Prevalence of poor effort and malingered neurocognitive dysfunction in litigating patients in Switzerland
Abstract
Abstract. To determine the prevalence of inauthentic cognitive test results, the data of 455 examinees who had finished at least two performance validity tests (PVTs) were analyzed retrospectively. The PVTs administered were the WMT, MSVT, NV-MSVT, ASTM, BSV, RMT, and RDS. Classification as “definite” or “probable” malingering was done according to the Slick criteria. Sociodemographic variables and diagnoses were described using binary logistic regression. Poor effort in at least two PVTs correlated significantly with education levels, immigration, and origin. Irrespective of education level, the highest risk of definite malingering was found in first-generation migrants. Cervical spine dysfunction, normal cerebral imaging, PTSD, somatoform, and/or depressive disorders also correlated with negative response bias. The probability that psychiatric patients fulfill criteria of probable malingering was higher than in patients with isolated organic mental disorders.
Zusammenfassung. 455 Exploranden, welche mindestens zwei Performanzvalidierung (PVTs) bearbeitet hatten, wurde retrospektiv hinsichtlich der Prävalenz nicht-authentischer Testbefunde analysiert. Zum Spektrum eingesetzter PVTs zählten der WMT, MSVT, NV-MSVT, AKGT, BSV, RMT und die Reliable Digit Span. Anhand der Slick-Kriterien erfolgte eine Klassifikation in „sichere“ oder „wahrscheinliche“ Aggravation/Simulation. Assoziationen dieser Gruppen mit demographischen Faktoren und Diagnosen wurden durch einfache logistische Regressionsmodelle beschrieben. Danach korrelierten unzureichende Anstrengungsbereitschaft in mindestens 2 PVTs signifikant mit Bildungsniveau, Immigration und Herkunftsregion. Bildungsunabhängig fand sich bei Migranten der 1. Generation ein signifikant höheres Risiko für sichere Aggravation. HWS-Beschwerden, unauffällige zerebrale Bildgebung, Posttraumatische Belastungsstörungen, somatoformen Störung und/oder depressive Störungen korrelierten ebenfalls mit negativer Antwortverzerrung. Psychiatrische Patienten erfüllten mit höherer Wahrscheinlichkeit die Kriterien einer wahrscheinlichen Aggravation als jene mit einer ausschliesslich hirnorganischen Störung.
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