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Development of a Virtual Reality Assessment of Everyday Living Skills

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Published on: April 23, 2014

Victoria Symptom Validity Test performance in a heterogenous clinical sample.

David W Loring¹, Glenn J Larrabee, Gregory P Lee

¹Department of Neurology, University of Florida, Gainesville, FL 2610-0236, USA. david.loring@neurology.ufl.edu

The Clinical Neuropsychologist

|April 25, 2007

Summary

Intentional response distortion is rare in clinical neuropsychological evaluations. The Victoria Symptom Validity Test (VSVT) showed minimal invalid performance among clinically referred patients, unlike some attorney-referred cases.

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Area of Science:

Neuropsychology
Clinical Psychology
Forensic Psychology

Background:

Symptom validity testing is crucial in neuropsychological assessments to detect response distortion.
The Victoria Symptom Validity Test (VSVT) is a tool used to evaluate the sincerity of patient effort.
Distinguishing genuine impairment from exaggerated symptoms is vital for accurate diagnosis and treatment planning.

Purpose of the Study:

To evaluate the prevalence of intentional response distortion using the VSVT in a clinical neuropsychological setting.
To compare response validity across different referral groups: clinically referred non-TBI, clinically referred TBI, and non-clinical referrals.
To determine if referral source impacts the likelihood of response distortion.

Main Methods:

Retrospective review of 374 patients undergoing neuropsychological assessment.
Classification of patients into non-TBI clinically referred, clinically referred TBI, and non-clinical referral groups.
Analysis of Victoria Symptom Validity Test (VSVT) performance, specifically focusing on statistically less than chance performance on hard VST items.

Main Results:

Intentional response distortion was rare (0.3%) in clinically referred non-TBI patients.
No clinically referred TBI patients demonstrated scores significantly less than chance on the VSVT.
A higher rate of response distortion (20%) was observed in attorney-referred or at-risk patients.
One clinically referred patient with a non-neurologic diagnosis and disability claim also performed worse than chance.

Conclusions:

Intentional response distortion is uncommon in patients referred for non-forensic neuropsychological evaluations.
The VSVT appears to be a reliable measure for detecting response distortion in most clinical referral contexts.
Referral source, particularly attorney referrals, may be associated with an increased risk of exaggerated symptoms.