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The impact of race and other demographic factors on the false positive rates of five embedded Performance Validity Tests (PVTs) in a Veteran sample.

Journal of clinical and experimental neuropsychology·2024
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Self-reported disability-seeking predicts PVT failure in veterans undergoing clinical neuropsychological evaluation.

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The TOMM1 discrepancy index (TDI): A new performance validity test (PVT) that differentiates between invalid cognitive testing and those diagnosed with dementia.

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When Failing One Performance Validity Test Matters.

John H Denning1,2

  • 1Mental Health Service, Ralph H. Johnson Veterans Affairs Healthcare System, Charleston, SC, USA.

Applied Neuropsychology. Adult
|December 8, 2023
PubMed
Summary

Failing even one freestanding, forced-choice, memory-based (Fr-FC-MB) Performance Validity Test (PVT) significantly impairs memory scores in veterans. This suggests closer scrutiny of individuals who fail a single PVT.

Keywords:
Cognitionmemoryneuropsychologyperformance validity testsveterans

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Area of Science:

  • Neuropsychology
  • Cognitive Assessment
  • Veterans Health

Background:

  • Consensus is lacking on interpreting cognitive test results when only one Performance Validity Test (PVT) fails.
  • Performance Validity Tests are crucial for identifying non-credible effort in cognitive assessments.

Purpose of the Study:

  • To investigate the impact of failing one freestanding, forced-choice, memory-based (Fr-FC-MB) PVT on memory performance in a large veteran sample.
  • To determine if failing a single Fr-FC-MB PVT significantly affects subsequent memory test scores.

Main Methods:

  • Examined data from 1,353 veterans.
  • Assessed the impact of failing zero, one, or two Fr-FC-MB PVTs (Test of Memory Malingering Trial 1 or Medical Symptom Validity Test) on memory measures.
  • Utilized the California Verbal Learning Test-II (CVLT-II) and Brief Visuospatial Memory Test-R (BVMT-R).

Main Results:

  • Veterans failing one Fr-FC-MB PVT showed significant declines in all memory indices compared to those failing none.
  • Large average effect sizes were observed for both BVMT-R (d = -0.9) and CVLT-II (d = -1.0).
  • Memory scores of those failing one PVT were comparable to those failing two PVTs.

Conclusions:

  • Failing even a single Fr-FC-MB PVT dramatically and negatively impacts memory performance.
  • Greater nuance and flexibility are needed in determining invalid test performance.
  • Individuals failing one Fr-FC-MB PVT warrant closer scrutiny regarding the credibility of their performance.