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Impaired or invalid? Limitations of assessing performance validity using the Boston Naming Test

Abramson, Dayna A; Resch, Zachary J; Ovsiew, Gabriel P; White, Daniel J; Bernstein, Matthew T; Basurto, Karen S; Soble, Jason R
The Boston Naming Test (BNT) has been proposed as an embedded performance validity test (PVT), though replication is needed to provide further empirical support of its simultaneous use as a cognitive ability measure and embedded PVT. This cross-sectional study examined BNT performance in a mixed neuropsychiatric sample of 137 patients with/without cognitive impairment. Four independent criterion PVTs classified 109 (80%) as valid and 28 (20%) as invalid. BNT raw and demographically-corrected T-scores were significantly higher among the valid group with small effect sizes (ηp
PMID: 32538174
ISSN: 2327-9109
CID: 5592492

Mean response latency indices on the Victoria Symptom Validity Test do not contribute meaningful predictive value over accuracy scores for detecting invalid performance

Cerny, Brian M; Rhoads, Tasha; Leib, Sophie I; Jennette, Kyle J; Basurto, Karen S; Durkin, Nicole M; Ovsiew, Gabriel P; Resch, Zachary J; Soble, Jason R
The utility of the Victoria Symptom Validity Test (VSVT) as a performance validity test (PVT) has been primarily established using response accuracy scores. However, the degree to which response latency may contribute to accurate classification of performance invalidity over and above accuracy scores remains understudied. Therefore, this study investigated whether combining VSVT accuracy and response latency scores would increase predictive utility beyond use of accuracy scores alone. Data from a mixed clinical sample of 163 patients, who were administered the VSVT as part of a larger neuropsychological battery, were analyzed. At least four independent criterion PVTs were used to establish validity groups (121 valid/42 invalid). Logistic regression models examining each difficulty level revealed that all VSVT measures were useful in classifying validity groups, both independently and when combined. Individual predictor classification accuracy ranged from 77.9 to 81.6%, indicating acceptable to excellent discriminability across the validity indices. The results of this study support the value of both accuracy and latency scores on the VSVT to identify performance invalidity, although the accuracy scores had superior classification statistics compared to response latency, and mean latency indices provided no unique benefit for classification accuracy beyond dimensional accuracy scores alone.
PMID: 33470869
ISSN: 2327-9109
CID: 5592792

Concordance between the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and Clinical Assessment of Attention Deficit-Adult (CAT-A) over-reporting validity scales for detecting invalid ADHD symptom reporting

Leib, Sophie I; Schieszler-Ockrassa, Christine; White, Daniel J; Gallagher, Virginia T; Carter, Dustin A; Basurto, Karen S; Ovsiew, Gabriel P; Resch, Zachary J; Jennette, Kyle J; Soble, Jason R
This study investigated the relationship between symptom validity scales on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in the context of Attention-Deficit/Hyperactivity Disorder (ADHD) evaluation. The sample comprised 140 consecutive patients referred for a neuropsychological evaluation of ADHD and were administered the CAT-A and the MMPI-2-RF and a battery of performance-based neurocognitive tests. Results indicated CAT-A/MMPI-2-RF symptom validity concordance of 51% between measures, with 38% concordant valid and 13% concordant invalid responses. Among those with discordance symptom validity results, rates of valid CAT-A/invalid MMPI-2-RF responding (41%) were more common than invalid CAT-A/valid MMPI-2-RF responding (8%). Results also indicated higher levels of ADHD symptoms among invalid responding within the CAT-A, whereas the MMPI-2-RF Cognitive Complaints scale did not differ by CAT-A validity status. Finally, symptom validity scales on both the CAT-A and MMPI-2-RF were largely discordant from neuropsychological test validity status per performance validity tests. Findings highlight the need for symptom validity testing when assessing ADHD and indicate that validity indices on broad personality assessments may assess different constructs than embedded validity indices in ADHD-specific measures.
PMID: 33719792
ISSN: 2327-9109
CID: 5592822

Assessment of differential neurocognitive performance based on the number of performance validity tests failures: A cross-validation study across multiple mixed clinical samples

Jennette, Kyle J; Williams, Christopher P; Resch, Zachary J; Ovsiew, Gabriel P; Durkin, Nicole M; O'Rourke, Justin J F; Marceaux, Janice C; Critchfield, Edan A; Soble, Jason R
PMID: 33759699
ISSN: 1744-4144
CID: 5592842

All of the accuracy in half of the time: Assessing abbreviated versions of the Test of Memory Malingering in the context of verbal and visual memory impairment

Cohen, Cari D; Rhoads, Tasha; Keezer, Richard D; Jennette, Kyle J; Williams, Christopher P; Hansen, Nicholas D; Ovsiew, Gabriel P; Resch, Zachary J; Soble, Jason R
PMID: 33836622
ISSN: 1744-4144
CID: 5592862

Examining Traditional and Novel Validity Indicators from the Medical Symptom Validity Test Across Levels of Verbal and Visual Memory Impairment

Cerny, Brian M; Resch, Zachary J; Rhoads, Tasha; Jennette, Kyle J; Singh, Palak G; Ovsiew, Gabriel P; Soble, Jason R
OBJECTIVE:This cross-sectional study examined accuracy of traditional Medical Symptom Validity Test (MSVT) validity indicators, including immediate recognition (IR), delayed recognition (DR), and consistency (CNS), as well as a novel indicator derived from the mean performance on IR, DR, and CNS across verbal, visual, and combined learning and memory impairment bands. METHOD/METHODS:A sample of 180 adult outpatients was divided into valid (n = 150) and invalid (n = 30) groups based on results of four independent criterion performance validity tests. Verbal and visual learning and recall were classified as indicative of no impairment, mild impairment, or severe impairment based on performance on the Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-Revised, respectively. RESULTS:In general, individual MSVT subtests were able to accurately classify performance as valid or invalid, even in the context of severe learning and memory deficits. However, as verbal and visual memory impairment increased, optimal MSVT cut-scores diverged from manual-specified cutoffs such that DR and CNS required cut-scores to be lowered to maintain adequate specificity. By contrast, the newly proposed scoring algorithm generally showed more robust psychometric properties across the memory impairment bands. CONCLUSIONS:The mean performance index, a novel scoring algorithm using the mean of the three primary MSVT subtests, may be a more robust validity indicator than the individual MSVT subtests in the context of bona fide memory impairment.
PMID: 34050349
ISSN: 1873-5843
CID: 5592882

Comparing the Independent and Aggregated Accuracy of Trial 1 and the First 10 TOMM Items for Detecting Invalid Neuropsychological Test Performance Across Civilian and Veteran Clinical Samples

Soble, Jason R; Cerny, Brian M; Ovsiew, Gabriel P; Rhoads, Tasha; Reynolds, Tristan P; Sharp, Dillion W; Jennette, Kyle J; Marceaux, Janice C; O'Rourke, Justin J F; Critchfield, Edan A; Resch, Zachary J
Previous studies support using two abbreviated tests of the Test of Memory Malingering (TOMM), including (a) Trial 1 (T1) and (b) the number of errors on the first 10 items of T1 (T1e10), as performance validity tests (PVTs). In this study, we examined the independent and aggregated predictive utility of TOMM T1 and T1e10 for identifying invalid neuropsychological test performance across two clinical samples. We employed cross-sectional research to examine two independent and demographically diverse mixed samples of military veterans and civilians (VA = 108; academic medical center = 234) of patients who underwent neuropsychological evaluations. We determined validity groups by patient performance on four independent criterion PVTs. We established concordances between passing/failing the TOMM T1e10 and T1, followed by logistic regression to determine individual and aggregated accuracy of T1e10 and T1 for predicting validity group membership. Concordance between passing T1e10 and T1 was high, as was overall validity (87-98%) across samples. By contrast, T1e10 failure was more highly concordant with T1 failure (69-77%) than with overall invalidity status (59-60%) per criterion PVTs, whereas T1 failure was more highly concordant with invalidity status (72-88%) per criterion PVTs. Logistic regression analyses demonstrated similar results, with T1 accounting for more variance than T1e10. However, combining T1e10 and T1 accounted for the most variance of any model, with T1e10 and T1 each emerging as significant predictors. TOMM T1 and, to a lesser extent, T1e10 were significant predictors of independent criterion-derived validity status across two distinct clinical samples, but they did not offer improved classification accuracy when aggregated.
PMID: 35139315
ISSN: 1558-688x
CID: 5592972

A comparison of embedded validity indicators from the Stroop Color and Word Test among adults referred for clinical evaluation of suspected or confirmed attention-deficit/hyperactivity disorder

Khan, Humza; Rauch, Andrew A; Obolsky, Maximillian A; Skymba, Haley; Barwegen, Kearston C; Wisinger, Amanda M; Ovsiew, Gabriel P; Jennette, Kyle J; Soble, Jason R; Resch, Zachary J
This study investigated the utility of four Stroop Color and Word Test (SCWT) indices, including the raw score and T score for the word reading (WR) and color naming (CN) trials, as embedded performance validity tests (PVTs) within a sample referred for evaluation of suspected or known attention-deficit/hyperactivity disorder (ADHD). Data were analyzed from a final sample of 317 patients consecutively referred for ADHD evaluation, which was divided into groups with invalid (n = 43; 14%) and valid neuropsychological test performance (n = 274; 86%). A subset of the valid group with confirmed ADHD diagnoses (n = 226; 71%) were also analyzed separately. Classification accuracy for the overall valid sample was in the acceptable range (AUCs = .757-.794), with optimal cut scores of WR raw ≤75 (54% sensitivity/90% specificity), WR T score ≤ 28 (54% sensitivity/88% specificity), CN raw ≤57 (42% sensitivity/90% specificity), and CN T score ≤ 30 (40% sensitivity/90% specificity). Classification accuracy was also in the acceptable range for the ADHD-confirmed subgroup (AUCs = .750-.790), with optimal cut scores of WR Raw ≤ 75 (54% sensitivity/89% specificity), WR T score ≤ 28 (54% sensitivity/87% specificity), CN Raw ≤ 57 (42% sensitivity/90% specificity), and CN T score ≤ 30 (40% sensitivity/90% specificity). These findings indicate that embedded PVTs derived from the SCWT, particularly those derived from the WR trial, are effective measures for determining validity status in samples with suspected or confirmed ADHD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMID: 35357873
ISSN: 1939-134x
CID: 5592982

Multivariable analysis of the relative utility and additive value of eight embedded performance validity tests for classifying invalid neuropsychological test performance

Jennette, Kyle J; Rhoads, Tasha; Resch, Zachary J; Cerny, Brian M; Leib, Sophie I; Sharp, Dillon W; Ovsiew, Gabriel P; Soble, Jason R
INTRODUCTION:This study investigated a combination of eight embedded performance validity tests (PVTs) derived from commonly administered neuropsychological tests to optimize sensitivity/specificity for detecting invalid neuropsychological test performance. The goal of this study was to evaluate what combination of these common embedded PVTs that have the most robust predictive power for detecting invalid neuropsychological test performance in a single diverse clinical sample. METHOD:Eight previously validated memory- and nonmemory-based embedded PVTs were examined among 231 patients undergoing neuropsychological evaluation. Patients were classified into valid/invalid groups based on four independent criterion PVTs. Embedded PVT accuracy was assessed using standard and stepwise multiple logistic regression models. RESULTS:Three PVTs, the Brief Visuospatial Memory Test-Revised Recognition Discrimination (BVMT-R-RD), Rey Auditory Verbal Learning Test Forced Choice, and WAIS-IV Digit Span Age Corrected Scaled Score, predicted 45.5% of the variance in validity group membership. BVMT-RD independently accounted for 32% of the variance in prediction of independent, criterion-defined validity group membership. CONCLUSIONS:This study demonstrated the incremental predictive power of multiple embedded PVTs derived from common neuropsychological measures in detecting invalid test performance and those measures accounting for the greatest portion of the variance. These results provide guidance for evaluating the most fruitful embedded PVTs and proof of concept to better guide selection of embedded validity indices. Further, this offers clinicians an efficient, empirically derived approach to assessing performance validity when time restraints potentially limit the use of freestanding PVTs.
PMID: 36197342
ISSN: 1744-411x
CID: 5593002

Cross-validation of a forced-choice validity indicator to enhance the clinical utility of the Rey Auditory Verbal Learning Test

Soble, Jason R; Sharp, Dillon W; Carter, Dustin A; Jennette, Kyle J; Resch, Zachary J; Ovsiew, Gabriel P; Critchfield, Edan A
A forced-choice (FC) recognition trial was recently developed as an embedded validity indicator for the Rey Auditory Verbal Learning Test (RAVLT), although it has not been replicated outside of the initial validation study. This study cross-validated the RAVLT FC trial for detecting invalid neuropsychological test performance and assessed the degree to which material-specific verbal memory impairment severity impacts its classification accuracy as a performance validity test (PVT). This cross-sectional study included 172 neuropsychiatric patients who completed the RAVLT and 4 independent criterion PVTs, which were used to classify validity groups (134 valid/38 invalid). Overall results showed the RAVLT FC had excellent classification accuracy for detecting invalid performance at a ≤13 cut-score (66% sensitivity/87% specificity). When patients were subdivided by memory impairment status, FC retained excellent classification accuracy among the normal memory and mild memory impairment groups with 66%-82% sensitivity and ≥89% specificity. Accuracy decreased among those with severe memory impairment, but remained significant with a lower, alternative cut-score of ≤11 (37% sensitivity/88% specificity). Findings were consistent with FC trials developed for other memory measures and support the utility of this novel RAVLT FC index for reliably identifying invalid performance, even in the context of significant verbal memory impairment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
PMID: 33900098
ISSN: 1939-134x
CID: 5593032