The Digit Span subtest was significantly revised for the WAIS-IV as an ordinal sequencing trial was added to increase working memory demands. The present investigation sought to validate an expanded version of Reliable Digit Span (RDS-R) as well as age-corrected scaled score (ACSS) from the recently revised Digit Span. Archival data were collected from 259 veterans completing the WAIS-IV Digit Span subtest and Word Memory Test (WMT). Veterans failing the WMT performed significantly worse (p < .001) on the ACSS, RDS-R, and traditional RDS. Operational characteristics of the ACSS, RDS-R, and RDS were essentially equivalent; however, sensitivity was quite modest when selecting cutoffs with strong specificity. While current results suggest that Digit Span effort indices can contribute to the detection of suboptimal effort, additional symptom validity indicators should be employed to compensate for limited sensitivity.
Base rate estimates for SPVT failure in VA disability exams are comparable to those in other medicolegal settings. However, failure in routine clinical exams is much higher in the VA than in other settings, possibly reflecting the hybrid nature of the VA's role in both healthcare and disability determination. Generally speaking, VA neuropsychologists use SPVTs frequently and eschew pejorative terms to describe their failure. Practitioners who require only one SPVT failure to establish response bias may overclassify patients. Those who use few or no SPVTs may fail to identify response bias. Additional clinical and theoretical implications are discussed.
Adults with attention-deficit/hyperactivity disorder (ADHD) are frequently prescribed stimulant medication and eligible for accommodations at work or school that serve as potent incentives to feign ADHD symptoms. The current investigation examined the predictive validity of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity scales in detecting and accurately classifying individuals attempting to feign ADHD. An archival ADHD clinical group (n = 34), normal control group (n = 37), and group instructed to feign ADHD symptoms (n = 32) completed the MMPI-2 and ADHD Current and Childhood Symptoms Scales. Behavior rating scales were unable to differentiate the clinical group from the simulated malingering group. Logistic regressions revealed that Infrequency-Psychopathology scale best detected response bias, followed by Infrequency scale, Back-Infrequency scale, Response Bias Scale (RBS), Henry-Heilbronner Index scale (HHI), and Fake Bad Scale (FBS). Results also indicate that recommended cutoffs for HHI, RBS, and FBS display inadequate sensitivity and specificity. Nevertheless, the MMPI-2 offers a number of validity indices that may assist in detecting individuals attempting to feign ADHD.
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