title: Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy.
abstract: Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure to solvents. One hundred and forty-five subjects referred to one of two Dutch national assessment centers for CTE were administered the Amsterdam Short-Term Memory Test (ASTM) and the Test of Memory Malingering (TOMM), two tests specifically developed for the detection of suboptimal performance. For both tests, very cautious cut-off scores were chosen with a specificity of 99%. Results indicated that suboptimal performance appears to be a substantial problem in this group of patients with suspected CTE after long-term exposure to organic solvents. Only 54% of our subjects obtained normal scores on both tests of malingering, i.e. at or above cut-off score. The two tests seemed to measure the same concept in that nearly all the subjects with low TOMM scores also had low ASTM scores. However, a higher proportion of subjects scored below the cut-off on the ASTM than on the TOMM.
authors.affiliation: Department of Psychology, Medical Spectrum Twente Hospital, Enschede, The Netherlands. msevanhout@ziekenhuis-mst.nl
authors.forename: Moniek S E
authors.initials: MS
authors.lastname: van Hout
authors.forename: Ben
authors.initials: B
authors.lastname: Schmand
authors.forename: Ellie M
authors.initials: EM
authors.lastname: Wekking
authors.forename: Gerard
authors.initials: G
authors.lastname: Hageman
authors.forename: Betto G
authors.initials: BG
authors.lastname: Deelman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000523:psychology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012997:Solvents / Q000633:toxicity*; D018709:Statistics, Nonparametric
chemical_list: D012997:Solvents