This study was designed to examine the clinical utility of critical items within the Recognition Memory Test (RMT) and the Word Choice Test (WCT). Archival data were collected from a mixed clinical sample of 202 patients clinically referred for neuropsychological testing (54.5% male; mean age = 45.3 years; mean level of education = 13.9 years). The credibility of a given response set was psychometrically defined using three separate composite measures, each of which was based on multiple independent performance validity indicators. Critical items improved the classification accuracy of both tests. They increased sensitivity by correctly identifying an additional 2-17% of the invalid response sets that passed the traditional cutoffs based on total score. They also increased specificity by providing additional evidence of noncredible performance in response sets that failed the total score cutoff. The combination of failing the traditional cutoff, but passing critical items was associated with increased risk of misclassifying the response set as invalid. Critical item analysis enhances the diagnostic power of both the RMT and WCT. Given that critical items require no additional test material or administration time, but help reduce both false positive and false negative errors, they represent a versatile, valuable, and time- and cost-effective supplement to performance validity assessment.

This study was designed to develop performance validity indicators embedded within the Delis-Kaplan Executive Function Systems (D-KEFS) version of the Stroop task. Archival data from a mixed clinical sample of 132 patients (50% male; M = 43.4; M = 14.1) clinically referred for neuropsychological assessment were analyzed. Criterion measures included the Warrington Recognition Memory Test-Words and 2 composites based on several independent validity indicators. An age-corrected scaled score ≤6 on any of the 4 trials reliably differentiated psychometrically defined credible and noncredible response sets with high specificity (.87-.94) and variable sensitivity (.34-.71). An inverted Stroop effect was less sensitive (.14-.29), but comparably specific (.85-90) to invalid performance. Aggregating the newly developed D-KEFS Stroop validity indicators further improved classification accuracy. Failing the validity cutoffs was unrelated to self-reported depression or anxiety. However, it was associated with elevated somatic symptom report. In addition to processing speed and executive function, the D-KEFS version of the Stroop task can function as a measure of performance validity. A multivariate approach to performance validity assessment is generally superior to univariate models. (PsycINFO Database Record

Results suggest that even a single error on the FCR is a reliable indicator of invalid responding. Further research is needed to investigate the clinical significance of the relationship between failing the FCR and level of self-reported psychiatric symptoms.

A link between noncredible responding and low scores on the Grooved Pegboard Test (GPB) is well documented in the clinical literature. However, no specific validity cutoffs have emerged in previous research. This study was designed to examine the classification accuracy of various demographically adjusted cutoffs on the GPB against established measures of performance validity. Analyses were based on a mixed clinical sample of 190 patients (52.1% female) medically referred for neuropsychological assessment. Mean age of participants was 44.1 years, with a mean education of 13.9 years. Criterion measures were the Recognition Memory Test and 3 composites based on several embedded validity indicators. A T score Յ29 for either hand or Յ31 on both hands were reliable markers of invalid performance (sensitivity ϭ .29 -.63; specificity ϭ .85-.91). Ipsative analyses revealed that these T score-based cutoffs have zero false positive rates. Failing these cutoffs had no consistent relationship with overall cognitive functioning. A moderate relationship between GPB failure and self-reported anxiety and depression emerged on face-valid screening measures. There was also a moderate relationship between GPB failure and Personality Assessment Inventory scales measuring somatic complaints, borderline traits, antisocial features, and substance use. The newly introduced GPB validity cutoffs were effective at separating credible and noncredible performance on neuropsychological testing. The complex relationship between failing the GPB and emotional problems is consistent with the psychogenic interference hypothesis. It may provide insight into the mechanism behind invalid responding and thus warrants further investigation.