The relationship between the self-report BASC-2 validity indicators and performance validity test failure after pediatric mild traumatic brain injury.

In adult populations, research on methodologies to identify noncredible performance and exaggerated symptoms during neuropsychological evaluations has grown exponentially in the past two decades. Far less work has focused on methods appropriate for children. Although several recent studies have used stand-alone performance validity tests with younger populations, a near absence of pediatric work has investigated other indices to identify response bias. The present study examined the relationship between the validity scales from the self-report Behavior Assessment System for Children, Second Edition (BASC-2) and performance on the Medical Symptom Validity Test (MSVT), a stand-alone performance validity test. The sample consisted of 274 clinically referred patients with mild traumatic brain injuries aged 8 through 17 years. Fifty patients failed the MSVT based on actuarial criteria. The majority of these patients (92%) provided valid self-report BASC-2 profiles, with only three patients (6%) producing an invalid profile due to an elevated F index. Analysis of valid/invalid self-report BASC-2 profiles and MSVT pass/fail did not reveal a significant relationship (p = 0.471, two-tailed Fisher's exact test). These findings suggest that performance validity tests like the MSVT provide substantively different information about the validity of a neuropsychological profile than that provided by the self-report validity scales of the BASC-2.

Performance on the test of memory malingering (TOMM) among a large clinic-referred pediatric sample.

Growing concerns with suboptimal effort in pediatric populations have led clinicians to investigate the utility of symptom validity tests (SVT) among children and adolescents. Performance on the Test of Memory Malingering (TOMM) was analyzed among a clinical sample of individuals ranging in age from 5 through 16 years. The 101 patients were referred for a variety of learning, developmental, psychiatric, and neurological concerns. All children were administered the TOMM as part of a clinical neuropsychological evaluation. Within the sample, 4 patients did not meet the adult cutoff criteria for passing the TOMM. Three of the 4 patients also demonstrated suboptimal effort on another SVT. Results revealed statistically significant correlations between TOMM performance and age, intelligence, and memory. Despite these correlations, 97 out of the 101 performed at or above the adult cutoff score. The findings suggest that children perform similarly to adults on the TOMM and that the TOMM is appropriate for use with pediatric clinical populations as young as 5 years.