꾀병척도의 타당도 연구: 경도 두부손상 환자를 중심으로
A study on validity of malingering scale: focused on patient on patient after mild head trauma
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본 연구에서는 진단이나 감정환자들을 평가하는 과정에서 꾀병을 의심하게 하는 검사 전과 검사 도중의 10가지 행동특성들을 선별하여 꾀병척도를 구성하였다. 본 연구에서는 보상금 지불을 의식한 경도두부 손상 환자들의 과장되고 작위적인 증상표현을 Mal척도를 사용하여 감별해낼 수 있을지 확인하고자 하였다. 이를 위해 보편적으로 활용되고 있는 다면적 인성검사를 중심으로 타당도를 검증한 결과 특히 F 척도와 연관성이 높았으며 임상 척도 중 PT와 SI의 특징을 나타내고 있었다. MRI상의 실재적 손상여부와 의도성을 고려하여 감정과 진단 환자를 구분한 후 그 밖의 인구통계학적 변인들을 추가하여 데이터 마이닝한 결과 꾀병 환자들은 억제와 의도성을 가진 상태에서 피상적이며 비효율적인 대처 방식으로 일관하고 있음이 확인되었다. 이것은 Mal척도의 개념적 정의와 일치하는 것이며 임상 장면에서 MMPI등과 교차적으로 사용할 수 있다는 것을 입증하는 결과이다. 이를 토대로 MMPI 특수척도와의 연관성 및 다양한 임상 증상의 꾀병탐지에 대한 절단 점수의 연구가 필요함을 제안하였다.
Abstract
The present studies tested the validity of malingering scale after mild head trauma, with two primary objectives in mind. They were : First, to differentiate the artificial and exaggerate complaints from true symptoms of mild head trauma. Second, to specify the psychological conditions of malingering. MMPI was administered to 89 patients after mild head trauma. Results showed that Malingering Scale had sufficient internal reliability(Cronbach's α=.9264) and conceptual validity. The results of data mining showed that superficial and nonadaptive coping skills might predict malingering mainly by suggesting of surpression and intention. The integrated model of malingering will fit clinical condition with compensation very well when the data from various neuropsychological assessment were added. The future study on malingering through data mining is desirable to simultaneous consider various clinical sample and scale procedure.
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