Construct validity of performance validity tests across multiple mixed-clinical samples

Few studies have systematically assessed construct validity across a diverse set of performance validity tests (PVTs). Clarifying whether PVTs measure a common construct or distinct aspects of performance validity has important clinical implications for neuropsychological data interpretation and PVT selection.

This study evaluated the latent structure of PVTs using retrospective data from multiple mixed-clinical samples (Sample 1: N = 115, Sample 2: N = 297; Sample 3: N = 160), with diverse mental health and neurocognitive diagnoses. Each sample was administered a variety of embedded and freestanding PVTs, and the latent structure was examined using exploratory factor analyses (Samples 1-2) and confirmatory factor analysis (CFA; Sample 3).

Initial analyses supported a unidimensional structure (Sample 1), whereas Samples 2-3 provided converging evidence for a two-factor solution characterized by moderately to strongly correlated Memory and Non-Memory factors (r = .65 to .71) and excellent model fit in Sample 3 (robust comparative fit index = .99, robust root mean square error of approximation = .045, standardized root mean square residual = .038). Memory-based PVTs demonstrated stronger and more consistent loadings than non-memory PVTs across samples.

Findings were consistent with a hierarchical organization with a general PVT construct at the highest strata and closely related Memory and Non-Memory factors nested beneath. Alternative design-based explanations are also considered. Clinically, results support the continued use of multiple memory and non-memory-based PVTs throughout a neuropsychological assessment. Future replication is needed using a prospective design with larger, more demographically and clinically diverse samples.