Cross-validation of verbal fluency measures as embedded performance validity tests in a clinical sample

This study evaluated the utility of the Controlled Oral Word Association Test (COWAT-FAS) and Animal Naming as embedded performance validity tests (PVTs) in a mixed clinical sample of 165 military veterans referred for neuropsychological evaluation. Participants had either a self-reported history of mild TBI or were referred for evaluation of possible ADHD. Participants were classified as credible (0 PVT failures; n = 92) or non-credible (≥2 PVT failures; n = 73). Classification accuracy was examined for COWAT and Animal Naming raw scores, demographically adjusted T-scores, and two previously published logistic regression models. Both verbal fluency measures significantly differentiated credible from non-credible groups. Optimal indices utilized COWAT raw scores, either alone or when embedded within the logistic regression formula. Findings support verbal fluency measures as efficient embedded, non-memory-based PVTs.