Elevations on select Conners' CPT-II scales indicate noncredible responding in adults with traumatic brain injury

Elevations on certain Conners' CPT-II scales are known to be associated with invalid responding. However, scales and cutoffs vary across studies. In addition, the methodology behind developing performance validity tests (PVTs) has been challenged for mistaking true impairment for noncredible presentation. Using ability-based tests as a PVT makes clinicians especially vulnerable to this criticism. The present study examined the ability of CPT-II to dissociate effort from impairment in 47 adults clinically referred for neuropsychological assessment. CPT-II scales previously identified as PVTs (Omissions, Commissions, Hit Reaction Time SE, Variability, and Perseverations) produced classification accuracies hovering around .50 sensitivity at .90 specificity. The subsample that failed these PVTs performed within normal range on other tests of working memory, processing speed, visual attention, and executive function. Results suggest that the select CPT-II based PVTs are sensitive to invalid responding, and are associated with depression and anxiety, but are unrelated to cognitive functioning.