Examining the clinical utility of the Medical Symptom Validity Immediate Recognition subtest as an abbreviated...

This study examined the psychometric properties of the Medical Symptom Validity Test (MSVT) and its primary validity subtests using manual-recommended and alternative cut-scores for detecting performance invalidity to evaluate whether the MSVT's Immediate Recall subtest could function as an abbreviated alternative to the full MSVT.

A mixed clinical sample of 411 adult neuropsychiatric patients was divided into valid (n = 331) and invalid (n = 80) based on four independent criterion performance validity tests (PVTs). MSVT psychometric properties were examined manual-recommended (≤85%) and alternative failure cut-scores (≤80%, ≤90%).

Using standard MSVT failure criteria (IR, DR, and/or CNS ≤85%) yielded 80% sensitivity, but unacceptable specificity of 79%. Among individual effort subtests, the manual-recommended cut-score for IR yielded the lowest sensitivity (60%), but the highest specificity (94%). Increasing the IR cut-scores to ≤90% improved sensitivity to 69% and yielded near-acceptable specificity levels (88%). Removal of those with one PVT failure from the valid group strengthen classification accuracy metrics for all MSVT cutoffs examined and resulted in 69% sensitivity/91% specificity at an IR cut-score of ≤90%.

Findings provide initial validation for the clinical utility of using the MSVT IR subtest as an abbreviated freestanding PVT and support increasing the IR failure cutoff to ≤90%, when used in conjunction with other validated PVTs. This study substantiates previous literature that demonstrates the use of abbreviated PVT administrations to help reduce evaluation costs and administration time, while maintaining comparable or improved psychometric properties.