Noncredible effort on the Nonverbal-Medical Symptom Validity Test (NV-MSVT): Impact on cognitive performance in pediatric mild traumatic brain injury

A comparison of MVP and MSVT performance among a diverse clinical pediatric sample

The Memory Validity Profile (MVP) and Medical Symptom Validity Test (MSVT) are performance validity tests (PVTs) used to identify potential noncredible test performance during psychological evaluations. This study sought to examine the agreement between MVP and MSVT pass rates, as well as to determine if there are differences in MVP pass rates when using the cutoff score in the MVP professional manual compared with the experimental cutoff score of <31. Via retrospective review of records, 106 clients at a private neuropsychological clinic who had been given the MVP and the MSVT were identified. Results indicated that only one client met the manual cutoff scores, compared to 20 clients who failed the MSVT, raising concerns regarding the sensitivity of the MVP. Utilizing the receiver operator characteristic (ROC), curve analyses indicated fair discriminability of the MVP for the 106 participants (AUC = .717) with acceptable sensitivity (.50) and specificity (.92) for an MVP total score cutoff of <31. These findings support the utility of the experimental cut score in improving the sensitivity while maintaining adequate specificity in a clinically mixed population.

Replicating a Meta-Analysis: The Search for the Optimal Word Choice Test Cutoff Continues

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.

Performance on the Memory Validity Profile in a mixed clinic-referred pediatric sample

The primary purpose of this study was to evaluate performance on the Memory Validity Profile (MVP) in a mixed pediatric clinical population. Goal 1, assessing MVP pass rates, yielded a slightly higher pass rate (98.58%) compared to research on other performance validity tests (PVTs) in youth when using manual-based cutoffs and a slightly lower pass rate (84.40%) using an experimental cutoffs (PASS Total ≥31) similar to others' research. Goal 2, determining if MVP performance was contingent on variables other than effort, yielded significant differences in age, sex, and intelligence (p < 0.05); but not parental education or occurrence/nonoccurrence of previous neurological issues, ADHD, or psychiatric disorders. Goal 3, investigating the agreement of an embedded PVT (Children and Adolescent Memory Profile [ChAMP] List Recognition [LR] subtest) with the MVP in classification of adequate vs. suboptimal effort, showed that the highest levels of consistency (81%) were achieved when experimental MVP and LR ss ≤5 cutoffs were utilized. In conclusion, the MVP is a useful tool in detecting suboptimal effort in children in a broad clinical sample and the ChAMP LR subtest adds to identification of suboptimal effort as an ePVT with the MVP. The established cutoffs stated in the MVP manual should be used, as these better identify suboptimal effort in children by age than experimental cutoffs (i.e., 31 and 32 PASS). The ChAMP LR cutoff should be ss ≤5, with MVP manual-based (75%) or experimental cutoffs (81%).