Performance validity and symptom validity tests: Are they measuring different constructs?

Area of Science:

• Neuropsychology
• Cognitive Assessment
• Psychometrics

Background:

• Understanding the interplay between performance validity, symptom validity, and self-reported symptoms is crucial in clinical and research settings.
• Combat veterans often present with complex symptom profiles, necessitating careful evaluation of cognitive function and symptom reporting.

Purpose of the Study:

• To investigate the relationships among performance validity tests (PVTs), symptom validity tests (SVTs), symptom self-report, and objective cognitive testing in combat veterans.
• To determine whether PVTs and SVTs measure distinct or overlapping constructs.

Main Methods:

• A cohort of 338 combat veterans completed a neurocognitive assessment battery, self-report symptom measures (depression, PTSD, sleep, pain), PVTs, and SVTs.
• Exploratory factor analysis, t tests, and multiple linear regressions were employed to analyze the data.

Main Results:

• A three-factor solution emerged: performance validity, cognitive performance, and symptom report, with SVTs loading on the symptom report factor.
• Failure on PVTs and SVTs was associated with more severe symptoms and poorer cognitive performance.
• PVT failure uniquely predicted cognitive performance, while both PVT and SVT failure uniquely predicted symptom report.

Conclusions:

• Performance validity and symptom validity tests capture related but distinct constructs.
• Symptom validity tests demonstrate the strongest association with symptom self-report.
• The relationship between SVTs and cognitive performance is influenced by the chosen cutoff score.