Ethical, Legal and Risk Management Considerations in the Neuropsychological Assessment of Veterans

Validation of the personality assessment inventory (PAI) cognitive bias (CBS) and cognitive bias scale of scales (CB-SOS) in a post-deployment veteran sample

Objective: The present study evaluated the function of four cognitive, symptom validity scales on the Personality Assessment Inventory (PAI), the Cognitive Bias Scale (CBS) and the Cognitive Bias Scale of Scales (CB-SOS) 1, 2, and 3 in a sample of Veterans who volunteered for a study of neurocognitive functioning. Method: 371 Veterans (88.1% male, 66.1% White) completed a battery including the Miller Forensic Assessment of Symptoms Test (M-FAST), the Word Memory Test (WMT), and the PAI. Independent samples t-tests compared mean differences on cognitive bias scales between valid and invalid groups on the M-FAST and WMT. Area under the curve (AUC), sensitivity, specificity, and hit rate across various scale point-estimates were used to evaluate classification accuracy of the CBS and CB-SOS scales. Results: Group differences were significant with moderate effect sizes for all cognitive bias scales between the WMT-classified groups (d = .52-.55), and large effect sizes between the M-FAST-classified groups (d = 1.27-1.45). AUC effect sizes were moderate across the WMT-classified groups (.650-.676) and large across M-FAST-classified groups (.816-.854). When specificity was set to .90, sensitivity was higher for M-FAST and the CBS performed the best (sensitivity = .42). Conclusion: The CBS and CB-SOS scales seem to better detect symptom invalidity than performance invalidity in Veterans using cutoff scores similar to those found in prior studies with non-Veterans.

Evaluating the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) over-reporting scales in a military neuropsychology clinic

Introduction: This study examines the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity scales to detect invalid responding within a sample of active duty United States Army soldiers referred for neuropsychological evaluations.Method: This study examines the relationship between performance validity testing and performance on the MMPI-2-RF over-reporting scales. Specifically, mean differences between those who passed (n = 152; 75.6%) or failed (n = 49; 24.4%) performance validity testing were compared. Receiver operator characteristic analyzes were also conducted to expand available information on the MMPI-2-RF over-reporting sensitivity and specificity in an Army sample.Results: This study has two distinct findings. First, effect size differences between those passing and failing performance validity testing are classified as small to medium in magnitude (ranging from d = . 30/g = .32 on F-r to d = .66/g = .73 on RBS). Second, over-reporting scales have higher specificity and poorer sensitivity. Likewise, performance of the over-reporting scales suggests that those who exceeding recommended cut scores are likely to have failed extra-test performance validity measures.Conclusion: These findings suggest that many who fail external performance measures may be undetected on the MMPI-2-RF over-reporting scales and that those exceeding recommended cut scores are likely to have failed extra-test performance validity testing. Implications for research on, and practice with, the MMPI-2-RF in military populations are discussed.