Poor symptom and performance validity in regularly referred Hospital outpatients: Link with standard clinical measures, and role of incentives

Dandachi-FitzGerald, Brechje; Twillert, Björn van; Sande, Peter van de; Os, Yindee van; Ponds, Rudolf

doi:10.1016/j.psychres.2016.02.061

Cited by 29 publications

(18 citation statements)

References 28 publications

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“…Second, youth with significant psychotic symptoms and Marines with depression showed slightly lower MCVE on ER40, so caution is warranted in interpreting ER40 MCVE data in these populations. In contrast, lower MCVE from the Marines with psychosomatic/physical problems appears consistent with prior research showing that individuals with higher psychosomatic complaints have elevated rates of performance validity concerns (Dandachi-FitzGerald, van Twillert, van de Sande,van Os, & Ponds, 2016;Martin & Schroeder, 2020).…”

supporting

confidence: 88%

Development and Application of Novel Performance Validity Metrics for Computerized Neurocognitive Batteries

Jp¹,

Moore²,

Dr³

et al. 2021

Preprint

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Objective: Data from neurocognitive assessments may not be accurate in the context of factors impacting validity, such as disengagement, unmotivated responding, or intentional underperformance. Performance validity tests (PVTs) were developed to address these phenomena and assess underperformance on neurocognitive tests. However, PVTs can be burdensome, rely on cutoff scores that reduce information, do not examine potential variations in task engagement across a battery, and are typically not well-suited to acquisition of large cognitive datasets. Here we describe the development of novel performance validity measures that could address some of these limitations by leveraging psychometric modeling from data embedded within the Penn Computerized Neurocognitive Battery (PennCNB). Method: We first developed these validity measures using simulations of invalid response patterns with parameters drawn from real data. Next, we examined their application in two large, independent samples: 1) children and adolescents from the Philadelphia Neurodevelopmental Cohort (n=9,498); and 2) adult servicemembers from the Marine Resiliency Study-II (n=1,444). Results: Our performance validity metrics detected patterns of invalid responding in simulated data, even at subtle levels. Furthermore, a combination of these metrics significantly predicted previously established validity rules for these tests in both developmental and adult datasets. Moreover, most clinical diagnostic groups did not show reduced validity estimates. Conclusion: These results provide proof-of-concept evidence for multivariate, data-driven performance validity metrics. These metrics offer a novel method for determining the performance validity for individual neurocognitive tests that is scalable, applicable across different tests, less burdensome, and dimensional. However, more research is needed into their application.

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supporting

confidence: 88%

Development and Application of Novel Performance Validity Metrics for Computerized Neurocognitive Batteries

Jp¹,

Moore²,

Dr³

et al. 2021

Preprint

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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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“…This study is part of a larger research project on SVT/PVT failure in clinically referred hospital outpatients and how such failure relates to performance on standard clinical instruments and external incentives (Dandachi-FitzGerald, Van Twillert, Van De Sande, Van Os, & Ponds, 2015). In total, 31 neuropsychologists in five hospitals in the southern part of the Netherlands participated in the study.…”

Section: Participantsmentioning

confidence: 99%

“…All diagnostic assessments were conducted for clinical purposes. Detailed information about the patient sample is given in Dandachi-FitzGerald et al (2015).…”

Section: Participantsmentioning

confidence: 99%

Neuropsychologists’ ability to predict distorted symptom presentation

Dandachi-FitzGerald

Merckelbach

Ponds

2016

Journal of Clinical and Experimental Neuropsychology

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Poor symptom and performance validity in regularly referred Hospital outpatients: Link with standard clinical measures, and role of incentives

Cited by 29 publications

References 28 publications

Development and Application of Novel Performance Validity Metrics for Computerized Neurocognitive Batteries

Development and Application of Novel Performance Validity Metrics for Computerized Neurocognitive Batteries

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

Neuropsychologists’ ability to predict distorted symptom presentation

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