Boone KB, Sherman D, Mishler J, Daoud G, Cottingham M, Victor TL, Ziegler E, Zeller MA, Wright M. Cross-validation of RAVLT performance validity indicators and the RAVLT/RO discriminant function in a large known groups sample.
Clin Neuropsychol 2022;
36:2342-2360. [PMID:
34311662 DOI:
10.1080/13854046.2021.1948611]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE
To cross-validate RAVLT performance validity cut-offs and the RAVLT/RO discriminant function in a large neuropsychological sample.
METHOD
RAVLT scores and the RAVLT/RO discriminant function were compared in credible (n = 100) and noncredible (n = 353) neuropsychology referrals.
RESULTS
Noncredible patients scored lower than credible patients on RAVLT scores and the RAVLT/RO discriminant function. With cut-offs set to ≥90% specificity, highest sensitivities were observed for the discriminant function (cut-off ≤.064; 55.8%), recognition total (cut-off ≤9; 53.1%), the recognition combination score (≤10; 47.7%), and total learning across trials (cut-off ≤31; 45.3%). Individuals with histories of learning difficulties were over-represented in the 10% of credible patients exceeding cut-offs. When these individuals were removed, cut-offs could be tightened while still maintaining at least 90% specificity, and thereby increasing sensitivity (e.g., recognition total cut-off ≤10, 65% sensitivity; RAVLT/RO discriminant function cut-off ≤.176, 58% sensitivity). When three of the most sensitive, non-overlapping scores were considered in combination, 17% of credible patients failed ≥1 of the three cut-offs, while 3% failed two, and only 1% failed all three. In contrast, in the noncredible sample, more than two-thirds failed one or more of the three cut-offs, nearly half failed ≥2, and nearly a quarter failed all three.
CONCLUSIONS
RAVLT PVT cut-offs and the RAVLT/RO discriminant function achieve approximately 50% sensitivity, and approach 65% sensitivity when cut-offs specific to samples without histories of learning problems are employed, confirming that RAVLT cut-offs and the RAVLT/RO discriminant function continue to be valuable techniques in the identification of performance invalidity.
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