression module from studies suggest that the reliability of the CIDI Depression module remains unconfirmed. The most critical issue in regard to the CIDI's performance is that clinical samples are used to test validity. A clinical sample has a higher prevalence of depression than a community sample. Conclusion: The results generated by the CIDI in a community setting likely will have a high false-positive rate, resulting in a falsely elevated prevalence rate. Given the widespread application of the CIDI internationally, addressing the outstanding concerns about validity with proper validation studies should become an international priority.


2017 ◽  
pp. 223-250
Author(s):  
Chriscelyn M. Tussey ◽  
Beth Caillouet Arredondo ◽  
Paul M. Richards

2003 ◽  
Vol 3 (1-2) ◽  
pp. 241-274 ◽  
Author(s):  
Jerry J. Sweet ◽  
John H. King

2021 ◽  
Author(s):  
Jochen Michely ◽  
Ingrid M. Martin ◽  
Raymond J. Dolan ◽  
Tobias U. Hauser

Serotonin is implicated in the valuation of aversive costs, such as delay or physical effort. However, its role in governing sensitivity to cognitive effort, for example deliberation costs during information gathering, is unclear. We show that week-long treatment with a serotonergic antidepressant enhances a willingness to gather information when trying to maximize reward. Using computational modelling, we show this arises from a diminished sensitivity to subjective deliberation costs during the sampling process. This result is consistent with the notion that serotonin alleviates sensitivity to aversive costs in a domain-general fashion, with implications for its potential contribution to a positive impact on motivational deficits in psychiatric disorders.


2019 ◽  
Vol 42 ◽  
Author(s):  
Hanna M. van Loo ◽  
Jan-Willem Romeijn

AbstractNetwork models block reductionism about psychiatric disorders only if models are interpreted in a realist manner – that is, taken to represent “what psychiatric disorders really are.” A flexible and more instrumentalist view of models is needed to improve our understanding of the heterogeneity and multifactorial character of psychiatric disorders.


2020 ◽  
Vol 29 (4) ◽  
pp. 2170-2188
Author(s):  
Lindsey R. Squires ◽  
Sara J. Ohlfest ◽  
Kristen E. Santoro ◽  
Jennifer L. Roberts

Purpose The purpose of this systematic review was to determine evidence of a cognate effect for young multilingual children (ages 3;0–8;11 [years;months], preschool to second grade) in terms of task-level and child-level factors that may influence cognate performance. Cognates are pairs of vocabulary words that share meaning with similar phonology and/or orthography in more than one language, such as rose – rosa (English–Spanish) or carrot – carotte (English–French). Despite the cognate advantage noted with older bilingual children and bilingual adults, there has been no systematic examination of the cognate research in young multilingual children. Method We conducted searches of multiple electronic databases and hand-searched article bibliographies for studies that examined young multilingual children's performance with cognates based on study inclusion criteria aligned to the research questions. Results The review yielded 16 articles. The majority of the studies (12/16, 75%) demonstrated a positive cognate effect for young multilingual children (measured in higher accuracy, faster reaction times, and doublet translation equivalents on cognates as compared to noncognates). However, not all bilingual children demonstrated a cognate effect. Both task-level factors (cognate definition, type of cognate task, word characteristics) and child-level factors (level of bilingualism, age) appear to influence young bilingual children's performance on cognates. Conclusions Contrary to early 1990s research, current researchers suggest that even young multilingual children may demonstrate sensitivity to cognate vocabulary words. Given the limits in study quality, more high-quality research is needed, particularly to address test validity in cognate assessments, to develop appropriate cognate definitions for children, and to refine word-level features. Only one study included a brief instruction prior to assessment, warranting cognate treatment studies as an area of future need. Supplemental Material https://doi.org/10.23641/asha.12753179


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