Thesis (MSc)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: Malingering is the intentional production or exaggeration of symptoms for personal gain
in the context of external incentives. Due to the absence of objective symptoms, depression may
represent a relatively attractive option for malingerers. Existing approaches to distinguish
between depressive symptoms and possible malingering often use time-consuming psychometric
tests or unreliable interview techniques. Short screening tests for malingering may be a
practicable alternative and recently South African cut-off scores on tests for malingering were
determined for a student sample. The purpose of this study was to establish South African cut-off
scores for persons with a diagnosis of depression on screening instruments for malingering.
Fifty-one subjects with a diagnosis of depression (measured by the Zung Depression
Scale) were randomly ascribed to one of two groups: an experimental group of 25 subjects
(instructed to simulate symptoms based on a malingering case scenario) and a control group of
26 subjects (instructed to do their best in the tests). No incentive was provided to the subjects.
Each subject completed the 21-item verbal memory forced choice test (FCT), the Rey IS-item
test (Rey IS-item), the dot-counting test (DCT), the Word Recognition test (WR) that is part of
the Alzheimer Disease Assessment Scale Cognitive Battery (ADAS-Cog) and the Structured
Inventory of Malingered Symptomatology (SIMS).
The WR test correctly classified 74.5% of subjects with a sensitivity of 93%. The FCT,
with a cut-off of> 15.5, correctly classified 72.5% of subjects. A regression equation was
computed by combining the FCT, DCT and SIMS. This correctly classified 74.5% of patients
with a sensitivity of 69%. The DCT accurately identified 64% of the malingerers using a cut-off score of> 65.57. The Rey15-item test showed poor results and does not seem to be useful as a
screening instrument.
The WR test shows promise as a screening instrument for malingering. Combining tests
when screening for malingering proved to be an effective way to distinguish between
malingering of depressive symptoms and real symptoms. The results of this study will help
provide guidelines to mental health workers on how to diagnose malingering in patients with
depression more objectively. / AFRIKAANSE OPSOMMING: Malingering is die opsetlike nabootsing of oordrywing van simptome vir persoonlike
gewin in die konteks van eksterne vergoeding. As gevolg van die subjektiewe aard van
simptome, kan depressie 'n relatief aantreklike opsie wees wanneer psigiatriese kondisies
gesimuleer word. Bestaande maniere om te onderskei tussen werklike depressiewe simptome en
moontlike malingering, gebruik tydrowende psigometriese toetse of onbetroubare
onderhoudstegnieke. Kort siftingstoetse vir malingering kan 'n praktiese altenatief wees en
onlangse Suid-Afrikaanse afsnypunte op toetse vir malingering is bepaal vir 'n
studentesteekproef. Die doel van hierdie studie was om Suid-Afrikaanse afsnypunte te verkry vir
malingeringstoetse vir mense met 'n diagnose van depressie.
Een en vyftig subjekte met 'n diagnose van depressie (gemeet deur die Zung
Depressieskaal) is ewekansig toegewys aan een van twee groepe: 'n eksperimentele groep van 25
subjekte (met die opdrag om simptome te simuleer op grond van 'n malingering-scenario) en 'n
kontrolegroep van 26 subjekte (met die opdrag om hulle bes te doen in die toetse). Geen
vergoeding is aan proefpersone gebied nie. Elke subjek het die 21-item verbal memory forced
choice test (FfC), die Rey 15-item test (Rey IS-item), die dot-counting test (DCT), die Word
Recognition test (WR) wat deel vorm van die Alzheimer Disease Assessment Scale Cognitive
Battery (ADAS-Cog) en die Structured Inventory of Malingered Symptomatology (SIMS)
voltooi.
Die WR het 74.5% van die subjekte korrek geklasifiseer met 'n sensitiwiteit van 93%.
Die FCT, met 'n afsnypunt van <15.5, het 72.5% van die subjekte korrek geklassifiseer. 'n
Regressie-vergelyking is bereken deur 'n kombinering van die FCT, DCT en SIMS. Dit het 74.5% van die subjekte korrek geklassifiseer met 'n sensitiwiteit van 69%. Die DeT kon 64%
van die malingeerders akkuraat identifiseer deur gebruik te maak van 'n afsnypunt van> 65.57.
Die Rey IS-item toets het swak resultate getoon en blyk nie bruikbaar te wees as 'n siftingstoets
nie.
Die WR toon potensiaal as In siftingstoets vir malingering. Die kombinering van toetse
wanneer pasiënte gesif word vir malingering blyk 'n effektiewe manier te wees om te onderskei
tussen die malingering van depressiewe simptome en werklike simptome. Die resultate van
hierdie studie kan help om riglyne te skep vir geestesgesondheidswerkers oor hoe om
malingering van depressie meer objektief te diagnoseer.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/51824 |
| Date | 12 1900 |
| Creators | De Villiers, Vesta Naomi |
| Contributors | Hugo, F. J., Spangenberg, J. J., Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 23 p. |
| Rights | Stellenbosch University |
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