Montreal Cognitive Assessment (MoCA): A validation study among prisoners

IF 1.1 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Criminal Behaviour and Mental Health Pub Date : 2023-08-08 DOI:10.1002/cbm.2306
Vânia Lima Pereira, Sandra Freitas, Mário R. Simões, Bianca Gerardo
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Abstract

Background

There are numerous scales for screening cognitive performance and thus identification of any potential deficits, but in spite of the vulnerability of the prison population to such problems, there has been no adequate validation of screening tools specifically for use with prisoners or others in the criminal justice system.

Aim

To validate the Montreal Cognitive Assessment (MoCA) for use with prisoners.

Methods

100 adult prisoners in one Portuguese prison were randomly invited by clinicians to take part in this study. A same size sample of community-living adult non-offenders of similar age was selected from the MoCA's normative study database in Portugal. For both groups, the key inclusion criterion was fluency in the Portuguese language. All participants completed the Mini Mental State Examination (MMSE) and the MoCA, both in Portuguese translation. Cronbach's alpha coefficient was calculated as an index of internal consistency and Pearson's r correlations calculated. Group performances were compared using independent samples t-test. Covariance analysis (ANCOVA) was computed with level of education as covariate. To measure the magnitude of the effect, η p 2 ${\eta }_{p}^{2}$ was used. A receiver operating characteristics curve analysis was computed to evaluate the discriminatory accuracy of MoCA and MMSE.

Results

The MoCA showed a ‘reasonable’ internal consistency index (α = 0.75) as well as positive and significant correlations with the MMSE. As a cognitive measure, however, the MoCA showed consistently superior psychometric properties and higher discriminatory accuracy (MoCA = 89%) than the MMSE (65%). According to the Youden index, the optimal cut-off point for the MoCA is below 24 points, whereas for the MMSE, it is below 27.

Conclusions

The MoCA is a valid cognitive screening tool for use with prisoners. Further validations against detailed cognitive evaluation would be a useful next step.

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蒙特利尔认知评估(MoCA):一项针对囚犯的验证研究。
背景:有许多量表可以用来筛查认知表现,从而识别任何潜在的缺陷,但尽管监狱人口容易受到这些问题的影响,但还没有充分验证专门用于囚犯或刑事司法系统中其他人的筛查工具。目的:验证蒙特利尔认知评估(MoCA)在囚犯中的应用。方法:临床医生随机邀请葡萄牙一所监狱的100名成年囚犯参加本研究。从葡萄牙MoCA的规范性研究数据库中选择了一个相同规模的年龄相仿的社区生活成年非罪犯样本。对于这两组人来说,关键的入选标准是葡萄牙语的流利程度。所有参与者都完成了小型精神状态检查(MMSE)和MoCA,均为葡萄牙语翻译。计算Cronbach的α系数作为内部一致性指数,并计算Pearson的r相关性。使用独立样本t检验比较各组表现。协方差分析(ANCOVA)以教育水平为协变量进行计算。为了测量效应的大小,使用了ηp 2${\eta}_{p}^{2}$。计算了受试者工作特性曲线分析,以评估MoCA和MMSE的判别准确性。结果:MoCA显示出“合理”的内部一致性指数(α=0.75),并且与MMSE呈正相关。然而,作为一种认知测量,MoCA始终表现出优于MMSE(65%)的心理测量特性和更高的辨别准确性(MoCA=89%)。根据Youden指数,MoCA的最佳临界点低于24分,而MMSE的最佳临界值低于27分。结论:MoCA是一种有效的囚犯认知筛查工具。根据详细的认知评估进行进一步的验证将是有用的下一步。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
40
期刊介绍: Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.
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