The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) may be unreliable at its standard recommended cutoff score when used with forensic psychiatric inpatient populations given high rates of genuine cognitive impairment. The present study sought to (a) examine the rate of invalid performance on the RBANS EI using the standard cutoff among incompetent to stand trial (IST) inpatients and (b) investigate the psychometric properties of the RBANS EI at various cutoff scores. This study was conducted using archival assessment data collected at a large forensic psychiatric hospital. Across the entire sample (N = 238, 79% male, Mage = 45 years, 24% primary Spanish-speaking), 79% were diagnosed with a schizophrenia spectrum disorder. Experiment 1 of the study (n = 165) contained IST patients who were classified as having a valid presentation. Experiment 2 contained a valid (n = 46) and invalid (n = 27) presentation group comprised of postadjudication and IST inpatients, respectively. In Experiment 1, over one third (36.4%) of the valid presentation sample scored above the standard recommended EI cutoff. In Experiment 2, applying the standard recommended cutoff score of > 3 was associated with a false positive rate of over 20%. Obtaining < 10% false positive errors was achieved at a cutoff score of > 5. At this cutoff score, the estimated local base rate of invalid responding among IST patients was 28%. Clinical and forensic implications and recommendations for adopting this more conservative RBANS EI cutoff score are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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提出一种更保守的可重复电池用于法医住院患者的神经心理状态评估 (RBANS) 努力指数截止分数。


考虑到真正认知障碍的发生率很高，当用于法医精神病住院患者群体使用时，用于评估神经心理状态 (RBANS) 努力指数 (EI) 的可重复电池在其标准推荐截止分数上可能不可靠。本研究旨在 (a) 使用无法接受审判 (IST) 住院患者的标准截止值检查 RBANS EI 的无效表现率，以及 (b) 调查 RBANS EI 在不同截止分数下的心理测量特性。这项研究是使用在一家大型法医精神病医院收集的档案评估数据进行的。在整个样本中（N = 238，79% 为男性，Mage = 45 岁，24% 主要讲西班牙语），79% 被诊断患有精神分裂症谱系障碍。该研究的实验 1（n = 165）包含被归类为具有有效表现的 IST 患者。实验 2 包含有效（n = 46）和无效（n = 27）演示组，分别由裁决后住院患者和 IST 住院患者组成。在实验 1 中，超过三分之一 (36.4%) 的有效演示样本得分高于标准推荐的 EI 截止值。在实验 2 中，应用标准推荐的截止分数 > 3 与超过 20% 的假阳性率相关。在 > 5 的截止分数处获得 < 10% 假阳性错误。在此截止分数下，IST 患者中无效响应的估计局部基本率为 28%。讨论了采用这种更保守的 RBANS EI 截止分数的临床和法医影响以及建议。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。