CVLT-II Forced Choice Recognition Trial as an Embedded Validity Indicator: A Systematic Review of the Evidence

Area of Science:

• Neuroscience
• Psychology
• Forensic Science

Background:

• The Forced Choice Recognition (FCR) trial from the California Verbal Learning Test, 2nd edition, serves as an embedded performance validity test (PVT).
• This systematic review is the first to evaluate the classification accuracy of FCR against established reference PVTs.

Purpose of the Study:

• To systematically review the classification accuracy of the FCR as a performance validity test.
• To assess the FCR's ability to detect invalid performance across diverse samples and compare it with established PVTs.

Main Methods:

• Systematic review of peer-reviewed studies published since 2002 containing FCR data.
• Analysis included 37 studies reporting FCR failure rates (N=7575) and 17 studies reporting concordance rates with reference PVTs (N=4432).

Main Results:

• Healthy controls consistently scored above 14 on FCR.
• Overall FCR classification accuracy was 72% (specificity .93, sensitivity .50) for detecting invalid performance.
• Failure rates were higher with external incentives to appear impaired (13.6%) and when participants failed reference PVTs (49.0%).

Conclusions:

• FCR ≤14 is highly specific but only moderately sensitive to invalid responding in the absence of significant neurocognitive disorder.
• Failing FCR is a strong indicator of invalid performance, while passing FCR does not definitively rule out non-credible presentation.
• Heterogeneity in study samples, reference PVTs, and criterion measures represent significant limitations for PVT research.