Jeroen J Roor1,2, Brechje Dandachi-FitzGerald3, Maarten J V Peters3, Hans Knoop4,5, Rudolf W H M Ponds6,7. 1. Department of Medical Psychology, VieCuri Medical Center, Venlo, The Netherlands. 2. School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands. 3. Faculty of Psychology and Neuroscience, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands. 4. Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands. 5. Department of Medical Psychology, Expert Centre for Chronic Fatigue, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands. 6. Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, The Netherlands. 7. Department of Psychiatry and Neuropsychology, Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands.
Abstract
OBJECTIVE: There is limited research examining the impact of the validity of cognitive test performance on treatment outcome. All known studies to date have operationalized performance validity dichotomously, leading to the loss of predictive information. Using the range of scores on a performance validity test (PVT), we hypothesized that lower performance at baseline was related to a worse treatment outcome following cognitive behavioral therapy (CBT) in patients with Chronic Fatigue Syndrome (CFS) and to lower adherence to treatment. METHOD: Archival data of 1081 outpatients treated with CBT for CFS were used in this study. At baseline, all patients were assessed with a PVT, the Amsterdam Short-Term Memory test (ASTM). Questionnaires assessing fatigue, physical disabilities, psychological distress, and level of functional impairment were administered before and after CBT. RESULTS: Our main hypothesis was not confirmed: the total ASTM score was not significantly associated with outcomes at follow-up. However, patients with a missing follow-up assessment had a lower ASTM performance at baseline, reported higher levels of physical limitations, and completed fewer therapy sessions. CONCLUSIONS: CFS patients who scored low on the ASTM during baseline assessment are more likely to complete fewer therapy sessions and not to complete follow-up assessment, indicative of limited adherence to treatment. However, if these patients were retained in the intervention, their response to CBT for CFS was comparable with subjects who score high on the ASTM. This finding calls for more research to better understand the impact of performance validity on engagement with treatment and outcomes.
OBJECTIVE: There is limited research examining the impact of the validity of cognitive test performance on treatment outcome. All known studies to date have operationalized performance validity dichotomously, leading to the loss of predictive information. Using the range of scores on a performance validity test (PVT), we hypothesized that lower performance at baseline was related to a worse treatment outcome following cognitive behavioral therapy (CBT) in patients with Chronic Fatigue Syndrome (CFS) and to lower adherence to treatment. METHOD: Archival data of 1081 outpatients treated with CBT for CFS were used in this study. At baseline, all patients were assessed with a PVT, the Amsterdam Short-Term Memory test (ASTM). Questionnaires assessing fatigue, physical disabilities, psychological distress, and level of functional impairment were administered before and after CBT. RESULTS: Our main hypothesis was not confirmed: the total ASTM score was not significantly associated with outcomes at follow-up. However, patients with a missing follow-up assessment had a lower ASTM performance at baseline, reported higher levels of physical limitations, and completed fewer therapy sessions. CONCLUSIONS: CFS patients who scored low on the ASTM during baseline assessment are more likely to complete fewer therapy sessions and not to complete follow-up assessment, indicative of limited adherence to treatment. However, if these patients were retained in the intervention, their response to CBT for CFS was comparable with subjects who score high on the ASTM. This finding calls for more research to better understand the impact of performance validity on engagement with treatment and outcomes.
Authors: Thomas Merten; Brechje Dandachi-FitzGerald; Vicki Hall; Thomas Bodner; Luciano Giromini; Johann Lehrner; Héctor González-Ordi; Pablo Santamaría; Ben Schmand; Giuseppe Di Stefano Journal: Psychol Inj Law Date: 2021-11-24