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A Two-interval Forced-choice Task for Multisensory Comparisons

A Two-interval Forced-choice Task for Multisensory Comparisons

Published on: November 9, 2018

Evaluation of performance validity using a Rey Auditory Verbal Learning Test forced-choice trial.

Lee Ashendorf^1,2, Michael A Sugarman^1,3

¹a Edith Nourse Rogers Memorial Veterans Hospital , Bedford , MA , USA.

The Clinical Neuropsychologist

|April 12, 2016

Summary

A new forced-choice (FC) recognition trial for the Rey Auditory Verbal Learning Test (RAVLT) effectively identifies invalid performance. This FC trial shows higher accuracy than standard RAVLT recognition in detecting poor effort in veterans.

Keywords:

RAVLT Validity effort memory veterans

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Last Updated: Mar 22, 2026

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Area of Science:

Neuropsychology
Cognitive Assessment
Performance Validity Testing

Background:

Forced-choice (FC) recognition memory is a standard method for assessing performance validity.
The Rey Auditory Verbal Learning Test (RAVLT) is widely used in neuropsychological evaluations.

Purpose of the Study:

To introduce and evaluate the classification accuracy of a novel FC recognition trial specifically designed for the RAVLT.
To determine if the FC trial can effectively differentiate between valid and invalid performance in a veteran sample.

Main Methods:

122 military veterans underwent the RAVLT and the FC procedure as part of a comprehensive neuropsychological assessment.
Participants were categorized into valid (n=94) and invalid (n=28) performance groups based on established validity measures.

Main Results:

The FC trial demonstrated strong classification accuracy with 67.9% sensitivity and 92.6% specificity for predicting validity group status (cutoff ≤13).
The FC trial significantly outperformed standard RAVLT recognition hits in predicting invalid performance, showing higher sensitivity (46.4%) and comparable specificity (91.5%).

Conclusions:

The RAVLT FC recognition trial is a valid and effective tool for assessing performance validity.
It is recommended for use as an additional measure alongside the standard RAVLT to enhance the detection of insufficient effort.