Known-groups cross-validation of the letter memory test in a compensation-seeking mixed neurologic sample

Compensation-seeking neuropsychological evaluees were classified into Honest (HON; n = 37) or Probable Cognitive Feigning (PCF; n = 53) groups based on results from the Victoria Symptom Validity Test, the Test of Memory Malingering, and the Digit Span subtest of the Wechsler Adult Intelligence Scale--3rd ed. The groups were generally comparable on demographic, background, and injury severity characteristics, although HON TBI participants were significantly more likely to have a documented loss of consciousness, whereas PCF participants were significantly more likely to be currently on disability. PCF participants scored significantly lower on many neuropsychological test, particularly of memory, as well as higher on most MMPI-2 clinical scales. The PCF group also had significantly higher scores on multiple indices of feigning of psychiatric symptoms. Results from the Letter Memory Test (LMT) were significantly lower for the PCF group, and using the recommended cutting score, specificity was .984, whereas sensitivity was .640, suggesting adequate performance on cross-validation.