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Invalid before impaired: an emerging paradox of embedded validity indicators
Laszlo A Erdodi1, Jonathan D Lichtenstein2
1a Department of Psychology, Neuropsychology Track , University of Windsor , Windsor , Canada.
The Clinical Neuropsychologist
|May 30, 2017
Summary
The invalid-before-impaired paradox in neuropsychological testing shows that invalid performance can affect cognitive scores globally. Genuine impairment and non-credible responses may be indistinguishable, necessitating balanced validity assessments.
Area of Science:
- Neuropsychology
- Psychometrics
- Cognitive Assessment
Background:
- Embedded validity indicators (EVIs) are crucial for detecting non-credible response sets in neuropsychological testing.
- An emerging issue, the 'invalid-before-impaired paradox,' highlights a challenge where invalid performance precedes genuine impairment in test score ranges.
- This paradox complicates the interpretation of cognitive assessments.
Purpose of the Study:
- To investigate the origins of the invalid-before-impaired paradox.
- To empirically examine this psychometric anomaly in a clinical sample.
- To propose solutions for maintaining the credibility of performance validity assessments.
Main Methods:
- Analysis of archival data from 312 patients undergoing neuropsychological assessment.
- Examination of Wechsler Adult Intelligence Scale (WAIS) subtest score distributions.
- Comparison of scores against standard normal curves and performance validity tests (PVTs).
Main Results:
- All examined WAIS subtests predicted performance validity, though with varying sensitivity.
- Subtests like Digit Span, Coding, and Symbol Search effectively differentiated response sets.
- Classification accuracy of these EVIs depended on base rates of low scores, requiring adjusted cutoffs for specificity.
Conclusions:
- Invalid performance exerts a global influence on WAIS scores.
- Genuine cognitive impairment and non-credible responding can be psychometrically indistinguishable.
- A balanced approach to performance validity assessment, compromising between alpha and beta biases, is essential.
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