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Related Experiment Video

Updated: Jun 18, 2025

The Spatial Memory Game: Testing the Relationship Between Spatial Language, Object Knowledge, and Spatial Cognition
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Multivariable utility of the Memory Integrated Language and Making Change Test.

John-Christopher A Finley1, Mira I Leese2, Jarett E Roseberry3

  • 1Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Applied Neuropsychology. Adult
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Summary

Combining the Memory Integrated Language Test (MIL) and Making Change Test Abbreviated Index (MCT-AI) significantly improves the detection of invalid performance in neuropsychological evaluations. This paired approach enhances accuracy and sensitivity while maintaining high specificity.

Keywords:
Digitalmalingerneuropsychologyperformance validitysymptom validity testtele-neuropsychology

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Area of Science:

  • Neuropsychology
  • Cognitive Assessment
  • Performance Validity Testing

Background:

  • Web-based performance validity tests (PVTs) like the Memory Integrated Language Test (MIL) and Making Change Test Abbreviated Index (MCT-AI) show promise individually.
  • Detecting invalid performance is crucial in neuropsychological evaluations.

Purpose of the Study:

  • To evaluate the combined efficacy of the MIL and MCT-AI for detecting invalid performance in a mixed neuropsychiatric sample.
  • To determine if using these PVTs together improves classification accuracy compared to independent use.

Main Methods:

  • 129 adult outpatients were assessed and classified into valid (n=104) or invalid (n=25) performance groups.
  • The MIL (cut score ≤41) and MCT-AI (cut score ≥1.05) were used in combination.
  • Classification accuracy was measured using the area under the curve (AUC).

Main Results:

  • Combined use of MIL and MCT-AI achieved an AUC of .84 (95% CI: .75, .93).
  • Sensitivity increased from .10-.31 to .70 with combined use, while specificity remained ≥.90.
  • Failing both tests was associated with significantly lower cognitive scores compared to failing only one.

Conclusions:

  • The combined use of MIL and MCT-AI is an effective strategy for identifying invalid performance in neuropsychological evaluations.
  • Pairing these PVTs aligns with guidelines recommending multiple measures for performance validity assessment.
  • This approach enhances the reliability of neuropsychological assessment findings.