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

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Performance and symptom validity tests assess distinct aspects of cognitive function and self-reported symptoms. Both validity types relate to cognitive performance and symptom reporting, with symptom validity tests showing the strongest link to symptom report.

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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.