Concurrent validity of three forced-choice measures of symptom validity

Area of Science:

• Neuropsychology
• Forensic Psychology
• Clinical Psychology

Background:

• Forced-choice recognition memory tests are crucial for evaluating assessment validity by identifying suboptimal effort.
• Discrepancies in performance can indicate intentional underperformance, necessitating reliable motivation measures.
• Existing measures vary in their ability to accurately detect poor effort.

Purpose of the Study:

• To evaluate and compare the efficacy of three distinct measures of motivation in a clinical sample.
• To assess the detection rates of poor effort using the California Verbal Learning Test (CVLT), Test of Memory Malingering (TOMM), and Medical Symptom Validity Test (MSVT).
• To examine the concordance and comparability of these symptom validity measures.

Main Methods:

• A clinical sample exceeding 150 individuals was assessed using multiple symptom validity tests.
• The Forced-Choice subtest of the CVLT and the TOMM were administered.
• The MSVT, utilizing its three easy subtests with cutoff scores of 85% and 70%, was also employed.

Main Results:

• The CVLT and TOMM identified comparable rates of poor effort (23% and 21%, respectively), but lacked full agreement.
• The MSVT at an 85% cutoff detected poor performance in 37% of individuals.
• Lowering the MSVT cutoff to 70% reduced the failure rate to 21%, aligning with the other measures.

Conclusions:

• The study suggests that adjusting the MSVT cutoff score to 70% enhances its comparability with other effort measures like the CVLT and TOMM.
• These findings are vital for accurately interpreting neuropsychological assessment data and identifying individuals feigning cognitive deficits.
• Further research should examine the implications of these adjusted cutoffs for clinical and forensic decision-making.