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Lace JW, Sanborn V, Galioto R. Standalone Performance Validity Tests May Be Differentially Related to Measures of Working Memory, Processing Speed, and Verbal Memory in Patients With Multiple Sclerosis. Assessment 2024; 31:732-744. [PMID: 37303186 DOI: 10.1177/10731911231178289] [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: 06/13/2023]
Abstract
Cognitive functioning may account for minimal levels (i.e., 5%-14%) of variance of performance validity test (PVT) scores in clinical examinees. The present study extended this research twofold: (a) by determining the variance cognitive functioning explains within three distinct PVTs (b) in a sample of patients with multiple sclerosis (pwMS). Seventy-five pwMS (Mage = 48.50, 70.6% female, 80.9% White) completed the Victoria Symptom Validity Test (VSVT), Word Choice Test (WCT), Dot Counting Test (DCT), and three objective measures of working memory, processing speed, and verbal memory as part of clinical neuropsychological assessment. Regression analyses in credible groups (ns ranged from 54 to 63) indicated that cognitive functioning explained 24% to 38% of the variance in logarithmically transformed PVT variables. Variance from cognitive testing differed across PVTs: verbal memory significantly influenced both VSVT and WCT scores; working memory influenced VSVT and DCT scores; and processing speed influenced DCT scores. The WCT appeared least related to cognitive functioning of the included PVTs. Alternative plausible explanations, including the apparent domain/modality specificity hypothesis of PVTs versus the potential sensitivity of these PVTs to neurocognitive dysfunction in pwMS were discussed. Continued psychometric investigations into factors affecting performance validity, especially in multiple sclerosis, are warranted.
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Affiliation(s)
- John W Lace
- Cleveland Clinic Foundation, OH, USA
- Prevea Health, Green Bay, WI, USA
| | - Victoria Sanborn
- Kent State University, OH, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Rachel Galioto
- Cleveland Clinic Foundation, Mellen Center for Multiple Sclerosis, OH, USA
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2
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Crișan I, Ali S, Cutler L, Matei A, Avram L, Erdodi LA. Geographic variability in limited English proficiency: A cross-cultural study of cognitive profiles. J Int Neuropsychol Soc 2023; 29:972-983. [PMID: 37246143 DOI: 10.1017/s1355617723000280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study was designed to evaluate the effect of limited English proficiency (LEP) on neurocognitive profiles. METHOD Romanian (LEP-RO; n = 59) and Arabic (LEP-AR; n = 30) native speakers were compared to Canadian native speakers of English (NSE; n = 24) on a strategically selected battery of neuropsychological tests. RESULTS As predicted, participants with LEP demonstrated significantly lower performance on tests with high verbal mediation relative to US norms and the NSE sample (large effects). In contrast, several tests with low verbal mediation were robust to LEP. However, clinically relevant deviations from this general pattern were observed. The level of English proficiency varied significantly within the LEP-RO and was associated with a predictable performance pattern on tests with high verbal mediation. CONCLUSIONS The heterogeneity in cognitive profiles among individuals with LEP challenges the notion that LEP status is a unitary construct. The level of verbal mediation is an imperfect predictor of the performance of LEP examinees during neuropsychological testing. Several commonly used measures were identified that are robust to the deleterious effects of LEP. Administering tests in the examinee's native language may not be the optimal solution to contain the confounding effect of LEP in cognitive evaluations.
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Affiliation(s)
- Iulia Crișan
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Sami Ali
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Alina Matei
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Luisa Avram
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Laszlo A Erdodi
- Department of Psychology, University of Windsor, Windsor, Canada
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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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6
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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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7
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Tyson BT, Pyne SR, Crisan I, Calamia M, Holcomb M, Giromini L, Erdodi LA. Logical memory, visual reproduction, and verbal paired associates are effective embedded validity indicators in patients with traumatic brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 36881969 DOI: 10.1080/23279095.2023.2179400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
OBJECTIVE This study was design to evaluate the potential of the recognition trials for the Logical Memory (LM), Visual Reproduction (VR), and Verbal Paired Associates (VPA) subtests of the Wechsler Memory Scales-Fourth Edition (WMS-IV) to serve as embedded performance validity tests (PVTs). METHOD The classification accuracy of the three WMS-IV subtests was computed against three different criterion PVTs in a sample of 103 adults with traumatic brain injury (TBI). RESULTS The optimal cutoffs (LM ≤ 20, VR ≤ 3, VPA ≤ 36) produced good combinations of sensitivity (.33-.87) and specificity (.92-.98). An age-corrected scaled score of ≤5 on either of the free recall trials on the VPA was specific (.91-.92) and relatively sensitive (.48-.57) to psychometrically defined invalid performance. A VR I ≤ 5 or VR II ≤ 4 had comparable specificity, but lower sensitivity (.25-.42). There was no difference in failure rate as a function of TBI severity. CONCLUSIONS In addition to LM, VR, and VPA can also function as embedded PVTs. Failing validity cutoffs on these subtests signals an increased risk of non-credible presentation and is robust to genuine neurocognitive impairment. However, they should not be used in isolation to determine the validity of an overall neurocognitive profile.
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Affiliation(s)
- Brad T Tyson
- Evergreen Neuroscience Institute, Evergreen Health Medical Center, Kirkland, WA, USA
| | | | - Iulia Crisan
- Department of Psychology, West University of Timisoara, Timisoara, Romania
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | | | - Laszlo A Erdodi
- Jefferson Neurobehavioral Group, New Orleans, LA, USA
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
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Chang F, Cerny BM, Tse PKY, Rauch AA, Khan H, Phillips MS, Fletcher NB, Resch ZJ, Ovsiew GP, Jennette KJ, Soble JR. Using the Grooved Pegboard Test as an Embedded Validity Indicator in a Mixed Neuropsychiatric Sample with Varying Cognitive Impairment: Cross-Validation Problems. Percept Mot Skills 2023; 130:770-789. [PMID: 36634223 DOI: 10.1177/00315125231151779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Embedded validity indicators (EVIs) derived from motor tests have received less empirical attention than those derived from tests of other neuropsychological abilities, particularly memory. Preliminary evidence suggests that the Grooved Pegboard Test (GPB) may function as an EVI, but existing studies were largely conducted using simulators and population samples without cognitive impairment. In this study we aimed to evaluate the GPB's classification accuracy as an EVI among a mixed clinical neuropsychiatric sample with and without cognitive impairment. This cross-sectional study comprised 223 patients clinically referred for neuropsychological testing. GPB raw and T-scores for both dominant and nondominant hands were examined as EVIs. A known-groups design, based on ≤1 failure on a battery of validated, independent criterion PVTs, showed that GPB performance differed significantly by validity group. Within the valid group, receiver operating characteristic curve analyses revealed that only the dominant hand raw score displayed acceptable classification accuracy for detecting invalid performance (area under curve [AUC] = .72), with an optimal cut-score of ≥106 seconds (33% sensitivity/88% specificity). All other scores had marginally lower classification accuracy (AUCs = .65-.68) for differentiating valid from invalid performers. Therefore, the GPB demonstrated limited utility as an EVI in a clinical sample containing patients with bona fide cognitive impairment.
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Affiliation(s)
- Fini Chang
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Psychology, 12247University of Illinois at Chicago, Chicago, Illinois, United States
| | - Brian M Cerny
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, United States
| | - Phoebe Ka Yin Tse
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Clinical Psychology, The Chicago School of Professional Psychology, Chicago, Illinois, United States
| | - Andrew A Rauch
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Psychology, Loyola University Chicago, Chicago, Illinois, United States
| | - Humza Khan
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, United States
| | - Matthew S Phillips
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Clinical Psychology, The Chicago School of Professional Psychology, Chicago, Illinois, United States
| | - Noah B Fletcher
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States
| | - Zachary J Resch
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States
| | - Gabriel P Ovsiew
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States
| | - Kyle J Jennette
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States
| | - Jason R Soble
- Department of Psychiatry, 12247University of Illinois College of Medicine, Chicago, Illinois, United States.,Department of Neurology, 12247University of Illinois College of Medicine, Chicago, Illinois, United States
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Kanser RJ, Logan PM, Steward KA, Vanderbleek EN, Kamper JE. Specificity of Embedded Performance Validity Tests in Elderly Veterans with Mild and Major Neurocognitive Disorder. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2022:6964520. [PMID: 36578198 DOI: 10.1093/arclin/acac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study explored the specificity of four embedded performance validity tests (PVTs) derived from common neuropsychological tasks in a sample of older veterans with verified cognitive decline and whose performance was deemed valid by licensed psychologists. METHOD Participants were 180 veterans who underwent comprehensive neuropsychological evaluation, were determined to have valid performance following profile analysis/conceptualization, and were diagnosed with mild neurocognitive disorder (i.e., MCI; n = 64) or major neurocognitive disorder (i.e., Dementia; n = 116). All participants completed at least one of four embedded PVTs: Reliable Digit Span (RDS), California Verbal Learning Test-2nd ed. Short Form (CVLT-II SF) Forced choice, Trails B:A, and Delis-Kaplan Executive Function System (DKEFS) Letter and Category Fluency. RESULTS Adequate specificity (i.e., ≥90%) was achieved at modified cut-scores for all embedded PVTs across MCI and Dementia groups. Trails B:A demonstrated near perfect specificity at its traditional cut-score (Trails B:A < 1.5). RDS ≤ 5 and CVLT-II SF Forced Choice ≤7 led to <10% false positive classification errors across MCI and dementia groups. DKEFS Letter and Category Fluency achieved 90% specificity at extremely low normative cut-scores. CONCLUSIONS RDS, Trails B:A, and CVLT-II SF Forced Choice reflect promising embedded PVTs in the context of dementia evaluations. DKEFS Letter and Category Fluency appear too sensitive to genuine neurocognitive decline and, therefore, are inappropriate PVTs in adults with MCI or dementia. Additional research into embedded PVT sensitivity (via known-groups or analogue designs) in MCI and dementia is needed.
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Affiliation(s)
- Robert J Kanser
- Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Patrick M Logan
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA.,Mental Health and Behavioral Science, Louisville VA Medical Center, Louisville, KY, USA
| | - Kayla A Steward
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Emily N Vanderbleek
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Joel E Kamper
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
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Kanser RJ, Rapport LJ, Hanks RA, Patrick SD. Utility of WAIS-IV Digit Span indices as measures of performance validity in moderate to severe traumatic brain injury. Clin Neuropsychol 2022; 36:1950-1963. [PMID: 34044725 DOI: 10.1080/13854046.2021.1921277] [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: 01/27/2023]
Abstract
Objective: The addition of Sequencing to WAIS-IV Digit Span (DS) brought about new Reliable Digit Span (RDS) indices and an Age-Corrected Scaled Score that includes Sequencing trials. Reports have indicated that these new performance validity tests (PVTs) are superior to the traditional RDS; however, comparisons in the context of known neurocognitive impairment are sparse. This study compared DS-derived PVT classification accuracies in a design that included adults with verified TBI. Methods: Participants included 64 adults with moderate-to-severe TBI (TBI), 51 healthy adults coached to simulate TBI (SIM), and 78 healthy comparisons (HC). Participants completed the WAIS-IV DS subtest in the context of a larger test battery. Results: Kruskal-Wallis tests indicated that all DS indices differed significantly across groups. Post hoc contrasts revealed that only RDS Forward and the traditional RDS differed significantly between SIM and TBI. ROC analyses indicated that RDS variables were comparable predictors of SIM vs. HC; however, the traditional RDS showed the highest sensitivity when approximating 90% specificity for SIM vs. TBI. A greater percentage of TBI scored RDS Sequencing < 1 compared to SIM and HC. Conclusion: In the context of moderate-to-severe TBI, the DS-derived PVTs showed comparable discriminability. However, the Greiffenstein et al. traditional RDS demonstrated the best classification accuracy with respect to specificity/sensitivity balance. This relative superiority may reflect that individuals with verified TBI are more likely to perseverate on prior instructions during DS Sequencing. Findings highlight the importance of including individuals with verified TBI when evaluating and developing PVTs.
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Affiliation(s)
- Robert J Kanser
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Lisa J Rapport
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Robin A Hanks
- Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI, USA
| | - Sarah D Patrick
- Department of Psychology, Wayne State University, Detroit, MI, USA
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Ali S, Crisan I, Abeare CA, Erdodi LA. Cross-Cultural Performance Validity Testing: Managing False Positives in Examinees with Limited English Proficiency. Dev Neuropsychol 2022; 47:273-294. [PMID: 35984309 DOI: 10.1080/87565641.2022.2105847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Base rates of failure (BRFail) on performance validity tests (PVTs) were examined in university students with limited English proficiency (LEP). BRFail was calculated for several free-standing and embedded PVTs. All free-standing PVTs and certain embedded indicators were robust to LEP. However, LEP was associated with unacceptably high BRFail (20-50%) on several embedded PVTs with high levels of verbal mediation (even multivariate models of PVT could not contain BRFail). In conclusion, failing free-standing/dedicated PVTs cannot be attributed to LEP. However, the elevated BRFail on several embedded PVTs in university students suggest an unacceptably high overall risk of false positives associated with LEP.
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Affiliation(s)
- Sami Ali
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Iulia Crisan
- Department of Psychology, West University of Timişoara, Timişoara, Romania
| | - Christopher A Abeare
- 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
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12
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Abeare K, Cutler L, An KY, Razvi P, Holcomb M, Erdodi LA. BNT-15: Revised Performance Validity Cutoffs and Proposed Clinical Classification Ranges. Cogn Behav Neurol 2022; 35:155-168. [PMID: 35507449 DOI: 10.1097/wnn.0000000000000304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/09/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Abbreviated neurocognitive tests offer a practical alternative to full-length versions but often lack clear interpretive guidelines, thereby limiting their clinical utility. OBJECTIVE To replicate validity cutoffs for the Boston Naming Test-Short Form (BNT-15) and to introduce a clinical classification system for the BNT-15 as a measure of object-naming skills. METHOD We collected data from 43 university students and 46 clinical patients. Classification accuracy was computed against psychometrically defined criterion groups. Clinical classification ranges were developed using a z -score transformation. RESULTS Previously suggested validity cutoffs (≤11 and ≤12) produced comparable classification accuracy among the university students. However, a more conservative cutoff (≤10) was needed with the clinical patients to contain the false-positive rate (0.20-0.38 sensitivity at 0.92-0.96 specificity). As a measure of cognitive ability, a perfect BNT-15 score suggests above average performance; ≤11 suggests clinically significant deficits. Demographically adjusted prorated BNT-15 T-scores correlated strongly (0.86) with the newly developed z -scores. CONCLUSION Given its brevity (<5 minutes), ease of administration and scoring, the BNT-15 can function as a useful and cost-effective screening measure for both object-naming/English proficiency and performance validity. The proposed clinical classification ranges provide useful guidelines for practitioners.
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Affiliation(s)
| | | | - Kelly Y An
- Private Practice, London, Ontario, Canada
| | - Parveen Razvi
- Faculty of Nursing, University of Windsor, Windsor, Ontario, Canada
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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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15
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Brantuo MA, An K, Biss RK, Ali S, Erdodi LA. Neurocognitive Profiles Associated With Limited English Proficiency in Cognitively Intact Adults. Arch Clin Neuropsychol 2022; 37:1579-1600. [PMID: 35694764 DOI: 10.1093/arclin/acac019] [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] [Accepted: 03/19/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The objective of the present study was to examine the neurocognitive profiles associated with limited English proficiency (LEP). METHOD A brief neuropsychological battery including measures with high (HVM) and low verbal mediation (LVM) was administered to 80 university students: 40 native speakers of English (NSEs) and 40 with LEP. RESULTS Consistent with previous research, individuals with LEP performed more poorly on HVM measures and equivalent to NSEs on LVM measures-with some notable exceptions. CONCLUSIONS Low scores on HVM tests should not be interpreted as evidence of acquired cognitive impairment in individuals with LEP, because these measures may systematically underestimate cognitive ability in this population. These findings have important clinical and educational implications.
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Affiliation(s)
- Maame A Brantuo
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor ON, Canada
| | - Kelly An
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor ON, Canada
| | - Renee K Biss
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor ON, Canada
| | - Sami Ali
- 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
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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 2022:1-11. [PMID: 35476611 DOI: 10.1080/23279095.2022.2064753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [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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Nussbaum S, May N, Cutler L, Abeare CA, Watson M, Erdodi LA. Failing Performance Validity Cutoffs on the Boston Naming Test (BNT) Is Specific, but Insensitive to Non-Credible Responding. Dev Neuropsychol 2022; 47:17-31. [PMID: 35157548 DOI: 10.1080/87565641.2022.2038602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study was designed to examine alternative validity cutoffs on the Boston Naming Test (BNT).Archival data were collected from 206 adults assessed in a medicolegal setting following a motor vehicle collision. Classification accuracy was evaluated against three criterion PVTs.The first cutoff to achieve minimum specificity (.87-.88) was T ≤ 35, at .33-.45 sensitivity. T ≤ 33 improved specificity (.92-.93) at .24-.34 sensitivity. BNT validity cutoffs correctly classified 67-85% of the sample. Failing the BNT was unrelated to self-reported emotional distress. Although constrained by its low sensitivity, the BNT remains a useful embedded PVT.
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Affiliation(s)
- Shayna Nussbaum
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Natalie May
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Laura Cutler
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Christopher A Abeare
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Mark Watson
- Mark S. Watson Psychology Professional Corporation, Mississauga, ON, Canada
| | - Laszlo A Erdodi
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
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Ali S, Brantuo MA, Cutler L, Kennedy A, Erdodi LA. Limited English proficiency inhibits auditory verbal learning in cognitively healthy young adults - exploring culturally responsive diagnostic and educational safeguards. APPLIED NEUROPSYCHOLOGY. CHILD 2022; 12:97-103. [PMID: 35148226 DOI: 10.1080/21622965.2022.2034628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study was designed to examine the effect of limited English proficiency (LEP) on the Hopkins Verbal Learning Test-Revised (HVLT-R). The HVLT-R was administered to 28 undergraduate student volunteers. Half were native speakers of English (NSE), half had LEP. The LEP sample performed significantly below NSE on individual acquisition trials and delayed free recall (large effects). In addition, participants with LEP scored 1.5-2 SDs below the normative mean. There was no difference in performance during recognition testing. LEP status was associated with a clinically significant deficit on the HVLT-R in a sample of cognitively healthy university students. Results suggest that low scores on auditory verbal learning tests in individuals with LEP should not be automatically interpreted as evidence of memory impairment or learning disability. LEP should be considered as grounds for academic accommodations. The generalizability of the findings is constrained by the small sample size.
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Affiliation(s)
- Sami Ali
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Maame A Brantuo
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Arianna Kennedy
- School of Social Work, University of Windsor, Windsor, ON, Canada
| | - Laszlo A Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
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Detecting Negative Response Bias Within the Trauma Symptom Inventory–2 (TSI-2): a Review of the Literature. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09427-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractThis systematic review was performed to summarize existing research on the symptom validity scales within the Trauma Symptom Inventory–Second Edition (TSI-2), a relatively new self-report measure designed to assess the psychological sequelae of trauma. The TSI-2 has built-in symptom validity scales to monitor response bias and alert the assessor of non-credible symptom profiles. The Atypical Response scale (ATR) was designed to identify symptom exaggeration or fabrication. Proposed cutoffs on the ATR vary from ≥ 7 to ≥ 15, depending on the assessment context. The limited evidence available suggests that ATR has the potential to serve as measure of symptom validity, although its classification accuracy is generally inferior compared to well-established scales. While the ATR seems sufficiently sensitive to symptom over-reporting, significant concerns about its specificity persist. Therefore, it is proposed that the TSI-2 should not be used in isolation to determine the validity of the symptom presentation. More research is needed for development of evidence-based guidelines about the interpretation of ATR scores.
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Lace JW, Merz ZC, Galioto R. Nonmemory Composite Embedded Performance Validity Formulas in Patients with Multiple Sclerosis. Arch Clin Neuropsychol 2021; 37:309-321. [PMID: 34467368 DOI: 10.1093/arclin/acab066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Research regarding performance validity tests (PVTs) in patients with multiple sclerosis (MS) is scant, with recommended batteries for neuropsychological evaluations in this population lacking suggestions to include PVTs. Moreover, limited work has examined embedded PVTs in this population. As previous investigations indicated that nonmemory-based embedded PVTs provide clinical utility in other populations, this study sought to determine if a logistic regression-derived PVT formula can be identified from selected nonmemory variables in a sample of patients with MS. METHOD A total of 184 patients (M age = 48.45; 76.6% female) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into "credible" (n = 146) or "noncredible" (n = 38) groups according to performance on standalone PVT. Missing data were imputed with HOTDECK. RESULTS Classification statistics for a variety of embedded PVTs were examined, with none appearing psychometrically appropriate in isolation (areas under the curve [AUCs] = .48-.64). Four exponentiated equations were created via logistic regression. Six, five, and three predictor equations yielded acceptable discriminability (AUC = .71-.74) with modest sensitivity (.34-.39) while maintaining good specificity (≥.90). The two predictor equation appeared unacceptable (AUC = .67). CONCLUSIONS Results suggest that multivariate combinations of embedded PVTs may provide some clinical utility while minimizing test burden in determining performance validity in patients with MS. Nonetheless, the authors recommend routine inclusion of several PVTs and utilization of comprehensive clinical judgment to maximize signal detection of noncredible performance and avoid incorrect conclusions. Clinical implications, limitations, and avenues for future research are discussed.
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Affiliation(s)
- John W Lace
- Section of Neuropsychology, P57, Cleveland Clinic, Cleveland, OH, USA
| | - Zachary C Merz
- LeBauer Department of Neurology, The Moses H. Cone Memorial Hospital, Greensboro, NC, USA
| | - Rachel Galioto
- Section of Neuropsychology, P57, Cleveland Clinic, Cleveland, OH, USA.,Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA
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21
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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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Messa I, Holcomb M, Lichtenstein JD, Tyson BT, Roth RM, Erdodi LA. They are not destined to fail: a systematic examination of scores on embedded performance validity indicators in patients with intellectual disability. AUST J FORENSIC SCI 2021. [DOI: 10.1080/00450618.2020.1865457] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Isabelle Messa
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | | | | | - Brad T Tyson
- Neuropsychological Service, EvergreenHealth Medical Center, Kirkland, WA, USA
| | - Robert M Roth
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Laszlo A Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
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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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Abeare K, Romero K, Cutler L, Sirianni CD, Erdodi LA. Flipping the Script: Measuring Both Performance Validity and Cognitive Ability with the Forced Choice Recognition Trial of the RCFT. Percept Mot Skills 2021; 128:1373-1408. [PMID: 34024205 PMCID: PMC8267081 DOI: 10.1177/00315125211019704] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In this study we attempted to replicate the classification accuracy of the newly introduced Forced Choice Recognition trial (FCR) of the Rey Complex Figure Test (RCFT) in a clinical sample. We administered the RCFTFCR and the earlier Yes/No Recognition trial from the RCFT to 52 clinically referred patients as part of a comprehensive neuropsychological test battery and incentivized a separate control group of 83 university students to perform well on these measures. We then computed the classification accuracies of both measures against criterion performance validity tests (PVTs) and compared results between the two samples. At previously published validity cutoffs (≤16 & ≤17), the RCFTFCR remained specific (.84-1.00) to psychometrically defined non-credible responding. Simultaneously, the RCFTFCR was more sensitive to examinees' natural variability in visual-perceptual and verbal memory skills than the Yes/No Recognition trial. Even after being reduced to a seven-point scale (18-24) by the validity cutoffs, both RCFT recognition scores continued to provide clinically useful information on visual memory. This is the first study to validate the RCFTFCR as a PVT in a clinical sample. Our data also support its use for measuring cognitive ability. Replication studies with more diverse samples and different criterion measures are still needed before large-scale clinical application of this scale.
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Affiliation(s)
- Kaitlyn Abeare
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Kristoffer Romero
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | | | - Laszlo A Erdodi
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
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Sirianni CD, Abeare CA, Ali S, Razvi P, Kennedy A, Pyne SR, Erdodi LA. The V-5 provides quick, accurate and cross-culturally valid measures of psychiatric symptoms. Psychiatry Res 2021; 298:113651. [PMID: 33618234 DOI: 10.1016/j.psychres.2020.113651] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/12/2020] [Indexed: 12/15/2022]
Abstract
This study was designed to cross-validate the V-5, a quick psychiatric screener, across administration formats and levels of examinee acculturation. The V-5 was administered twice (once at the beginning and once at the end of the testing session) to three samples (N = 277) with varying levels of symptom severity and English language proficiency, varying type of administration, alongside traditional self-reported symptom inventories as criterion measures. The highest rest-retest reliability was observed on the Depression (.84) and Pain scales (.85). The V-5 was sensitive to the variability in symptom severity. Classification accuracy was driven by the base rate of the target construct, and was invariant across administration format (in-person or online) or level of English proficiency. The V-5 demonstrated promise as a cross-culturally robust screening instrument that is sensitive to change over time, lends itself to online administration, and is suitable for examinees with limited English proficiency.
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Affiliation(s)
| | | | - Sami Ali
- School of Social Work, University of Windsor, Windsor ON, Canada
| | - Parveen Razvi
- Faculty of Nursing, University of Windsor, Windsor ON, Canada
| | - Arianna Kennedy
- School of Social Work, University of Windsor, Windsor ON, Canada
| | - Sadie R Pyne
- Learning Disability Association of Windsor-Essex, Windsor ON Canada
| | - Laszlo A Erdodi
- Department of Psychology, University of Windsor, Windsor ON, Canada.
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Abeare K, Razvi P, Sirianni CD, Giromini L, Holcomb M, Cutler L, Kuzmenka P, Erdodi LA. Introducing Alternative Validity Cutoffs to Improve the Detection of Non-credible Symptom Report on the BRIEF. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09402-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sabelli AG, Messa I, Giromini L, Lichtenstein JD, May N, Erdodi LA. Symptom Versus Performance Validity in Patients with Mild TBI: Independent Sources of Non-credible Responding. PSYCHOLOGICAL INJURY & LAW 2021. [DOI: 10.1007/s12207-021-09400-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Cutler L, Abeare CA, Messa I, Holcomb M, Erdodi LA. This will only take a minute: Time cutoffs are superior to accuracy cutoffs on the forced choice recognition trial of the Hopkins Verbal Learning Test - Revised. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1425-1439. [PMID: 33631077 DOI: 10.1080/23279095.2021.1884555] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study was designed to evaluate the classification accuracy of the recently introduced forced-choice recognition trial to the Hopkins Verbal Learning Test - Revised (FCRHVLT-R) as a performance validity test (PVT) in a clinical sample. Time-to-completion (T2C) for FCRHVLT-R was also examined. METHOD Forty-three students were assigned to either the control or the experimental malingering (expMAL) condition. Archival data were collected from 52 adults clinically referred for neuropsychological assessment. Invalid performance was defined using expMAL status, two free-standing PVTs and two validity composites. RESULTS Among students, FCRHVLT-R ≤11 or T2C ≥45 seconds was specific (0.86-0.93) to invalid performance. Among patients, an FCRHVLT-R ≤11 was specific (0.94-1.00), but relatively insensitive (0.38-0.60) to non-credible responding0. T2C ≥35 s produced notably higher sensitivity (0.71-0.89), but variable specificity (0.83-0.96). The T2C achieved superior overall correct classification (81-86%) compared to the accuracy score (68-77%). The FCRHVLT-R provided incremental utility in performance validity assessment compared to previously introduced validity cutoffs on Recognition Discrimination. CONCLUSIONS Combined with T2C, the FCRHVLT-R has the potential to function as a quick, inexpensive and effective embedded PVT. The time-cutoff effectively attenuated the low ceiling of the accuracy scores, increasing sensitivity by 19%. Replication in larger and more geographically and demographically diverse samples is needed before the FCRHVLT-R can be endorsed for routine clinical application.
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Affiliation(s)
- Laura Cutler
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Christopher A Abeare
- Department of Psychology, Neuropsychology Track, University of Windsor, Windsor, ON, Canada
| | - Isabelle Messa
- 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
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Abeare CA, Hurtubise JL, Cutler L, Sirianni C, Brantuo M, Makhzoum N, Erdodi LA. Introducing a forced choice recognition trial to the Hopkins Verbal Learning Test – Revised. Clin Neuropsychol 2020; 35:1442-1470. [DOI: 10.1080/13854046.2020.1779348] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | | | - Maame Brantuo
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Nadeen Makhzoum
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Laszlo A. Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
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Identifying Novel Embedded Performance Validity Test Formulas Within the Repeatable Battery for the Assessment of Neuropsychological Status: a Simulation Study. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09382-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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