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Racial differences in positive findings on embedded performance validity tests.

Gabrielle Hromas1, Summer Rolin2, Jeremy J Davis1

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Applied Neuropsychology. Adult
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Summary
This summary is machine-generated.

Performance validity tests (PVTs) showed significantly higher failure rates in African American (AA) older adults compared to European American (EA) individuals. These findings highlight the need for careful interpretation of PVTs in diverse populations.

Keywords:
Embedded validityfalse positive rateneuropsychologyperformance validityracial groups

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Area of Science:

  • Neuroscience
  • Psychology
  • Gerontology

Background:

  • Embedded performance validity tests (PVTs) are used to assess response consistency in cognitive evaluations.
  • Concerns exist regarding potential racial and ethnic disparities in PVT performance.
  • This study investigated performance validity in older adults from diverse racial backgrounds.

Purpose of the Study:

  • To examine differences in positive findings on embedded performance validity tests (PVTs) between African American (AA) and European American (EA) older adults.
  • To assess the impact of race on PVT failure rates in a large cohort of older adults undergoing cognitive aging research.

Main Methods:

  • Secondary analysis of National Alzheimer's Coordinating Center data from 22,688 participants.
  • Exclusion of individuals with dementia, mild cognitive impairment, or abnormal Mini-Mental State Examination (MMSE) scores.
  • Propensity score matching used to create comparable AA and EA groups (N=3,024) based on age, education, sex, and MMSE, with 50% of the final sample identifying as AA.

Main Results:

  • No significant differences in age, education, sex, MMSE, or premorbid ability estimates were found between racial groups.
  • African American participants showed significantly higher failure rates on both raw score (13% vs. 3.8%) and age-adjusted (20.6% vs. 5.9%) performance validity tests compared to European American participants (p < .0001).

Conclusions:

  • Performance validity tests (PVTs) demonstrate significantly higher failure rates in African American older adults compared to European American older adults.
  • Results suggest a need for cautious interpretation of embedded PVTs when assessing underrepresented racial groups.
  • Consideration should be given to adjusting PVT cutoffs to enhance diagnostic accuracy in diverse populations.