Examining embedded validity indicators in Conners continuous performance test-3 (CPT-3)

Prior research has identified a variety of embedded performance validity indicators on the Conners' Continuous Performance Test-II (CPT-II). The purpose of this study was to examine embedded validity indicators within the updated third edition of the Conners Continuous Performance Test (CPT-3).

This study used a retrospective chart review from an ADHD evaluation clinic at a Mid-Atlantic VA hospital. Participants were 197 military veterans who completed a clinical assessment for ADHD. All participants were consecutive referrals to the ADHD clinic who completed the CPT-3 and the Test of Memory Malingering, Trial 1 (TOMM1).

Logistic regression analyses indicated that the following five variables were able to significantly predict validity status on the TOMM1: detectability (d'), omissions (OMI), commissions (COM), hit reaction time (HRT) standard deviation (SD), and HRT inter-stimulus interval (ISI) change. Among these measures, HRT SD and HRT ISI change were identified as the scores with the highest AUC values. Optimal cutoffs for all significant predictors were identified. A number of composite EVIs were created using various combinations of CPT-3 scores. All composite EVIs significantly differentiated between pass and fail status on the TOMM1.

Several CPT-3 variables have clinical utility as embedded validity indicators; however, due to low sensitivity, they should not be used in isolation. These scores may be used as indicators of invalid performance but should not be used to rule out invalid performance. Identified CPT-3 scores may be useful as one component in a multivariate, multi-point continuous approach to performance validity sampling.