레이복합도형검사(Rey Complex Figure Test; RCFT)의 사병변별지표에 대한 연구
A Study of Malingering Discrimination Index of Rey Complex Figure Test; RCFT
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초록
본 연구에서는 레이복합도형검사의 사병변별력을 검토하기 위해, 외상후 경도의 뇌손상을 입은 사병집단(24명)과 솔직집단(25명), 그리고 외상경험이 없는 정상집단(24명), 이들 세 집단에 레이복합도형검사를 실시했다. 그 결과 레이복합도형검사의 모사시간, 모사점수, 즉시회상, 지연회상, 정긍정, 오긍정, 정부정, 재인지표 및 비특이적 재인오류에서 사병집단이 솔직집단과 정상집단보다 일관되게 빈약한 양상을 보였다. 또한 사병집단과 솔직집단의 정확분류율을 검토한 결과, 특정도 .95이상에서 모사점수(.54), 즉시회상(.54), 지연회상(.58)이 단일 변인으로서는 비교적 양호한 민감도를 보였다. 그리고 본 연구에서는 Lu Boone, Cozolino, & Mitchell(2003)의 조합점수에서 정긍정 대신 재인지표(정긍정과 정부정의 합)를 포함한 새로운 사병변별지표{모사점수 + 재인지표 - (비특이적 재인오류 * 3)}를 제안하였는데, 이 사병변별지표가 사병집단과 솔직집단의 분류시 특정도를 .96으로 유지하면서, 민감도가 .83이고, 정확분류율이 .90으로 높게 나왔다. 끝으로 본 연구의 임상적 의의와 제한점이 논의되었다.
Abstract
This study was to examined the effectiveness of the Rey Complex Figure Test to detect malingering. This test was administrated to three groups: the malingering (n=24) and the effortful (n=25) groups with mild traumatic brain injury and the normal control group without head injury (n=24). The malingering group did consistently poorer than the effortful group and the normal control group on the various variables for the Rey Complex Figure Test, these variables are the copy time, the copy score, the immediate recall, the delayed recall, the true positive, the false positive, the true negative, the recognition index and the atypical recognition errors. When examining the classification accuracy between the malingering group and the effortful group, the copy time (.54), the immediate recall (.54) and the delayed recall (.58), showed better sensitivity as single variables while maintaining a specificity of at least .95. From the result of this study, we can suggest a new malingering detection index, which is the copy score + the recognition index - (the atypical recognition errors * 3), with including the recognition index (the sum of the true positives and the true negatives) instead of just the true positives in the combination score of Lu, Boone, Cozolino, & Mitchell (2003). This malingering detection index has high sensitivity and classification accuracy, (.83 and .90, respectively), while maintaining the specificity of .96 when classified between the malingering and the effortful groups. The clinical implications and the limitations of this study are also discussed.
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