Adherence to Validity Testing Recommendations in Neuropsychological Assessment: A Survey of INS and NAN Members

Hirst, Rayna B; Han, Cecilia S.; Teague, Anna M.; Rosen, Alexis S; Gretler, Julie; Quittner, Zoe

doi:10.1093/arclin/acx009

Cited by 21 publications

(21 citation statements)

References 27 publications

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“…In fact, a survey conducted by Martin et al (2015) found that neuropsychologists tend to administer an average of four to six PVTs. Similarly, Hirst et al (2017) recently reported that Veterans Affairs health care providers typically administer five to eight PVTs. Ultimately, the overall clinical presentation is generally considered not credible if multiple independent PVTs (typically two or more) do not look credible (Larrabee et al, 2019; Sherman et al, 2020).…”

Section: The Current Meta-analysismentioning

confidence: 99%

The Inventory of Problems–29 (IOP-29): A systematic review and bivariate diagnostic test accuracy meta-analysis.

Puente-López¹,

Pina²,

López‐Nicolás³

et al. 2023

Psychological Assessment

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29 (IOP-29) is a 29-item self-administered symptom validity test (SVT) that assesses the credibility of clinical presentations related to posttraumatic stress disorder, depression/anxiety, psychosis, cognitive impairment and combination thereof. To date, no publications have summarized the classification accuracy of the IOP-29 using a bivariate meta-analytical approach that preserves the twodimensional nature of the estimators. Our objective was to conduct a systematic review and bivariate diagnostic test accuracy meta-analysis of the IOP-29 according to the relevant guidelines. Twenty-one independent samples were included, with a total sample size of 4,163 participants. The results indicated that the IOP-29 is able to discriminate adequately between instructed simulators and healthy controls/clinical patients. Using the recommended cutoff (False Disorder Probability Score [FDS], ≥.50), a sensitivity of 82% was achieved, maintaining specificity at 93% (false positive rate of 7%). The language of the test and the type of comparison group have been identified as possible sources of heterogeneity. Specificity decreases for the non-English version of the IOP-29, for the FDS ≥ .30, and also decreases for studies using clinical controls, for all three cutoff scores. In general, our findings support the usefulness of the IOP-29 as an SVT; however, most of the included studies use a simulation design and have been coauthored by the test authors. Likewise, about half of the studies did not include bona fide patient controls but only nonclinical controls. The results obtained are highly promising, but further research, especially that using the criterion group paradigm, is recommended. Public Significance StatementFollowing a bivariate meta-analytic model, we have evaluated the discriminative ability of the IOP-29, a novel symptom validity test. The results obtained indicate that it is able to discriminate adequately between instructed simulators and healthy controls/clinical patients.

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Section: The Current Meta-analysismentioning

confidence: 99%

The Inventory of Problems–29 (IOP-29): A systematic review and bivariate diagnostic test accuracy meta-analysis.

Puente-López¹,

Pina²,

López‐Nicolás³

et al. 2023

Psychological Assessment

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“…As of 2015, surveys indicate that neuropsychologists, on average, administer four to six PVTs in total (i.e., three to four embedded PVTs and one to two stand-alone PVTs in each evaluation; Martin, Schroeder, & Odland, 2015 ). Within Veterans Affairs health settings, neuropsychologists report using five to eight PVTs ( Hirst et al, 2017 ), and when performance validity is assessed, 89% of neuropsychologists employ at least two PVTs ( Young, Roper, & Arentsen, 2016 ). Surveys of experts in neuropsychological validity testing also indicate an average number of eight PVTs in forensic neuropsychological evaluations ( Schroeder, Martin, & Odland, 2016 ).…”

Section: Invalid Presentation On Examination (Criterion B)mentioning

confidence: 99%

Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria

Sherman

Slick

Iverson

2020

Archives of Clinical Neuropsychology

248

193

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Objectives Empirically informed neuropsychological opinion is critical for determining whether cognitive deficits and symptoms are legitimate, particularly in settings where there are significant external incentives for successful malingering. The Slick, Sherman, and Iversion (1999) criteria for malingered neurocognitive dysfunction (MND) are considered a major milestone in the field’s operationalization of neurocognitive malingering and have strongly influenced the development of malingering detection methods, including serving as the criterion of malingering in the validation of several performance validity tests (PVTs) and symptom validity tests (SVTs) (Slick, D.J., Sherman, E.M.S., & Iverson, G. L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13(4), 545–561). However, the MND criteria are long overdue for revision to address advances in malingering research and to address limitations identified by experts in the field. Method The MND criteria were critically reviewed, updated with reference to research on malingering, and expanded to address other forms of malingering pertinent to neuropsychological evaluation such as exaggeration of self-reported somatic and psychiatric symptoms. Results The new proposed criteria simplify diagnostic categories, expand and clarify external incentives, more clearly define the role of compelling inconsistencies, address issues concerning PVTs and SVTs (i.e., number administered, false positives, and redundancy), better define the role of SVTs and of marked discrepancies indicative of malingering, and most importantly, clearly define exclusionary criteria based on the last two decades of research on malingering in neuropsychology. Lastly, the new criteria provide specifiers to better describe clinical presentations for use in neuropsychological assessment. Conclusions The proposed multidimensional malingering criteria that define cognitive, somatic, and psychiatric malingering for use in neuropsychological assessment are presented.

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“…The usefulness of PVTs and SVTs has been demonstrated in numerous studies, in particular in patients in which external incentives are present (Bianchini, Curtis, & Greve, 2006;Boone, 2013: Chapter 2), but also in psychological assessments of clinically referred patients (Dandachi-FitzGerald, van Twillert, van de Sande, van Os, & Ponds, 2016;Locke, Smigielski, Powell, & Stevens, 2008). Because of these findings, assessment validity has now become an integral part of a neuropsychological evaluation (Hirst et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Performance and Symptom Validity Assessment in Patients with Apathy and Cognitive Impairment

Dandachi-FitzGerald

Duits

Leentjens

et al. 2019

J Int Neuropsychol Soc

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Objective:Performance and symptom validity tests (PVTs and SVTs) measure the credibility of the assessment results. Cognitive impairment and apathy potentially interfere with validity test performance and may thus lead to an incorrect (i.e., false-positive) classification of the patient’s scores as non-credible. The study aimed at examining the false-positive rate of three validity tests in patients with cognitive impairment and apathy.Methods:A cross-sectional, comparative study was performed in 56 patients with dementia, 41 patients with mild cognitive impairment, and 41 patients with Parkinson’s disease. Two PVTs – the Test of Memory Malingering (TOMM) and the Dot Counting Test (DCT) – and one SVT – the Structured Inventory of Malingered Symptomatology (SIMS) – were administered. Apathy was measured with the Apathy Evaluation Scale, and severity of cognitive impairment with the Mini Mental State Examination.Results:The failure rate was 13.7% for the TOMM, 23.8% for the DCT, and 12.5% for the SIMS. Of the patients with data on all three tests (n = 105), 13.5% failed one test, 2.9% failed two tests, and none failed all three. Failing the PVTs was associated with cognitive impairment, but not with apathy. Failing the SVT was related to apathy, but not to cognitive impairment.Conclusions:In patients with cognitive impairment or apathy, failing one validity test is not uncommon. Validity tests are differentially sensitive to cognitive impairment and apathy. However, the rule that at least two validity tests should be failed to identify non-credibility seemed to ensure a high percentage of correct classification of credibility.

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Adherence to Validity Testing Recommendations in Neuropsychological Assessment: A Survey of INS and NAN Members

Abstract: Results highlight the need for continued training on the importance of validity testing practices across different countries and all assessment settings, and identify groups of neuropsychologists to whom training could be targeted to maximize effectiveness.

Cited by 21 publications

References 27 publications

The Inventory of Problems–29 (IOP-29): A systematic review and bivariate diagnostic test accuracy meta-analysis.

The Inventory of Problems–29 (IOP-29): A systematic review and bivariate diagnostic test accuracy meta-analysis.

Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria

Performance and Symptom Validity Assessment in Patients with Apathy and Cognitive Impairment

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