Validation of the Hopkins Verbal Learning Test - Revised and Brief Visuospatial Memory Test - Revised forced choice...

The objective of this study was to develop and validate novel forced choice (FC) trials for the Hopkins Verbal Learning Test - Revised (HVLT-R) and Brief Visuospatial Memory Test - Revised (BVMT-R) as performance validity tests (PVTs), and to compare their accuracy in predicting suboptimal test engagement against existing recognition discrimination (RD) trials.

We retrospectively analyzed 357 adult outpatients who completed the HVLT-R and BVMT-R during routine neuropsychological evaluations at a Midwestern U.S. hospital. Validity status was classified using established consensus criteria (≥2 PVT failures). Novel FC trials were administered approximately 10 minutes after respective standard administrations. Receiver operating characteristic analyses estimated classification accuracy, and cutoffs emphasizing specificity (≥.90) were derived.

Individual FC trials demonstrated poor accuracy (AUC = .55-.69), whereas a combined FC composite achieved acceptable accuracy (AUC = .72). In comparison, individual RD indices showed acceptable accuracy (AUC = .73-.77), and the combined RD composite demonstrated acceptable to good classification accuracy (AUC = .78-.80). Sensitivities were low for individual FC (.11 to .42) and RD scores (.21 to .58).

Novel FC trials for the HVLT-R and BVMT-R may provide adjunctive indicators of noncredible performance. However, RD indices remain more sensitive overall. Though FC trials show promise, RD indices better classified invalid performance, and further research is needed before FC measures can be implemented widely.