title: Development of a Cognitive Level Explanation Model in Brain Injury : Comparisons between Disability and Non-Disability Evaluation Groups.
abstract: OBJECTIVE
  We investigated whether Disability Evaluation (DE) situations influence patients' neuropsychological test performances and psychopathological characteristics and which variable play a role to establish an explanation model using statistical analysis.
  
  
  METHODS
  Patients were 536 (56.6%) brain-injured persons who met inclusion and exclusion criteria, classified into the DE group (DE; n = 300, 56.0%) and the non-DE group (NDE; n = 236, 44.0%) according to the neuropsychological testing's purpose. Next, we classified DE subjects into DE cluster 1 (DEC1; 91, 17.0%), DE cluster 2 (DEC2; 125; 23.3%), and DE cluster 3 (DEC3; 84, 15.7%) via two-step cluster analysis, to specify DE characteristics. All patients completed the K-WAIS, K-MAS, K-BNT, SCL-90-R, and MMPI.
  
  
  RESULTS
  In comparisons between DE and NDE, the DE group showed lower intelligence quotients and more severe psychopathologic symptoms, as evaluated by the SCL-90-R and MMPI, than the NDE group did. When comparing the intelligence among the DE groups and NDE group, DEC1 group performed worst on intelligence and memory and had most severe psychopathologic symptoms than the NDE group did. The DEC2 group showed modest performance increase over the DEC1 and DEC3, similar to the NDE group. Paradoxically, the DEC3 group performed better than the NDE group did on all variables.
  
  
  CONCLUSIONS
  The DE group showed minimal "faking bad" patterns. When we divided the DE group into three groups, the DEC1 group showed typical malingering patterns, the DEC2 group showed passive malingering patterns, and the DEC3 group suggested denial of symptoms and resistance to treatment.
authors: Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea.
authors: Tae-Hee
authors: TH
authors: Shin
authors: Chang-Bong
authors: CB
authors: Gong
authors: Min-Su
authors: MS
authors: Kim
authors: Jin-Sung
authors: JS
authors: Kim
authors: Dai-Seg
authors: DS
authors: Bai
authors: Oh-Lyong
authors: OL
authors: Kim