Sensitivity and Specificity of Finger Tapping Test Scores for the Detection of Suspect Effort

Abstract

Past studies indicate that patients with incentive to fake neuropsychological symptoms are likely to have lower finger tapping scores than credible patients. The present study builds upon past research by investigating finger tapping performance for seven groups: (a) noncredible patients (as determined by failed psychometric and behavioral criteria), and patients with (b) closed head injury, (c) dementia, (d) mental retardation, (e) psychosis, or (f) depression, and (g) healthy older controls. Results showed that men tapped faster than women, requiring that groups be divided by gender. Noncredible male and female patients tapped slower than their comparison group counterparts. Dominant hand score proved to be more sensitive to noncredible performance than other scores (nondominant, sum of both hands, difference between dominant and nondominant), especially for women. Sensitivity, specificity, and positive and negative predictive value tables are presented. With specificity set at 90% for the comparison groups combined, a dominant hand cutoff score of </=35 for men yielded 50% sensitivity, while a score of </=28 yielded 61% sensitivity for women. Specificity values for specific cutoff scores varied significantly across the comparison groups, indicating that cutoffs should be adjusted for the particular differential diagnosis. In conclusion, results indicate that when using finger tapping scores to detect noncredible performance: (a) Dominant hand performance is more sensitive, and (b) cutoffs should be selected based on gender and claimed diagnosis.

Computerized Finger Tapping Task in Adult Unipolar Depressed Patients and Healthy Subjects: Influence of Age, Gender, Education, and Hand Dominance

“…As in previous studies, men tapped faster than women (Arnold et al, 2005;Ashendorf, Vanderslice-Barr, & McCaffrey, 2009;Bornstein, 1985;Christianson & Leathem, 2004;Coleman et al, 1997;Elias, Robbins, Walter, & Schultz, 1993;Gur et al, 2010;Heaton, Miller, Taylor, & Grant, 2004;Hubel et al, 2013aHubel et al, , 2013bMitrushina, Boone, Razani, & D'Elia, 2005;Peters, 1980;Peters & Campagnaro, 1996;Ruff & Parker;Schmidt et al, 2000;Ylikoski et al, 1998), outperforming women by three to five taps (Ashendorf et al, 2009;Mitrushina et al, 2005). Heaton and colleagues (2004) reported that about 16% to 20% of the test scores were accounted for by gender.…”

“…Given that motor retardation is a common feature of depression (American Psychiatry Association, 2013;Caligiuri & Ellwanger, 2000), tests of fine psychomotor performance, such as the Finger Tapping Test (FTT), have been widely utilized in several studies on depression (Arnold et al, 2005;Bashir, Khade, Kosaraju, Kumar, & Rani, 2013;Caligiuri & Ellwanger, 2000;Hill, Keshavan, Thase, & Sweeney, 2004;Hueng et al, 2011;Kertzman et al, 2010;Lampe, Sitskoorn, & Heeren, 2004;Meyer et al, 2006;Rohling, Green, Allen, & Iverson, 2002;Schrijvers, Hulstijn, & Sabbe, 2008;Swann, Katz, Bowden, Berman, & Stokes, 1999) proving to be reliable to access impairments and discard malingering (Arnold et al, 2005;Rohling et al, 2002).…”

“…The FTT was developed as part of the Halstead-Reitan Battery (Halstead, 1947) and consists in a test of fine psychomotor performance, measured through self-directed manual motor speed and control (Christianson & Leathem, 2004;Strauss, Sherman, & Spreen, 2006), recurrently employed to assess impairment resulting from traumas, diseases, and other clinical conditions, such as brain injury (Arnold et al, 2005;Hubel, Yund, Herron, & Woods, 2013a;Kane, Roebuck-Spencer, Short, Kabat, & Wilken, 2007), Alzheimer's disease (Arnold et al, 2005;Dwolatzky et al, 2003Dwolatzky et al, , 2004Kane et al, 2007), Parkinson's disease Shimoyama, Ninchoji, & Uemura, 1990), multiple sclerosis Wilken et al, 2003), mild cognitive impairment (Dwolatzky et al, , 2004, and mental retardation (Arnold et al, 2005).…”

“…Furthermore, many find it resourceful to detect fake symptoms in forensic contexts (Arnold et al, 2005;Hubel et al, 2013a;Rohling et al, 2002), having also been used to study the relationship between manual dexterity and performance, in order to draw inferences about the functional integrity of the two cerebral hemispheres (Hervé, Mazoyer, Crivello, Perchey, & Tzourio-Mazoyer, 2005;Peters, 1980;Schmidt, Oliveira, Krahe, & Filgueiras, 2000;Strauss et al, 2006).…”

Multidisciplinary Assessment and Diagnosis of Conversion Disorder in a Patient with Foreign Accent Syndrome

“…Additionally, cued verbal recall on a list-learning task was reasonably intact, while performance on a subsequent recognition trial was severely impaired. Finger-tapping speed also fell in the severely impaired range with the patient's raw score falling below criteria often used to verify adequate effort [45].…”