Malingeren in de neuropsychologie: ontwikkeling en interpretatie van tests voor het detecteren van een suboptimale inzet

Abstract

'Malingeren' is 'het opzettelijk produceren van valse of sterk overdreven lichamelijke of psychische symptomen, waarbij externe motieven de aanleiding vormen' (DSM-IV, 1994). Het is een fenomeen dat vooral wordt gezien bij patie¨nten met moeilijk te objectiveren syndromen en bij procederende patie¨nten. In deze groepen lopen de geschatte malinger prevalenties uiteen van dertig tot zelfs zestig procent. Drie malingertests, de Test of Memory Malingering TOMM), de Word Memory Test (WMT) en de Amsterdamse Korte Termijn Geheugen Test (AKTG), blijken betrouwbare en valide instrumenten en slechte prestaties op deze tests vormen een sterke aanwijzing voor malingeren bij niet-demente patie¨nten. Malingertests zijn onmisbaar bij neuropsychologisch onderzoek.

Two validation studies of a performance validity test for autistic adults

“…However, our Faux-Pas Test data suggest that classic tests to measure social cognition may be susceptible to simulation as well. Simulation on more general cognitive tasks are commonly observed in simulation studies focusing on cognitive profiles (e.g., Hardeman, 2006;Mestdagh et al, 2019).…”

“…In the field of neuropsychology, symptom validity tests (SVT's) and performance validity tests (PVT's) are widely used to ascertain the 'accuracy or truthfulness of the examinee's behavioral presentation (signs), self-reported symptoms (including their cause and course), or performance on neuropsychological measures ' (p. 420, Bush et al, 2005). People may exaggerate or even simulate particular symptoms or difficulties in order to receive an incentive such as financial and medical aids (i.e., specific drugs), access to treatment or support, exemptions, or reduced responsibility for criminal actions (Hardeman, 2006;Maras, Marshall, & Sands, 2019;Merckelbach, Smeets, & Jelicic, 2009). Although the exact prevalence of aggravation and simulation of psychological or physical difficulties is difficult to determine, and also varies according to context (e.g., criminal / psychiatric), sample's characteristics, and SVT's/PVT's used (Dandachi-FitzGerald, Ponds, & Merten, 2013), aggravation/simulation is estimated as high as 30-60% for cases of whiplash, chronic fatigue, and chronic toxic encephalopathy (e.g., Hardeman, 2006;Mestdagh et al, 2019).…”

“…People may exaggerate or even simulate particular symptoms or difficulties in order to receive an incentive such as financial and medical aids (i.e., specific drugs), access to treatment or support, exemptions, or reduced responsibility for criminal actions (Hardeman, 2006;Maras, Marshall, & Sands, 2019;Merckelbach, Smeets, & Jelicic, 2009). Although the exact prevalence of aggravation and simulation of psychological or physical difficulties is difficult to determine, and also varies according to context (e.g., criminal / psychiatric), sample's characteristics, and SVT's/PVT's used (Dandachi-FitzGerald, Ponds, & Merten, 2013), aggravation/simulation is estimated as high as 30-60% for cases of whiplash, chronic fatigue, and chronic toxic encephalopathy (e.g., Hardeman, 2006;Mestdagh et al, 2019). For mental health conditions such as Attention Deficit Hyperactivity Disorder (ADHD; Sullivan, May, & Galbally, 2007), depression (Monaro et al, 2018), and Post Traumatic Stress Disorders (PTSD;Young, 2017) the prevalence estimations range from 10% to almost 50%.…”