Sensitivity and Specificity of a Digit Symbol Recognition Trial in the Identification of Response Bias

Kim, Nancy; Boone, Kyle Brauer; Victor, Tara L.; Lu, Po H.; Keatinge, Carolyn; Mitchell, Cary L.

doi:10.1093/arclin/acq040

Cited by 47 publications

(23 citation statements)

References 25 publications

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“…Future research would benefit from systematically examining these possible confounds. Etherton et al, 2006;N. Kim et al, 2010); BR Fail ϭ base rate of failure; SENS ϭ sensitivity; SPEC ϭ specificity.…”

Section: Discussionmentioning

confidence: 99%

Early bird fails the PVT? The effects of timing artifacts on performance validity tests.

Zuccato¹,

Tyson

Erdődi

2018

Psychological Assessment

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This study was designed to investigate the effects of timing on the likelihood of failing the Recognition Memory Test-Words (RMT) and Word Choice Test (WCT). The RMT and WCT were administered in counterbalanced order either at the beginning (Time 1) or at the end (Time 2) of a test battery to a mixed clinical sample of 196 patients (M = 44.5 years, 55.1% female) medically referred for neuropsychological evaluation. The risk of failing the accuracy score was higher at Time 1 on both the RMT (relative risk [RR]: 1.44-1.64) and the WCT (RR: 1.21-1.50) across a range of cutoffs. Likewise, the risk of failing the time-to-completion score was higher at Time 1 on both the RMT (RR: 1.30-1.94) and the WCT (RR: 1.58-3.75). Established cutoffs failed to reach specificity standards at Time 1; more liberal cutoffs cleared specificity thresholds at Time 2. According to our findings, the RMT and WCT may be prone to false-positive errors at Time 1. Conversely, when administered at Time 2, existing cutoffs may have lower sensitivity, but they are highly specific to invalid performance. Timing should be considered during both test selection and the interpretation of RMT and WCT scores. Using conservative cutoffs for morning administrations and liberal cutoffs for afternoon administrations may be necessary to neutralize timing artifacts. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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Section: Discussionmentioning

confidence: 99%

Early bird fails the PVT? The effects of timing artifacts on performance validity tests.

Zuccato¹,

Tyson

Erdődi

2018

Psychological Assessment

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“…Data were collected through a retrospective chart review in the clinical archives of the hospital's neuropsychology service. Identify- Erdodi, Tyson, et al, 2017;Etherton et al, 2006;Kim, Boone, Victor, Lu, et al, 2010); SS ACSS ϭ WAIS-IV Symbol Search age-corrected scaled score (Erdodi, Tyson, et al, 2017;Etherton et al, 2006).…”

Section: Methodsmentioning

confidence: 99%

Low scores on the Grooved Pegboard Test are associated with invalid responding and psychiatric symptoms.

Erdődi¹,

Seke²,

Shahein³

et al. 2017

Psychology & Neuroscience

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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.

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“…Failure on the symptom validity tests were classified as follows: (a) WMT: scores that fell below the cutoff scores recommended in the manual (Green, 2003); (b) TMT Part A time to completion >62 seconds (Iverson, Lange, Green, & Franzen, 2002); (c) CPT-II Omissions (raw score) >35 or Hit Reaction Time Standard Error (raw score) >16 (Ord, Boettcher, Greve, & Bianchini, 2010) (Etherton, Bianchini, Heinly, & Greve, 2006;Kim et al, 2010). Patients were classified as having failed symptom validity testing if they failed the WMT and failed one or more of the four embedded markers.…”

Section: Measures and Proceduresmentioning

confidence: 99%

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

Lange

Pancholi

Bhagwat

et al. 2012

Journal of Clinical and Experimental Neuropsychology

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The purpose of this study was to examine the influence of poor effort on neuropsychological test performance in military personnel following mild traumatic brain injury (MTBI). Participants were 143 U.S. service members who sustained a TBI, divided into three groups based on injury severity and performance on the Word Memory Test and four embedded markers of poor effort: MTBI-pass (n = 87), MTBI-fail (n = 21), and STBI-pass (n = 35; where STBI denotes severe TBI). Patients were evaluated at the Walter Reed Army Medical Center on average 3.9 months (SD = 3.4) post injury. The majority of the sample was Caucasian (84.6%), was male (93.0%), and had 12+ years of education (96.5%). Measures included the Personality Assessment Inventory (PAI) and 13 common neurocognitive measures. Patients in the MTBI-fail group performed worse on the majority of neurocognitive measures, followed by the Severe TBI-Pass group and the MTBI-pass group. Using a criterion of three or more low scores <10th percentile, the MTBI-fail group had the greatest rate of impairment (76.2%), followed by the Severe TBI-Pass group (34.3%) and MTBI-pass group (16.1%). On the PAI, the MTBI-fail group had higher scores on the majority of clinical scales (p < .05). There were a greater number of elevated scales (e.g., 5 or more elevated mild or higher) in the MTBI-fail group (71.4%) than in the MTBI-pass group (32.2%) and Severe TBI-Pass group (17.1%). Effort testing is an important component of postacute neuropsychological evaluations following combat-related MTBI. Those who fail effort testing are likely to be misdiagnosed as having severe cognitive impairment, and their symptom reporting is likely to be inaccurate.

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Sensitivity and Specificity of a Digit Symbol Recognition Trial in the Identification of Response Bias

Cited by 47 publications

References 25 publications

Early bird fails the PVT? The effects of timing artifacts on performance validity tests.

Early bird fails the PVT? The effects of timing artifacts on performance validity tests.

Low scores on the Grooved Pegboard Test are associated with invalid responding and psychiatric symptoms.

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

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