ABSTRACT
This study examined embedded performance validity indicators (PVI) based on the number of impaired scores in an evaluation and the overall test battery mean (OTBM). Adult participants (N = 175) reporting traumatic brain injury were grouped using eight PVI. Participants who passed all PVI (n = 67) demonstrated fewer impaired scores and higher OTBM than those who failed two or more PVI (n = 66). Impairment was defined at three levels: T scores < 40, 35, and 30. With specificity ≥.90, sensitivity ranged from .51 to .71 for number of impaired scores and .74 for OTBM.
Subject(s)
Brain Injuries/physiopathology , Cognition Disorders/physiopathology , Language Tests/statistics & numerical data , Neuropsychological Tests , Psychomotor Performance/physiology , Adult , Brain Injuries/complications , Cognition Disorders/etiology , Female , Humans , Male , Middle Aged , Neuropsychological Tests/statistics & numerical data , Reproducibility of Results , Sensitivity and Specificity , Severity of Illness Index , Wechsler Scales/statistics & numerical dataABSTRACT
This study examined the relationship of performance validity and neuropsychological outcomes in a sample of individuals referred for independent neuropsychological examination in the context of reported traumatic brain injury (82% mild). Archival data were examined on 175 participants aged 20 to 65 who were administered at least two performance validity measures. Participants who passed all effort measures (Pass; n = 61) outperformed those who failed two or more (Fail; n = 70) on the majority of tests in the neuropsychological battery. The Fail group showed a higher percentage of impaired test scores than the Pass group with impairment defined at three levels (T scores < 40, 35, and 30). At the most conservative impairment cutoff (T < 30), 16% of the Pass group demonstrated impaired scores on more than three measures, while 79% of the Fail group showed impaired scores on more than three measures. The number of effort measures failed correlated highly with the overall test battery mean (r = -.73). On cognitive domain summary scores, effect sizes based on levels of effort (d = 1.12 to 1.86) were higher than those based on injury severity (d = 0.03 to 0.36).
Subject(s)
Brain Injuries/psychology , Cognition Disorders/diagnosis , Disability Evaluation , Malingering/diagnosis , Malingering/psychology , Adult , Aged , Brain Injuries/complications , Brain Injuries/diagnosis , Cognition Disorders/etiology , Female , Humans , Male , Middle Aged , Reproducibility of Results , Severity of Illness Index , Statistics as Topic , Young AdultABSTRACT
Picture Completion (PC) indices from the Wechsler Adult Intelligence Scale, Third Edition, were investigated as performance validity indicators (PVIs) in a sample referred for independent neuropsychological examination. Participants from an archival database were included in the study if they were between the ages of 18 and 65 and were administered at least two PVIs. Effort measure performance yielded groups that passed all or failed one measure (Pass; n= 95) and failed two or more PVIs (Fail-2; n= 61). The Pass group performed better on PC than the Fail-2 group. PC cut scores were compared in differentiating Pass and Fail-2 groups. PC raw score of ≤12 showed the best classification accuracy in this sample correctly classifying 91% of Pass and 41% of Fail-2 cases. Overall, PC indices show good specificity and low sensitivity for exclusive use as PVIs, demonstrating promise for use as adjunctive embedded measures.
