The Visual Association Test-Extended: a cross-sectional study of the performance validity measures

Area of Science:

• Neuropsychology
• Cognitive Assessment
• Performance Validity Testing

Background:

• Knowledge of performance validity tests (PVTs) is widespread, necessitating the development of novel assessment tools.
• Existing PVTs require validation against new instruments to ensure continued efficacy in detecting invalid test performance.

Purpose of the Study:

• To validate the newly developed Visual Association Test-Extended (VAT-E) as a performance validity test.
• To assess the VAT-E's ability to differentiate between genuine cognitive impairment and simulated deficits.

Main Methods:

• The Visual Association Test-Extended (VAT-E) was administered to healthy controls (n=226), patients with mild cognitive impairment (MCI) (n=76), Alzheimer's disease (AD) (n=26), and individuals instructed to feign memory deficits (n=29).
• A second study compared litigating patients classified as Malingering of Neurocognitive Dysfunction (MND) (n=26) or non-MND (n=67).
• The VAT-E was compared with the Test of Memory Malingering (TOMM) and the Word Memory Test (WMT).

Main Results:

• The VAT-E demonstrated high specificity (93-100%) in differentiating MCI and AD patients from simulators, with sensitivity ranging from 86-100%.
• It differentiated MND from non-MND with 54% sensitivity and 97% specificity.
• The VAT-E showed perfect agreement with TOMM and moderate agreement with WMT in classifying participants.

Conclusions:

• Preliminary findings suggest the VAT-E is a potentially valuable performance validity test.
• It effectively distinguishes individuals with genuine memory impairments from those feigning deficits or suspected of malingering cognitive dysfunction.