Further validation of the expanded auditory verbal learning test for detecting poor effort and response bias: data...

The present study aimed to further examine the specificity of the Exaggeration Index of the expanded Auditory Verbal Learning Test procedure for detecting inadequate effort or response bias in a nonlitigating sample with unequivocal brain damage. Data from 56 patients with intractable epilepsy undergoing presurgical evaluation for temporal lobectomy were analyzed. In this sample, specificity was excellent at the recommended cut-off (94%), and comparable to that of another well-researched instrument for detecting inadequate effort, the Recognition Memory Test. Findings strongly support the generalizability of the specificity estimates obtained by Barrash et al. and, more broadly, the clinical utility of the Exaggeration Index. To facilitate diagnostic decision-making, the probability of invalid performances associated with each score on the Exaggeration Index, based on all clinical cross-validation samples reported to date, is also presented.