Neuropsychologists' ability to predict distorted symptom presentation

Research output: Contribution to journalArticleAcademicpeer-review

159 Downloads (Pure)

Abstract

OBJECTIVE: We explored to what extent experienced neuropsychologists can predict distorted symptom presentation of clinically referred hospital outpatients.

METHOD: Using clinical files and interview results, 31 neuropsychologists made predictions as to how 203 patients would perform on two response validity tests. Their predictions were matched against actual passing or failing two such tests, of which one measured overreporting of symptoms and the other underperformance on cognitive tests.

RESULTS: Clinical predictions and test outcomes agreed in 76% of the cases, with Cohen's kappa being .26, 95% confidence interval, CI [.08, .44]. Of the 152 patients for whom neuropsychologists had predicted nondistorted symptom presentations, 14 patients (9.2%) failed both response validity tests. Of the 51 patients for whom neuropsychologists had predicted problematic response validity, 35 patients (68.6%) passed both tests.

CONCLUSIONS: Clinical prediction of distorted symptom presentation is far from perfect. Our findings show that response validity tests have incremental value in that they may correct initial clinical judgment.

Original languageEnglish
Pages (from-to)257-264
Number of pages8
JournalJournal of Clinical and Experimental Neuropsychology
Volume39
Issue number3
Early online date7 Sep 2016
DOIs
Publication statusPublished - 2017

Cite this

@article{402373f97f774f39ab20fe5845e9ea6c,
title = "Neuropsychologists' ability to predict distorted symptom presentation",
abstract = "OBJECTIVE: We explored to what extent experienced neuropsychologists can predict distorted symptom presentation of clinically referred hospital outpatients.METHOD: Using clinical files and interview results, 31 neuropsychologists made predictions as to how 203 patients would perform on two response validity tests. Their predictions were matched against actual passing or failing two such tests, of which one measured overreporting of symptoms and the other underperformance on cognitive tests.RESULTS: Clinical predictions and test outcomes agreed in 76{\%} of the cases, with Cohen's kappa being .26, 95{\%} confidence interval, CI [.08, .44]. Of the 152 patients for whom neuropsychologists had predicted nondistorted symptom presentations, 14 patients (9.2{\%}) failed both response validity tests. Of the 51 patients for whom neuropsychologists had predicted problematic response validity, 35 patients (68.6{\%}) passed both tests.CONCLUSIONS: Clinical prediction of distorted symptom presentation is far from perfect. Our findings show that response validity tests have incremental value in that they may correct initial clinical judgment.",
author = "Brechje Dandachi-FitzGerald and Harald Merckelbach and Ponds, {Rudolf W H M}",
note = "Open access",
year = "2017",
doi = "10.1080/13803395.2016.1223278",
language = "English",
volume = "39",
pages = "257--264",
journal = "Journal of Clinical and Experimental Neuropsychology",
issn = "1380-3395",
publisher = "Psychology Press Ltd",
number = "3",

}

TY - JOUR

T1 - Neuropsychologists' ability to predict distorted symptom presentation

AU - Dandachi-FitzGerald, Brechje

AU - Merckelbach, Harald

AU - Ponds, Rudolf W H M

N1 - Open access

PY - 2017

Y1 - 2017

N2 - OBJECTIVE: We explored to what extent experienced neuropsychologists can predict distorted symptom presentation of clinically referred hospital outpatients.METHOD: Using clinical files and interview results, 31 neuropsychologists made predictions as to how 203 patients would perform on two response validity tests. Their predictions were matched against actual passing or failing two such tests, of which one measured overreporting of symptoms and the other underperformance on cognitive tests.RESULTS: Clinical predictions and test outcomes agreed in 76% of the cases, with Cohen's kappa being .26, 95% confidence interval, CI [.08, .44]. Of the 152 patients for whom neuropsychologists had predicted nondistorted symptom presentations, 14 patients (9.2%) failed both response validity tests. Of the 51 patients for whom neuropsychologists had predicted problematic response validity, 35 patients (68.6%) passed both tests.CONCLUSIONS: Clinical prediction of distorted symptom presentation is far from perfect. Our findings show that response validity tests have incremental value in that they may correct initial clinical judgment.

AB - OBJECTIVE: We explored to what extent experienced neuropsychologists can predict distorted symptom presentation of clinically referred hospital outpatients.METHOD: Using clinical files and interview results, 31 neuropsychologists made predictions as to how 203 patients would perform on two response validity tests. Their predictions were matched against actual passing or failing two such tests, of which one measured overreporting of symptoms and the other underperformance on cognitive tests.RESULTS: Clinical predictions and test outcomes agreed in 76% of the cases, with Cohen's kappa being .26, 95% confidence interval, CI [.08, .44]. Of the 152 patients for whom neuropsychologists had predicted nondistorted symptom presentations, 14 patients (9.2%) failed both response validity tests. Of the 51 patients for whom neuropsychologists had predicted problematic response validity, 35 patients (68.6%) passed both tests.CONCLUSIONS: Clinical prediction of distorted symptom presentation is far from perfect. Our findings show that response validity tests have incremental value in that they may correct initial clinical judgment.

U2 - 10.1080/13803395.2016.1223278

DO - 10.1080/13803395.2016.1223278

M3 - Article

C2 - 27603924

VL - 39

SP - 257

EP - 264

JO - Journal of Clinical and Experimental Neuropsychology

JF - Journal of Clinical and Experimental Neuropsychology

SN - 1380-3395

IS - 3

ER -