Fragen der neuropsychologischen Diagnostik bei Simulationsverdacht

Zusammenfassung

Es wird ein Überblick über Ansätze und Methoden der neuropsychologischen Diagnostik bei Verdacht auf negative Antwortverzerrungen und suboptimales Leistungsverhalten geliefert. Dabei werden nach einem Überblick über wichtige konzeptionelle Probleme und traditionelle Ansätze der Diagnostik bei Simulationsverdacht insbesondere neuere Entwicklungen seit Beginn der 90er Jahre berücksichtigt. Als wesentliche Ansätze der Simulationsdiagnostik werden die Strategien des Testbodeneffektes, der Leistungskurve, der Fehlergröße, der Symptomvalidierungstestung, inkonsistenter oder untypischer Leistungsprofile und die Untersuchung der Präsentation psychischer Folgen von zerebralen Verletzungen diskutiert. Außerdem wird auf Fragebogenindikatoren eingegangen. Eine Reihe neu entwickelter simulationssensibler Tests wird vorgestellt. Im Gegensatz zum internationalen Standard muss eingeschätzt werden, dass sich Simulationsforschung und -diagnostik in Deutschland in einem Anfangsstadium befinden und vermutlich unbefriedigend in der klinischen Ausbildung berücksichtigt werden.

Abstract

Current problems and neuropsychological assessment strategies of malingering detection (assessment of negative response bias or non-optimal test behaviour) are reviewed. First, the paper discusses major conceptual problems inherent in the definition of malingering, factitious disorders, and somatoform disorders. Traditional and modern test approaches and diagnostic procedures are reviewed. Two case vignettes illustrate the application of particular strategies for malingering assessment. In German speaking countries, malingering research has not yet aroused profound interest comparable to that in English speaking countries. Diagnostic standards and instruments still have to be refined.

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