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Crişan I, Erdodi L. Examining the cross-cultural validity of the test of memory malingering and the Rey 15-item test. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:721-731. [PMID: 35476611 DOI: 10.1080/23279095.2022.2064753] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study was designed to investigate the cross-cultural validity of two freestanding performance validity tests (PVTs), the Test of Memory Malingering - Trial 1 (TOMM-1) and the Rey Fifteen Item Test (Rey-15) in Romanian-speaking patients. METHODS The TOMM-1 and Rey-15 free recall (FR) and the combination score incorporating the recognition trial (COMB) were administered to a mixed clinical sample of 61 adults referred for cognitive evaluation, 24 of whom had external incentives to appear impaired. Average scores on PVTs were compared between the two groups. Classification accuracies were computed using one PVT against another. RESULTS Patients with identifiable external incentives to appear impaired produced significantly lower scores and more errors on validity indicators. The largest effect sizes emerged on TOMM-1 (Cohen's d = 1.00-1.19). TOMM-1 was a significant predictor of the Rey-15 COMB ≤20 (AUC = .80; .38 sensitivity; .89 specificity at a cutoff of ≤39). Similarly, both Rey-15 indicators were significant predictors of TOMM-1 at ≤39 as the criterion (AUCs = .73-.76; .33 sensitivity; .89-.90 specificity). CONCLUSION Results offer a proof of concept for the cross-cultural validity of the TOMM-1 and Rey-15 in a Romanian clinical sample.
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Affiliation(s)
- Iulia Crişan
- Department of Psychology, West University of Timişoara, Timişoara, Romania
| | - Laszlo Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
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Parsons J, Rodrigues NB, Erdodi LA. The classification accuracy of Warrington's recognition memory test (words) as a performance validity Test in a neurorehabilitation setting. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-11. [PMID: 38913011 DOI: 10.1080/23279095.2024.2337130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
This study was designed to evaluate the classification accuracy of the Warrington's Recognition Memory Test (RMT) in 167 patients (97 or 58.1% men; MAge = 40.4; MEducation= 13.8) medically referred for neuropsychological evaluation against five psychometrically defined criterion groups. At the optimal cutoff (≤42), the RMT produced an acceptable combination of sensitivity (.36-.60) and specificity (.85-.95), correctly classifying 68.4-83.3% of the sample. Making the cutoff more conservative (≤41) improved specificity (.88-.95) at the expense of sensitivity (.30-.60). Lowering the cutoff to ≤40 achieved uniformly high specificity (.91-.95) but diminished sensitivity (.27-.48). RMT scores were unrelated to lateral dominance, education, or gender. The RMT was sensitive to a three-way classification of performance validity (Pass/Borderline/Fail), further demonstrating its discriminant power. Despite a notable decline in research studies focused on its classification accuracy within the last decade, the RMT remains an effective free-standing PVT that is robust to demographic variables. Relatively low sensitivity is its main liability. Further research is needed on its cross-cultural validity (sensitivity to limited English proficiency).
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Affiliation(s)
- Jenna Parsons
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Nelson B Rodrigues
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
- Star UBB Institute, Babeș-Bolyai University, Cluj-Napoca, Romania
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Tyson BT, Shahein A, Abeare CA, Baker SD, Kent K, Roth RM, Erdodi LA. Replicating a Meta-Analysis: The Search for the Optimal Word Choice Test Cutoff Continues. Assessment 2023; 30:2476-2490. [PMID: 36752050 DOI: 10.1177/10731911221147043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This study was designed to expand on a recent meta-analysis that identified ≤42 as the optimal cutoff on the Word Choice Test (WCT). We examined the base rate of failure and the classification accuracy of various WCT cutoffs in four independent clinical samples (N = 252) against various psychometrically defined criterion groups. WCT ≤ 47 achieved acceptable combinations of specificity (.86-.89) at .49 to .54 sensitivity. Lowering the cutoff to ≤45 improved specificity (.91-.98) at a reasonable cost to sensitivity (.39-.50). Making the cutoff even more conservative (≤42) disproportionately sacrificed sensitivity (.30-.38) for specificity (.98-1.00), while still classifying 26.7% of patients with genuine and severe deficits as non-credible. Critical item (.23-.45 sensitivity at .89-1.00 specificity) and time-to-completion cutoffs (.48-.71 sensitivity at .87-.96 specificity) were effective alternative/complementary detection methods. Although WCT ≤ 45 produced the best overall classification accuracy, scores in the 43 to 47 range provide comparable objective psychometric evidence of non-credible responding. Results question the need for designating a single cutoff as "optimal," given the heterogeneity of signal detection environments in which individual assessors operate. As meta-analyses often fail to replicate, ongoing research is needed on the classification accuracy of various WCT cutoffs.
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Affiliation(s)
| | | | | | | | | | - Robert M Roth
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Crișan I, Sava FA. Validity assessment in Eastern Europe: cross-validation of the Dot Counting Test and MODEMM against the TOMM-1 and Rey-15 in a Romanian mixed clinical sample. Arch Clin Neuropsychol 2023:acad085. [PMID: 37961918 DOI: 10.1093/arclin/acad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE This study investigated performance validity in the understudied Romanian clinical population by exploring classification accuracies of the Dot Counting Test (DCT) and the first Romanian performance validity test (PVT) (Memory of Objects and Digits and Evaluation of Memory Malingering/MODEMM) in a heterogeneous clinical sample. METHODS We evaluated 54 outpatients (26 females; MAge = 62.02; SDAge = 12.3; MEducation = 2.41, SDEducation = 2.82) with the Test of Memory Malingering 1 (TOMM-1), Rey Fifteen Items Test (Rey-15) (free recall and recognition trials), DCT, MODEMM, and MMSE/MoCA as part of their neuropsychological assessment. Accuracy parameters and base failure rates were computed for the DCT and MODEMM indicators against the TOMM-1 and Rey-15. Two patient groups were constructed according to psychometrically defined credible/noncredible performance (i.e., pass/fail both TOMM-1 and Rey-15). RESULTS Similar to other cultures, a cutoff of ≥18 on the DCT E score produced the best combination between sensitivity (0.50-0.57) and specificity (≥0.90). MODEMM indicators based on recognition accuracy, inconsistencies, and inclusion false positives generated 0.75-0.86 sensitivities at ≥0.90 specificities. Multivariable models of MODEMM indicators reached perfect sensitivities at ≥0.90 specificities against two PVTs. Patients who failed the TOMM-1 and Rey-15 were significantly more likely to fail the DCT and MODEMM than patients who passed both PVTs. CONCLUSIONS Our results offer proof of concept for the DCT's cross-cultural validity and the applicability of the MODEMM on Romanian clinical examinees, further recommending the use of heterogeneous validity indicators in clinical assessments.
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Affiliation(s)
- Iulia Crișan
- Department of Psychology, West University of Timișoara, Timișoara 300223, Romania
| | - Florin Alin Sava
- Department of Psychology, West University of Timişoara, Timișoara 300223, Romania
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Erdodi LA. From "below chance" to "a single error is one too many": Evaluating various thresholds for invalid performance on two forced choice recognition tests. BEHAVIORAL SCIENCES & THE LAW 2023; 41:445-462. [PMID: 36893020 DOI: 10.1002/bsl.2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/16/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
This study was designed to empirically evaluate the classification accuracy of various definitions of invalid performance in two forced-choice recognition performance validity tests (PVTs; FCRCVLT-II and Test of Memory Malingering [TOMM-2]). The proportion of at and below chance level responding defined by the binomial theory and making any errors was computed across two mixed clinical samples from the United States and Canada (N = 470) and two sets of criterion PVTs. There was virtually no overlap between the binomial and empirical distributions. Over 95% of patients who passed all PVTs obtained a perfect score. At chance level responding was limited to patients who failed ≥2 PVTs (91% of them failed 3 PVTs). No one scored below chance level on FCRCVLT-II or TOMM-2. All 40 patients with dementia scored above chance. Although at or below chance level performance provides very strong evidence of non-credible responding, scores above chance level have no negative predictive value. Even at chance level scores on PVTs provide compelling evidence for non-credible presentation. A single error on the FCRCVLT-II or TOMM-2 is highly specific (0.95) to psychometrically defined invalid performance. Defining non-credible responding as below chance level scores is an unnecessarily restrictive threshold that gives most examinees with invalid profiles a Pass.
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Affiliation(s)
- Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
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Cutler L, Greenacre M, Abeare CA, Sirianni CD, Roth R, Erdodi LA. Multivariate models provide an effective psychometric solution to the variability in classification accuracy of D-KEFS Stroop performance validity cutoffs. Clin Neuropsychol 2023; 37:617-649. [PMID: 35946813 DOI: 10.1080/13854046.2022.2073914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectiveThe study was designed to expand on the results of previous investigations on the D-KEFS Stroop as a performance validity test (PVT), which produced diverging conclusions. Method The classification accuracy of previously proposed validity cutoffs on the D-KEFS Stroop was computed against four different criterion PVTs in two independent samples: patients with uncomplicated mild TBI (n = 68) and disability benefit applicants (n = 49). Results Age-corrected scaled scores (ACSSs) ≤6 on individual subtests often fell short of specificity standards. Making the cutoffs more conservative improved specificity, but at a significant cost to sensitivity. In contrast, multivariate models (≥3 failures at ACSS ≤6 or ≥2 failures at ACSS ≤5 on the four subtests) produced good combinations of sensitivity (.39-.79) and specificity (.85-1.00), correctly classifying 74.6-90.6% of the sample. A novel validity scale, the D-KEFS Stroop Index correctly classified between 78.7% and 93.3% of the sample. Conclusions A multivariate approach to performance validity assessment provides a methodological safeguard against sample- and instrument-specific fluctuations in classification accuracy, strikes a reasonable balance between sensitivity and specificity, and mitigates the invalid before impaired paradox.
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Affiliation(s)
- Laura Cutler
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
| | - Matthew Greenacre
- Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Christopher A Abeare
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
| | | | - Robert Roth
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
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Gur N, Hegedish O, Hoofien D, Pilowsky Peleg T. The Temporal Memory Sequence Test (TMST) in children: Validity test performance in clinically referred children. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:9-16. [PMID: 34870554 DOI: 10.1080/21622965.2021.2008936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Validity evaluation is fundamental in neuropsychological assessment in adults, with increasing interest among pediatric neuropsychologists. Although some measures exist, given time constraints placed on clinicians, and children's limited sustained attention, development of less time-consuming measures is beneficial. We explored the use of the Temporal Memory Sequence Test (TMST), a new performance validity test, in clinically referred children. One minor adaptation included reading the instructions and labels to non-fluent readers. Participants were 68 consecutive clinically referred children and adolescents, aged 6-18 years, with neurological (n = 46) or behavioral (n = 22) difficulties. Applying the adult cutoff, 83.8% passed the TMST. Age, gender, and diagnosis did not differ between children passing the TMST cutoff and those who failed it. Classification accuracy calculated against three embedded measures of performance validity (Wechsler scale Digit Span, Coding, and Processing Speed Index) indicated specificity over 90% (Digit Span: 94%, Coding: 96%, Processing Speed Index: 92%) and sensitivity between 30 and 33%. For individuals without Intellectual Disability (ID), 90.9% passed the TMST, and intelligence did not predict success. Thus, the use of the TMST with the adult cutoff was supported in children without ID, offering an additional validity measure for clinically referred children.
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Affiliation(s)
- N Gur
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,The Neuropsychological Unit, Schneider Children's Medical Center, Petach Tikvah, Israel
| | - O Hegedish
- Department of Psychology, University of Haifa, Haifa, Israel
| | - D Hoofien
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Psychology, Tel Aviv-Jaffa Academic College, Israel.,The National Institute for Neuropsychological Rehabilitation, Israel
| | - T Pilowsky Peleg
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.,The Neuropsychological Unit, Schneider Children's Medical Center, Petach Tikvah, Israel
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Profile of Embedded Validity Indicators in Criminal Defendants with Verified Valid Neuropsychological Test Performance. Arch Clin Neuropsychol 2022; 38:513-524. [DOI: 10.1093/arclin/acac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/21/2022] [Accepted: 08/09/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
Few studies have examined the use of embedded validity indicators (EVIs) in criminal-forensic practice settings, where judgements regarding performance validity can carry severe consequences for the individual and society. This study sought to examine how various EVIs perform in criminal defendant populations, and determine relationships between EVI scores and intrapersonal variables thought to influence performance validity.
Method
Performance on 16 empirically established EVI cutoffs were examined in a sample of 164 criminal defendants with valid performance who were referred for forensic neuropsychological evaluation. Subsequent analyses examined the relationship between EVI scores and intrapersonal variables in 83 of these defendants.
Results
Half of the EVIs (within the Wechsler Adult Intelligence Scale Digit Span Total, Conners’ Continuous Performance Test Commissions, Wechsler Memory Scale Logical Memory I and II, Controlled Oral Word Association Test, Trail Making Test Part B, and Stroop Word and Color) performed as intended in this sample. The EVIs that did not perform as intended were significantly influenced by relevant intrapersonal variables, including below-average intellectual functioning and history of moderate–severe traumatic brain injury and neurodevelopmental disorder.
Conclusions
This study identifies multiple EVIs appropriate for use in criminal-forensic settings. However, based on these findings, practitioners may wish to be selective in choosing and interpreting EVIs for forensic evaluations of criminal court defendants.
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Holcomb M, Pyne S, Cutler L, Oikle DA, Erdodi LA. Take Their Word for It: The Inventory of Problems Provides Valuable Information on Both Symptom and Performance Validity. J Pers Assess 2022:1-11. [PMID: 36041087 DOI: 10.1080/00223891.2022.2114358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This study was designed to compare the validity of the Inventory of Problems (IOP-29) and its newly developed memory module (IOP-M) in 150 patients clinically referred for neuropsychological assessment. Criterion groups were psychometrically derived based on established performance and symptom validity tests (PVTs and SVTs). The criterion-related validity of the IOP-29 was compared to that of the Negative Impression Management scale of the Personality Assessment Inventory (NIMPAI) and the criterion-related validity of the IOP-M was compared to that of Trial-1 on the Test of Memory Malingering (TOMM-1). The IOP-29 correlated significantly more strongly (z = 2.50, p = .01) with criterion PVTs than the NIMPAI (rIOP-29 = .34; rNIM-PAI = .06), generating similar overall correct classification values (OCCIOP-29: 79-81%; OCCNIM-PAI: 71-79%). Similarly, the IOP-M correlated significantly more strongly (z = 2.26, p = .02) with criterion PVTs than the TOMM-1 (rIOP-M = .79; rTOMM-1 = .59), generating similar overall correct classification values (OCCIOP-M: 89-91%; OCCTOMM-1: 84-86%). Findings converge with the cumulative evidence that the IOP-29 and IOP-M are valuable additions to comprehensive neuropsychological batteries. Results also confirm that symptom and performance validity are distinct clinical constructs, and domain specificity should be considered while calibrating instruments.
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Affiliation(s)
| | | | - Laura Cutler
- Department of Psychology, Neuropsychology Track, University of Windsor
| | | | - Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor
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Erdodi LA. Multivariate Models of Performance Validity: The Erdodi Index Captures the Dual Nature of Non-Credible Responding (Continuous and Categorical). Assessment 2022:10731911221101910. [PMID: 35757996 DOI: 10.1177/10731911221101910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was designed to examine the classification accuracy of the Erdodi Index (EI-5), a novel method for aggregating validity indicators that takes into account both the number and extent of performance validity test (PVT) failures. Archival data were collected from a mixed clinical/forensic sample of 452 adults referred for neuropsychological assessment. The classification accuracy of the EI-5 was evaluated against established free-standing PVTs. The EI-5 achieved a good combination of sensitivity (.65) and specificity (.97), correctly classifying 92% of the sample. Its classification accuracy was comparable with that of another free-standing PVT. An indeterminate range between Pass and Fail emerged as a legitimate third outcome of performance validity assessment, indicating that the underlying construct is an inherently continuous variable. Results support the use of the EI model as a practical and psychometrically sound method of aggregating multiple embedded PVTs into a single-number summary of performance validity. Combining free-standing PVTs with the EI-5 resulted in a better separation between credible and non-credible profiles, demonstrating incremental validity. Findings are consistent with recent endorsements of a three-way outcome for PVTs (Pass, Borderline, and Fail).
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Dunn A, Pyne S, Tyson B, Roth R, Shahein A, Erdodi L. Critical Item Analysis Enhances the Classification Accuracy of the Logical Memory Recognition Trial as a Performance Validity Indicator. Dev Neuropsychol 2021; 46:327-346. [PMID: 34525856 DOI: 10.1080/87565641.2021.1956499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE : Replicate previous research on Logical Memory Recognition (LMRecog) and perform a critical item analysis. METHOD : Performance validity was psychometrically operationalized in a mixed clinical sample of 213 adults. Classification of the LMRecog and nine critical items (CR-9) was computed. RESULTS : LMRecog ≤20 produced a good combination of sensitivity (.30-.35) and specificity (.89-.90). CR-9 ≥5 and ≥6 had comparable classification accuracy. CR-9 ≥5 increased sensitivity by 4% over LMRecog ≤20; CR-9 ≥6 increased specificity by 6-8% over LMRecog ≤20; CR-9 ≥7 increased specificity by 8-15%. CONCLUSIONS : Critical item analysis enhances the classification accuracy of the optimal LMRecog cutoff (≤20).
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Affiliation(s)
- Alexa Dunn
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Sadie Pyne
- Windsor Neuropsychology, Windsor, Canada
| | - Brad Tyson
- Neuroscience Institute, Evergreen Neuroscience Institute, EvergreenHealth Medical Center, Kirkland, USA
| | - Robert Roth
- Neuropsychology Services, Dartmouth-Hitchcock Medical Center, USA
| | - Ayman Shahein
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Laszlo Erdodi
- Department of Psychology, University of Windsor, Windsor, Canada
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Erdodi LA. Five shades of gray: Conceptual and methodological issues around multivariate models of performance validity. NeuroRehabilitation 2021; 49:179-213. [PMID: 34420986 DOI: 10.3233/nre-218020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study was designed to empirically investigate the signal detection profile of various multivariate models of performance validity tests (MV-PVTs) and explore several contested assumptions underlying validity assessment in general and MV-PVTs specifically. METHOD Archival data were collected from 167 patients (52.4%male; MAge = 39.7) clinicially evaluated subsequent to a TBI. Performance validity was psychometrically defined using two free-standing PVTs and five composite measures, each based on five embedded PVTs. RESULTS MV-PVTs had superior classification accuracy compared to univariate cutoffs. The similarity between predictor and criterion PVTs influenced signal detection profiles. False positive rates (FPR) in MV-PVTs can be effectively controlled using more stringent multivariate cutoffs. In addition to Pass and Fail, Borderline is a legitimate third outcome of performance validity assessment. Failing memory-based PVTs was associated with elevated self-reported psychiatric symptoms. CONCLUSIONS Concerns about elevated FPR in MV-PVTs are unsubstantiated. In fact, MV-PVTs are psychometrically superior to individual components. Instrumentation artifacts are endemic to PVTs, and represent both a threat and an opportunity during the interpretation of a given neurocognitive profile. There is no such thing as too much information in performance validity assessment. Psychometric issues should be evaluated based on empirical, not theoretical models. As the number/severity of embedded PVT failures accumulates, assessors must consider the possibility of non-credible presentation and its clinical implications to neurorehabilitation.
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Abeare CA, An K, Tyson B, Holcomb M, Cutler L, May N, Erdodi LA. The emotion word fluency test as an embedded performance validity indicator - Alone and in a multivariate validity composite. APPLIED NEUROPSYCHOLOGY. CHILD 2021; 11:713-724. [PMID: 34424798 DOI: 10.1080/21622965.2021.1939027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This project was designed to cross-validate existing performance validity cutoffs embedded within measures of verbal fluency (FAS and animals) and develop new ones for the Emotion Word Fluency Test (EWFT), a novel measure of category fluency. METHOD The classification accuracy of the verbal fluency tests was examined in two samples (70 cognitively healthy university students and 52 clinical patients) against psychometrically defined criterion measures. RESULTS A demographically adjusted T-score of ≤31 on the FAS was specific (.88-.97) to noncredible responding in both samples. Animals T ≤ 29 achieved high specificity (.90-.93) among students at .27-.38 sensitivity. A more conservative cutoff (T ≤ 27) was needed in the patient sample for a similar combination of sensitivity (.24-.45) and specificity (.87-.93). An EWFT raw score ≤5 was highly specific (.94-.97) but insensitive (.10-.18) to invalid performance. Failing multiple cutoffs improved specificity (.90-1.00) at variable sensitivity (.19-.45). CONCLUSIONS Results help resolve the inconsistency in previous reports, and confirm the overall utility of existing verbal fluency tests as embedded validity indicators. Multivariate models of performance validity assessment are superior to single indicators. The clinical utility and limitations of the EWFT as a novel measure are discussed.
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Affiliation(s)
- Christopher A Abeare
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
| | - Kelly An
- Private Practice, London, Ontario, Canada
| | - Brad Tyson
- Evergreen Health Medical Center, Kirkland, Washington, USA
| | - Matthew Holcomb
- Jefferson Neurobehavioral Group, New Orleans, Louisiana, USA
| | - Laura Cutler
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
| | - Natalie May
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
| | - Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, Ontario, Canada
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