Differentiating poor validity from probable impairment on the medical symptom validity test: a cross-validation study.

Aims: In neuropsychological evaluations, it is often difficult to ascertain whether poor performance on measures of validity is due to poor effort or malingering, or whether there is genuine cognitive impairment. Dunham and Denney created an algorithm to assess this question using the Medical Symptom Validity Test (MSVT). We assessed the ability of their algorithm to detect poor validity versus probable impairment, and concordance of failure on the MSVT with other freestanding tests of performance validity.

Use of Latent Class Analysis to define groups based on validity, cognition, and emotional functioning.

Objective: Latent Class Analysis (LCA) was used to classify a heterogeneous sample of neuropsychology data. In particular, we used measures of performance validity, symptom validity, cognition, and emotional functioning to assess and describe latent groups of functioning in these areas.

Method: A data-set of 680 neuropsychological evaluation protocols was analyzed using a LCA.

Clinimetric validity of the Trail Making Test Czech version in Parkinson's disease and normative data for older adults.

Objective: The influence of demographic variables on the Trail Making Test (TMT) performance in older individuals and empirical findings on clinical validity in predementia states, such as Parkinson's disease mild cognitive impairment (PD-MCI), are limited. The principal aim of this study was to add normative data for the Czech population of older adults and explore the clinimetric properties between PD-MCI and PD patients with normal cognition (PD-NC).

Method: The study included 125 PD patients classified as 77 PD-MCI and 48 PD-NC and 528 older individuals (60-74 years, further subdivided for normative tables into 60-64, 65-69 and 70-74 age groups) and very old individuals (aged 75-96, further subdivided into 75-79, 80-84, 85-96) cognitively intact Czech adults.

Strategies of successful and unsuccessful simulators coached to feign traumatic brain injury.

Objective: The present study evaluated strategies used by healthy adults coached to simulate traumatic brain injury (TBI) during neuropsychological evaluation.

Method: Healthy adults (n = 58) were coached to simulate TBI while completing a test battery consisting of multiple performance validity tests (PVTs), neuropsychological tests, a self-report scale of functional independence, and a debriefing survey about strategies used to feign TBI.

Results: "Successful" simulators (n = 16) were classified as participants who failed 0 or 1 PVT and also scored as impaired on one or more neuropsychological index.

Neuropsychological test validity in Veterans presenting with subjective complaints of 'very severe' cognitive symptoms following mild traumatic brain injury.

Objective: This study explored the utility of combining data from measures of performance validity and symptom validity among Veterans undergoing neuropsychological evaluation for mild traumatic brain injury (mTBI).

Background: Persistent cognitive impairments following mTBI are often reported by returning combat veterans. However, objectively-measured cognitive deficits are not common among individuals with mTBI, raising the question of whether negative impression management influences self-ratings.

Evaluating the Medical Symptom Validity Test (MSVT) in a Sample of Veterans Between the Ages of 18 to 64.

The purpose of the current study was to compare three potential profiles of the Medical Symptom Validity Test (MSVT; Pass, Genuine Memory Impairment Profile [GMIP], and Fail) on other freestanding and embedded performance validity tests (PVTs). Notably, a quantitatively computed version of the GMIP was utilized in this investigation. Data obtained from veterans referred for a neuropsychological evaluation in a metropolitan Veteran Affairs medical center were included (N = 494).

Embedded Measures of Performance Validity in the Rey Complex Figure Test in a Clinical Sample of Veterans.

The purpose of this study was to determine how well scores from the Rey Complex Figure Test (RCFT) could serve as embedded measures of performance validity in a large, heterogeneous clinical sample at an urban-based Veterans' Affairs hospital. Participants were divided into credible performance (n = 244) and noncredible performance (n = 87) groups based on common performance validity tests during their respective clinical evaluations. We evaluated how well preselected RCFT scores could discriminate between the 2 groups using cut scores from single indexes as well as multivariate logistic regression prediction models.

The Prague Stroop Test: Normative standards in older Czech adults and discriminative validity for mild cognitive impairment in Parkinson's disease.

Objective: The aim of this study was to provide normative data for older and very old Czech adults on the Prague Stroop Test (PST) and to test its discriminative validity in individuals with Parkinson's disease mild cognitive impairment (PD-MCI).

Method: The construction of the PST was modeled after the Victoria Stroop Test. We examined 539 participants aged 60-96 that met strict inclusion criteria.

Is Co-norming Required?

Researchers who have been responsible for developing test batteries have argued that competent practice requires the use of a "fixed battery" that is co-normed. We tested this assumption with three normative systems: co-normed, meta-regressed norms and a system of these two methods. We analyzed two samples: 330 referred patients and 99 undergraduate volunteers.

Wechsler Adult Intelligence Scale-IV Dyads for Estimating Global Intelligence.

All possible two-subtest combinations of the core Wechsler Adult Intelligence Scale-IV (WAIS-IV) subtests were evaluated as possible viable short forms for estimating full-scale IQ (FSIQ). Validity of the dyads was evaluated relative to FSIQ in a large clinical sample (N = 482) referred for neuropsychological assessment. Sample validity measures included correlations, mean discrepancies, and levels of agreement between dyad estimates and FSIQ scores.

Utility of the Montreal Cognitive Assessment and Mini-Mental State Examination in predicting general intellectual abilities.

Objective: To determine whether scores from 2 commonly used cognitive screening tests can help predict general intellectual functioning in older adults.

Background: Cutoff scores for determining cognitive impairment have been validated for both the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). However, less is known about how the 2 measures relate to general intellectual functioning as measured by the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV).

Embedded measures of performance validity using verbal fluency tests in a clinical sample.

The objective of this study was to determine to what extent verbal fluency measures can be used as performance validity indicators during neuropsychological evaluation. Participants were clinically referred for neuropsychological evaluation in an urban-based Veteran's Affairs hospital. Participants were placed into 2 groups based on their objectively evaluated effort on performance validity tests (PVTs).

Comparisons of five performance validity indices in bona fide and simulated traumatic brain injury.

A number of performance validity tests (PVTs) are used to assess memory complaints associated with traumatic brain injury (TBI); however, few studies examine the concordance and predictive accuracy of multiple PVTs, specifically in the context of combined models in known-group designs. The present study compared five widely used PVTs: the Test of Memory Malingering (TOMM), Medical Symptom Validity Test (MSVT), Reliable Digit Span (RDS), Word Choice Test (WCT), and California Verbal Learning Test - Forced Choice (CVLT-FC). Participants were 51 adults with bona fide moderate to severe TBI and 58 demographically comparable healthy adults coached to simulate memory impairment.

Finger Tapping Test performance as a measure of performance validity.

The Finger Tapping Test (FTT) has been presented as an embedded measure of performance validity in most standard neuropsychological evaluations. The present study evaluated the utility of three different scoring systems intended to detect invalid performance based on FTT. The scoring systems were evaluated in neuropsychology cases from clinical and independent practices, in which credible performance was determined based on passing all performance validity measures or failing two or more validity indices.

Czech version of Rey Auditory Verbal Learning test: normative data.

The present study provides normative data stratified by age for the Rey Auditory Verbal Learning test Czech version (RAVLT) derived from a sample of 306 cognitively normal subjects (20-85 years). Participants met strict inclusion criteria (absence of any active or past neurological or psychiatric disorder) and performed within normal limits on other neuropsychological measures. Our analyses revealed significant relationships between most RAVLT indices and age and education.

WAIS-IV reliable digit span is no more accurate than age corrected scaled score as an indicator of invalid performance in a veteran sample undergoing evaluation for mTBI.

Reliable Digit Span (RDS) is a measure of effort derived from the Digit Span subtest of the Wechsler intelligence scales. Some authors have suggested that the age-corrected scaled score provides a more accurate measure of effort than RDS. This study examined the relative diagnostic accuracy of the traditional RDS, an extended RDS including the new Sequencing task from the Wechsler Adult Intelligence Scale-IV, and the age-corrected scaled score, relative to performance validity as determined by the Test of Memory Malingering.

Assessing effort: differentiating performance and symptom validity.

The current study aimed to clarify the relationship among the constructs involved in neuropsychological assessment, including cognitive performance, symptom self-report, performance validity, and symptom validity. Participants consisted of 120 consecutively evaluated individuals from a veteran's hospital with mixed referral sources. Measures included the Wechsler Adult Intelligence Scale-Fourth Edition Full Scale IQ (WAIS-IV FSIQ), California Verbal Learning Test-Second Edition (CVLT-II), Trail Making Test Part B (TMT-B), Test of Memory Malingering (TOMM), Medical Symptom Validity Test (MSVT), WAIS-IV Reliable Digit Span (RDS), Post-traumatic Check List-Military Version (PCL-M), MMPI-2 F scale, MMPI-2 Symptom Validity Scale (FBS), MMPI-2 Response Bias Scale (RBS), and the Postconcussive Symptom Questionnaire (PCSQ).

Number of impaired scores as a performance validity indicator.

This study examined embedded performance validity indicators (PVI) based on the number of impaired scores in an evaluation and the overall test battery mean (OTBM). Adult participants (N = 175) reporting traumatic brain injury were grouped using eight PVI. Participants who passed all PVI (n = 67) demonstrated fewer impaired scores and higher OTBM than those who failed two or more PVI (n = 66).

Do administration instructions alter optimal neuropsychological test performance? Data from healthy volunteers.

The degree to which patients should be prompted to give their best effort has not been adequately addressed in the literature, nor has the issue of the extent to which they should be informed that measures of effort will be included in the assessment battery. Three groups of undergraduates were given three different instructional sets prior to completing a neuropsychological evaluation. The instructions provided different levels of motivation to perform optimally as well as possible warning regarding the detection of poor effort.

Derivation of an embedded Rey Auditory Verbal Learning Test performance validity indicator.

This study derived an embedded performance validity indicator for the Rey Auditory Verbal Learning Test (AVLT) using an archival dataset. Participants aged 20 to 65 (N = 167) who reported traumatic brain injury and completed at least two performance validity tests were included. The group who passed all performance validity measures (n = 68) demonstrated higher scores on all AVLT trials than the group who failed two or more validity indicators (n = 62).

Czech version of the Trail Making Test: normative data and clinical utility.

The Trail Making Test (TMT) comprises two psychomotor tasks that measure a wide range of visual-perceptual and executive functions. The purpose of this study was to provide Czech normative data and to examine the relationship between derived TMT indices and demographic variables. The TMT was administered to 421 healthy adults.

Rasch analysis of the postconcussive symptom questionnaire: measuring the core construct of brain injury symptomatology.

The Postconcussive Symptom Questionnaire (PCSQ; Lees-Haley, 1992 ) is purported to measure four constructs. These include psychological, cognitive, somatic, and infrequency (i.e.

Performance validity and neuropsychological outcomes in litigants and disability claimants.

This study examined the relationship of performance validity and neuropsychological outcomes in a sample of individuals referred for independent neuropsychological examination in the context of reported traumatic brain injury (82% mild). Archival data were examined on 175 participants aged 20 to 65 who were administered at least two performance validity measures. Participants who passed all effort measures (Pass; n = 61) outperformed those who failed two or more (Fail; n = 70) on the majority of tests in the neuropsychological battery.