Detection of suboptimal effort with the Rey Complex Figure Test and Recognition Trial

The Rey Complex Figure Test is a neuropsychological instrument that can be employed in different cultural backgrounds. Meyers and Meyers (1995) proposed an extended test version including a Recognition Trial (RT), which permits an examination of test motivation through analyses of test profiles and rare recognition mistakes. In the present study, data from a full-effort group (clinical patients) and an insufficient-effort group (forensic patients) was analyzed. For both samples, a double gold standard was set for group membership. It was found that, on the average, both groups obtained similar results on the Immediate and Delayed Recall Trials, but they differed significantly on the Copy Trial and the RT. Only in the full-effort group did the total number of rare mistakes fit a random distribution (binomial distribution, approximating a Poisson distribution). In contrast, the error distribution of the insufficient-effort group did not fit such a model. Applying the Meyers and Meyers criteria for questionable effort based on rare mistakes and the analysis of memory error patterns (MEPs) yielded a specificity of .78 and a sensitivity of .50, whereas a classification using MEPs only yielded a specificity of .85 and a sensitivity of .48. A formula developed by Lu, Boone, Cozolino, and Mitchell (2003) yielded a specificity of .95 and a sensitivity of .52. Built-in RCFT validity indicators may need to be improved in order to elevate classification accuracy.