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Demographic and Psychiatric Correlates of Performance Validity Profiles of Individuals Assessed Subsequent to Motor Vehicle Accidents

机译：机动车事故后评估的个人绩效效用概况的人口统计学和精神病学相关因素

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摘要

The current study explored the effects of cultural, demographic and psychiatric variables on Performance Validity Test (PVT) base rates of failure (BR FAIL) in 325 examinees with traumatic brain injury (TBI) following motor vehicle accidents. PVTs are widely used measures of credibility in neuropsychological assessment. Gaps in the PVT literature regarding the effects of various demographic, cultural, and psychiatric factors limit the generalizability of PVTs.;Higher false-positive rates in minority groups may lead to the inaccurate characterization of members as noncredible, resulting in the denial of treatment and compensation following injuries. To address this gap in the literature, the first objective of the study explored the relationship between BR FAIL, and limited English proficiency, time spent in Canada, education, age, gender, and injury severity. Results indicated that examinees with limited English proficiency had higher BRFAIL on PVTs with low verbal mediation (i.e., tests that did not have verbal components beyond the instructions) compared to Anglophone Canadians. Examinees who had language interpreters had higher BRFAIL on PVTs with both high and low verbal mediation compared to examinees assessed in English. Examinees who immigrated to Canada had higher BRFAIL on both high and low verbal mediation PVTs compared to Canadian-born examinees. Examinees aged 40 to 49 and those with less than high school education had higher BRFAIL for low verbal mediation PVTs than other groups. There were no differences for gender or TBI severity on BRFAIL. These results may be explained by several cultural factors, including cultural concepts of distress and differences in health literacy, which may contribute to PVT BRFAIL. As such, neuropsychologists should consider the contribution of these cultural factors when interpreting PVT results of examinees who have immigrated to Canada.;Another important gap in the literature is in regards the relationship between PVTs and dissociative symptoms (i.e., disrupted consciousness, affect, and memory). Findings on the effects of psychiatric factors (e.g., posttraumatic, depressive, and anxious symptoms) on PVT BRFAIL are mixed but generally indicate that PVTs are robust to psychiatric disorders except psychosis. However, disruptions in consciousness, memory, and affect due to dissociative pathology might be expected to interfere with test performance. The second objective of this study explored the relationship between BR FAIL and dissociative, posttraumatic, anxious, and depressive symptoms. Results indicated elevated rates of PVT BRFAIL for examinees with higher levels of self-reported posttraumatic, depressive, and anxious symptoms. Results also indicated that those with high self-reported dissociative symptoms had higher BRFAIL for verbally mediated PVTs. The findings suggest that dissociative symptoms may interfere with verbally mediated PVTs, and highlight the need for further research into the effects of dissociative pathology on neuropsychological and PVT performance.;The current study demonstrated that previously unexplored cultural, demographic, and psychiatric factors are related to PVT performance, and may affect the interpretation of PVTs. Implications, limitations, and avenues for future research are discussed.
机译：当前的研究探讨了文化，人口统计学和精神病学变量对325名机动车事故导致的颅脑外伤（TBI）的考生的绩效有效性测试（PVT）基本失败率（BR FAIL）的影响。 PVT是在神经心理学评估中广泛使用的可信度度量。 PVT文献中关于各种人口，文化和精神因素的影响的空白限制了PVT的推广性;少数群体中较高的假阳性率可能导致成员的不可信描述不准确，从而导致拒绝治疗和受伤后赔偿。为了弥补文献中的这一空白，该研究的第一个目标是探索BR FAIL与英语能力有限，在加拿大花费的时间，教育程度，年龄，性别和伤害严重程度之间的关系。结果表明，英语能力有限的考生与英语能力较低的人相比，在语言调解程度较低的PVT上的BRFAIL较高（即，没有超出指令范围的语言成分的测试）。与以英语评估的考生相比，具有语言翻译能力的考生在口语调解的高低上对PVT的BRFAIL更高。与加拿大出生的考生相比，移民到加拿大的考生在高和低语言调解PVT上的BRFAIL较高。年龄在40至49岁之间的受测者以及受过高中教育程度不高的受测者对口头调解PVT较低的BRFAIL高于其他人群。 BRFAIL的性别或TBI严重程度无差异。这些结果可以用几种文化因素来解释，包括困扰的文化概念和健康素养的差异，这可能有助于PVT BRFAIL。因此，神经心理学家在解释移民到加拿大的考生的PVT结果时应考虑这些文化因素的影响。;文献中的另一个重要空白是关于PVT与分离症状（即意识障碍，情感和心理障碍）之间的关系。记忆）。关于精神因素（例如创伤后，抑郁和焦虑症状）对PVT BRFAIL的影响的研究结果参差不齐，但通常表明PVT对除精神病以外的精神疾病具有抵抗力。但是，由于分离性病理引起的意识，记忆和影响的破坏可能会干扰测试性能。这项研究的第二个目标是探索BR FAIL与分离性，创伤后，焦虑和抑郁症状之间的关系。结果表明，自我报告的创伤后，抑郁和焦虑症状水平较高的考生，PVT BRFAIL的发生率升高。结果还表明，具有较高自我报告的解离症状的患者对于口头介导的PVT的BRFAIL较高。这些发现表明，解离症状可能会干扰口头介导的PVT，并强调有必要进一步研究解离病理对神经心理学和PVT表现的影响。;当前研究表明，先前未经探索的文化，人口统计学和精神因素与PVT的性能，并可能影响PVT的解释。讨论了未来研究的含义，局限性和途径。

著录项

  • 作者

    Nussbaum, Shayna Hannah.;

  • 作者单位

    University of Windsor (Canada).;

  • 授予单位 University of Windsor (Canada).;
  • 学科 Psychology.;Cognitive psychology.;Clinical psychology.
  • 学位 Ph.D.
  • 年度 2018
  • 页码 284 p.
  • 总页数 284
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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