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Performance validity measures in clinical patients with aphasia
Thomas Bodner1, Thomas Merten2, Thomas Benke1
1a Department of Neurology , Medical University of Innsbruck , Innsbruck , Austria.
Journal of Clinical and Experimental Neuropsychology
|February 23, 2019
Summary
Performance validity tests (PVTs) can misdiagnose genuine patients with aphasia after stroke. The Test of Memory Malingering showed robustness, unlike other PVTs, highlighting the need for clinical context in interpretation.
Area of Science:
- Neuropsychology
- Neurology
- Clinical Assessment
Background:
- Performance validity tests (PVTs) are crucial in neuropsychological assessments, particularly in forensic contexts, to differentiate genuine performance from invalid profiles.
- PVTs may face limitations when genuine cognitive symptoms, such as aphasia, are present.
Purpose of the Study:
- To evaluate the robustness of four common PVTs in patients with acute cerebrovascular stroke and aphasia.
- To determine the impact of genuine language impairment on PVT performance.
Main Methods:
- Assessed 15 acute stroke patients with varying degrees of aphasia using four PVTs.
- Confirmed left-hemisphere infarction via neuroimaging in all participants.
Main Results:
- The Test of Memory Malingering demonstrated robustness against language impairment.
- Unacceptable false-positive rates were observed for the Fifteen-Item Test (60%), Reliable Spatial Span (40%), and Reliable Digit Span (73.3%).
- 26.7% of patients scored positive on at least three of the four PVTs.
Conclusions:
- Findings contribute to the discussion on false-positive risks in patient populations with genuine symptoms.
- Interpreting PVT results without considering the full clinical context may lead to misdiagnosis with serious consequences.
