The Dangers of Failing One or More Performance Validity Tests in Individuals Claiming Mild Traumatic Brain Injury-Related Postconcussive Symptoms

Proto, Daniel; Pastorek, Nicholas J.; Miller, Brian; Romesser, Jennifer; Sim, Anita H.; Linck, John

doi:10.1093/arclin/acu044

Cited by 85 publications

(26 citation statements)

References 43 publications

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“…One procedure for overall classification is to require deviations on multiple tests (e.g., ArenasPinto et al, 2014;Axelrod & Wall, 2007;Grunseit, Perdices, Dunbar, & Cooper, 1994;Ingraham & Aiken, 1996;Proto et al, 2014). Several approaches have been adopted to determine the number of required deviations.…”

Section: Overall Classification As Impaired or Unimpairedmentioning

confidence: 99%

“…The familywise error issue also is prominent in the normative comparisons context (e.g., Berthelson, Mulchan, Odland, Miller, & Mittenberg, 2013;Bilder, Sugar, & Hellemann, 2014;Brooks, 2010;Crawford et al, 2007;Davis & Millis, 2014;Larrabee, 2008Larrabee, , 2014Loewenstein et al, 2006;Meyers et al, 2014;Naglieri & Paolitto, 2010;Palmer, Boone, Lesser, & Wohl, 1998;Proto et al, 2014;Schretlen et al, 2008). It has been argued that in clinical practice, lack of control over familywise error in normative comparisons may result in overdiagnosis and unnecessary treatment, increasing patient burden and unnecessary costs to the health care system (Binder et al, 2009;Brooks, Iverson, Holdnack, & Feldman, 2008;Gisslén, Price, & Nilsson, 2011;Torti, Focà, Cesana, & Lescure, 2011).…”

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confidence: 99%

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Normative comparisons for large neuropsychological test batteries: User-friendly and sensitive solutions to minimize familywise false positives

Huizenga

Rentergem

Grasman

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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Introduction. In neuropsychological research and clinical practice, a large battery of tests is often administered to determine whether an individual deviates from the norm. We formulate three criteria for such large battery normative comparisons. First, familywise false-positive error rate (i.e., the complement of specificity) should be controlled at, or below, a prespecified level. Second, sensitivity to detect genuine deviations from the norm should be high. Third, the comparisons should be easy enough for routine application, not only in research, but also in clinical practice. Here we show that these criteria are satisfied for current procedures used to assess an overall deviation from the norm-that is, a deviation given all test results. However, we also show that these criteria are not satisfied for current procedures used to assess test-specific deviations, which are required, for example, to investigate dissociations in a test profile. We therefore propose several new procedures to assess such test-specific deviations. These new procedures are expected to satisfy all three criteria. Method. In Monte Carlo simulations and in an applied example pertaining to Parkinson disease, we compare current procedures to assess test-specific deviations (uncorrected and Bonferroni normative comparisons) to new procedures (Holm, one-step resampling, and step-down resampling normative comparisons). Results. The new procedures are shown to: (a) control familywise false-positive error rate, whereas uncorrected comparisons do not; (b) have higher sensitivity than Bonferroni corrected comparisons, where especially step-down resampling is favorable in this respect; (c) be user-friendly as they are implemented in a user-friendly normative comparisons website, and as the required normative data are provided by a database. Conclusion. These new normative comparisons procedures, especially step-down resampling, are valuable additional tools to assess test-specific deviations from the norm in large test batteries.

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Section: Overall Classification As Impaired or Unimpairedmentioning

confidence: 99%

mentioning

confidence: 99%

Normative comparisons for large neuropsychological test batteries: User-friendly and sensitive solutions to minimize familywise false positives

Huizenga

Rentergem

Grasman

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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“…invalid performance in individuals with a history of TBI, and failure of even one of these PVTs warrants consideration of poor performance validity, particularly in individuals with a history of mTBI [51][52]. Aligned with standard scoring for the CVLT-II and the TOMM, participants were classified as failing PVTs if their performance fell below 45 on TOMM Trial 2 or the Retention Trial or below 15 on CVLT-II Forced Choice.…”

Section: Validity Indicatorsmentioning

confidence: 99%

Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

et al. 2016

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Abstract-A comprehensive evaluation, including the assessment of neurobehavioral symptoms, has been instituted at the Department of Veterans Affairs (VA) healthcare system to address the large number of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans returning with mild traumatic brain injuries (mTBIs). The Validity-10 is a measure of symptom overreporting embedded within the Neurobehavioral Symptom Inventory, a component of the comprehensive evaluation that assesses postconcussive symptom severity. The Validity-10 is composed of 10 unlikely/low-frequency items and a validated cutoff score to identify postconcussive symptom overreporting. We examined the items and cutoff used in the initial development and validation study of the Validity-10 through retrospective chart reviews of 331 treatment-seeking Veterans who sustained an mTBI. The Validity-10 exhibited significant relationships with psychiatric variables, VA service connection, and neuropsychological performance validity (all p < 0.01), but nonsignificant relationships with demographic and injury variables (all p > 0.05). Furthermore, the Validity-10 modestly predicted neuropsychological performance validity test failure over and above psychiatric comorbidities and VA service connection. The present study supports the use of the Validity-10 to assess symptom validity in treatment-seeking OIF/OEF Veterans with a history of mTBI.

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“…Indisputably, studies involving military service members show both high rates of 'psychological distress' and SVT/PVT failures (Cooper, et al 2014;French et al 2014;Proto et al 2014). Are these related?…”

Section: The Military Mtbi Conundrum and Svt/pvt Performancementioning

confidence: 99%

Neuroimaging as a biomarker in symptom validity and performance validity testing

Bigler

2015

Brain Imaging and Behavior

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How neuropsychological assessment findings are deemed valid has been a topic of numerous articles but few have addressed any role that neuroimaging studies could provide. Within military and various clinical samples of individuals undergoing neuropsychological evaluations, high levels of failure on measures of symptom validity testing (SVT) and/or performance validity testing (PVT) have been reported. Where 'failure' is defined as a below cut-score performance on some pre-determined set-point on a SVT/PVT measure, are such failures always indicative of invalid test findings or are there other explanations, especially based on informative neuroimaging findings? This review starts with the premise that even though the SVT/PVT task is designed to be simple and easy to perform, it nonetheless requires intact frontoparietal attention, working memory and task engagement (motivation) networks. If there is damage or pathology within any aspect of these networks as demonstrated by neuroimaging findings, the patient may perform below the cut-point as a result of the underlying damage or pathophysiology. The argument is made that neuroimaging findings should be considered as to where SVT/PVT cut-points are established and there should be much greater flexibility in SVT/PVT measures based on other personal, demographic and neuroimaging information. Several case studies are used to demonstrate these points.

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The Dangers of Failing One or More Performance Validity Tests in Individuals Claiming Mild Traumatic Brain Injury-Related Postconcussive Symptoms

Cited by 85 publications

References 43 publications

Normative comparisons for large neuropsychological test batteries: User-friendly and sensitive solutions to minimize familywise false positives

Normative comparisons for large neuropsychological test batteries: User-friendly and sensitive solutions to minimize familywise false positives

Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

Neuroimaging as a biomarker in symptom validity and performance validity testing

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