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Digit Span embedded validity indicators in neurologically-intact veterans.

Robert D Shura1,2,3, Sarah L Martindale1,2,3, Katherine H Taber1,2,4,5

  • 1Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Salisbury, NC, USA.

The Clinical Neuropsychologist
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Summary
This summary is machine-generated.

The Wechsler Adult Intelligence Scale-IV Digit Span age-corrected scaled score best identified noncredible performance in veterans. However, all validity indicators showed low sensitivity, suggesting they cannot replace standalone performance validity tests.

Keywords:
Digit SpanWAIS-IVperformance validitysensitivityspecificityveteran

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Area of Science:

  • Neuropsychology
  • Psychometrics

Background:

  • Embedded validity measures in neuropsychological evaluations require updates and validation across diverse samples.
  • The Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) is a widely used cognitive assessment tool.

Purpose of the Study:

  • To evaluate the effectiveness of WAIS-IV Digit Span validity indicators in identifying noncredible performance among post-deployment veterans.
  • To compare the diagnostic accuracy of Digit Span age-corrected scaled score (ACSS) and various Reliable Digit Span (RDS) measures.

Main Methods:

  • A sample of 275 neurologically-intact veterans completed diagnostic interviews, the WAIS-IV, the Medical Symptom Validity Test (MSVT), and the b Test.
  • A Noncredible group was identified based on failure of either the MSVT or the b Test (21.09% of the sample).
  • Diagnostic accuracy (AUC, sensitivity) was calculated for Digit Span ACSS, RDS variants, and Vocabulary minus Digit Span scores.

Main Results:

  • The Digit Span ACSS demonstrated the highest AUC (.648), but with low sensitivity (0.17) at the optimal cutoff.
  • Working Memory RDS had the highest AUC (.629) among RDS measures, while Enhanced RDS and Alternate RDS showed higher sensitivities (0.22).
  • Vocabulary minus Digit Span measures were not significant predictors of noncredible performance.

Conclusions:

  • Digit Span ACSS was the most effective indicator of noncredible performance, surpassing traditional RDS measures in this veteran sample.
  • Despite congruent cutoff scores with prior research, overall sensitivity of embedded validity indicators was low.
  • Embedded Digit Span validity indicators are useful adjuncts but insufficient to replace standalone performance validity tests.