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Excessive decline from premorbid functioning: detecting performance invalidity with the WAIS-IV and demographic
Phillip K Martin1, Ben P Hunter1, Amanda M Rach1
1a Department of Psychiatry and Behavioral Sciences , University of Kansas School of Medicine , Wichita , KS , USA.
The Clinical Neuropsychologist
|March 10, 2017
Summary
New validity measures, Excessive Decline from Premorbid Functioning (EDPF)-FSIQ and EDPF-VW, accurately identify invalid test performance in neuropsychological assessments. These tools offer improved classification accuracy compared to existing methods.
Area of Science:
- Neuropsychology
- Cognitive Assessment
- Performance Validity Testing
Background:
- Excessive Decline from Premorbid Functioning (EDPF) is a construct representing atypical discrepancies between predicted premorbid ability and current cognitive test performance.
- Such discrepancies may indicate performance invalidity rather than genuine neurocognitive impairment.
- Existing methods for detecting performance invalidity require enhancement for improved accuracy.
Purpose of the Study:
- To introduce and evaluate novel embedded Performance Validity Tests (PVTs) designed to measure Excessive Decline from Premorbid Functioning (EDPF).
- To assess the classification accuracy of EDPF-FSIQ, EDPF-VW, and EDPF-PP in distinguishing between valid and invalid test performance.
- To compare the efficacy of these new EDPF indices against established measures like the Reliable Digit Span.
Main Methods:
- Developed new embedded PVTs (EDPF-FSIQ, EDPF-VW, EDPF-PP) by comparing WAIS-IV scores with demographically predicted premorbid estimates from the Test of Premorbid Functioning (TOPF).
- Utilized ROC analyses to determine classification accuracy in a sample of 230 neuropsychological outpatients, excluding those with dementia, intellectual disability, or left-sided stroke.
- Examined accuracy across mixed neuropsychological samples and specific diagnostic subgroups (neurocognitive, TBI, psychiatric).
Main Results:
- All EDPF indices showed significant group differences (p < .001).
- EDPF-FSIQ achieved an AUC of .837 (56% sensitivity, ≥90% specificity), and EDPF-VW achieved an AUC of .850 (61% sensitivity, ≥90% specificity).
- EDPF-VW and EDPF-FSIQ maintained high accuracy across diagnostic groups, outperforming the Reliable Digit Span.
Conclusions:
- EDPF-FSIQ and EDPF-VW effectively discriminate between valid and invalid test performance in neuropsychological evaluations.
- These novel measures integrate demographic premorbid ability estimates and assess performance across multiple cognitive domains.
- EDPF validity measures offer a valuable advancement in detecting performance invalidity.
Keywords:
Test of Premorbid Functioning (TOPF)Wechsler Adult Intelligence Scaleeffortexcessive declinemalingeringperformance validityMore Related Videos
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