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Making Sure Neuropsychological Data Are Meaningful: Use of Performance Validity Testing in Medicolegal and Clinical Contexts

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Abstract

Performance validity testing (PVT) is a standard of practice in situations where there are prominent secondary gain issues; however, it is suggested that their use may benefit neuropsychological evaluations in clinical contexts, as engagement in neuropsychological evaluations can affect the validity of testing and can occur for a variety of reasons outside of secondary gain issues. Several methods of embedded index development, as well as methods to combine them are discussed, including issues related to use of multiple indices. The potential limitations to administration of multiple indices are also explored. It is suggested that neuropsychological evaluations can benefit from PVT in regular clinical practice to assist with reaching firmer diagnostic conclusions by assuring test result validity.

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References

  • Axelrod, B. N., Fichtenberg, N. L., Millis, S. R., & Wertheimer, J. C. (2006). Detecting incomplete effort with Digit Span from the Wechsler Adult Intelligence Scale-Third Edition. The Clinical Neuropsychologist, 20, 513–523.

    Article  PubMed  Google Scholar 

  • Boone, K. B. (2009). The need for continuous and comprehensive sampling of effort/response bias during neuropsychological examinations. The Clinical Neuropsychologist, 23, 729–741.

    Article  PubMed  Google Scholar 

  • Boone, K. B. (2013). Clinical practice of forensic neuropsychology: an evidence-based approach. New York: Guilford Press.

    Google Scholar 

  • Bush, S. S., Ruff, R. M., Troster, A. I., Barth, J. T., Koffler, S. P., Pliskin, N. H., … Reynolds, C. R. (2005). Symptom validity assessment: practice issues and medical necessity NAN Policy & Planning Committee. Archives of Clinical Neuropsychology, 20, 419–426.

  • Carroll, L. J., Cassidy, J. D., Peloso, P. M., Borg, J., von Holst, H., Holm, L., … Paniak, C. (2004). Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43, 84–105.

  • Constantinou, M., Bauer, L., Ashendorf, L., Fisher, J. M., & McCaffery, R. J. (2005). Is poor performance on recognition memory effort measures indicative of generalized poor performance on neuropsychological tests? Archives of Clinical Neuropsychology, 20, 191–198.

    Article  PubMed  Google Scholar 

  • Dean, A. C., Victor, T. L., Boone, K. B., Philpott, L. M., & Hess, R. A. (2008). Dementia and effort test performance. The Clinical Neuropsychologist, 23, 133–152.

    Article  PubMed  Google Scholar 

  • Delis, A. C., Kramer, J. H., Kaplan, E., & Ober, B. (2000). California Verbal Learning Test (2nd ed.). San Antonio: Psychological Corporation.

    Google Scholar 

  • Dikmen, S. S., Machamer, J. E., Winn, H. R., & Temkin, N. R. (1995). Neuropsychological outcome at 1-year post head injury. Neuropsychology, 80–90.

  • Green, P. (2004). The manual for the Medical Symptom Validity Test for Windows. Edmonton: Green’s Publishing Inc.

    Google Scholar 

  • Greffenstein, M. F., Baker, J., & Gola, T. (1994). Validation of malingered amnesia measures with a large clinical sample. Psychological Assessment, 6, 218–224.

    Article  Google Scholar 

  • Greve, K. W., & Bianchini, K. J. (2002). Using the Wisconsin Card Sorting Test to detect malingering: an analysis of the specificity of two methods in nonmalingering normal and patient samples. Journal of Clinical and Experimental Neuropsychology, 24, 48–54.

    Article  PubMed  Google Scholar 

  • Heaton, R. K., Miller, S. W., Taylor, M. J., & Grant, I. (2004). Revised comprehensive norms for an expanded Halstead-Reitan Battery: demographically adjusted neuropsychological norms for African American and Caucasian Adults. Lutz: Psychological Assessment Resources, Inc.

    Google Scholar 

  • Heilbronner, R. L., Sweet, J. J., Morgan, J. E., Larrabee, G. J., Millis, S. R., & Conference Participants. (2009). American Academy of Clinical Neuropsychology consensus conference statement on the neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 23, 1093–1129.

    Article  PubMed  Google Scholar 

  • Howe, L. L. S., Anderson, A. M., Kaufman, D. A. S., Sachs, B. C., & Loring, D. W. (2007). Characterization of the Medical Symptom Validity Test in evaluation of clinically referred memory disorders patients. Archives of Clinical Neuropsychology, 22, 753–761.

    Article  PubMed  Google Scholar 

  • Larrabee, G. J. (2003). Detection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17, 410–425.

    Article  PubMed  Google Scholar 

  • Larrabee, G. J. (2008). Aggregation across multiple indicators improves the detection of malingering: relationship to likelihood ratios. The Clinical Neuropsychologist, 22, 666–679.

    Article  PubMed  Google Scholar 

  • Meyers, J. E., & Volbrecht, M. E. (2003). A validation of multiple malingering detection methods in a large clinical sample. Archives of Clinical Neuropsychology, 18, 261–276.

    Article  PubMed  Google Scholar 

  • Meyers, J. E., Volbrecht, M. E., Axelrod, B. N., & Reinsch-Boothby, L. (2011). Embedded symptom validity tests and overall neuropsychological test performance. Archives of clinical Neuropsychology, 26, 8–15.

    Article  PubMed  Google Scholar 

  • Millis, S. R. (2004). Evaluation of malingered neurocognitive disorders. In M. Rizzo & P. Eslinger (Eds.), Principles and practice of behavioral neurology and neuropsychology (pp. 1077–1089). Philadelphia: Saunders.

    Google Scholar 

  • Millis, S. R. (2009). What clinicians need to know about symptoms exaggeration, insufficient effort, and malingering: statistical and measurement matters. In J. E. Morgan & J. J. Sweet (Eds.), Neuropsychology of malingering (pp. 21–37). New York: Psychology Press.

    Google Scholar 

  • Millis, S. R., & Volinski, C. T. (2001). Assessment of response bias in mild head injury: beyond malingering tests. Journal of Clinical and Experimental Neuropsychology, 23, 809–828.

    Article  PubMed  Google Scholar 

  • Millis, S. R., Ross, S. R., & Ricker, J. H. (1998). Detection of incomplete effort on the Wechsler Adult Intelligence Scale-Revised: a cross validation. Journal of Clinical and Experimental Neuropsychology, 20, 167–173.

    Article  PubMed  Google Scholar 

  • Mittenberg, W., Theroux-Fichera, S., Zielinski, R. E., & Heilbronner, R. (1993a). Identification of malingered head injury on the Wechsler Adult Intelligence Scale, Revised. Professional Psychology: Research and Practice, 26, 491–498.

    Article  Google Scholar 

  • Mittenberg, W., Azrin, R., Millsaps, C., & Heilbronner, R. (1993b). Identification of malingered head injury on the Wechsler Memory Scale-Revised. Psychological Assessment, 5, 34–40.

    Article  Google Scholar 

  • Odland, A.P., Lammy, A.B..., Martin, P.K., Grote, C.L., & Mittenberg, W. (2015). Advanced administration and interpretation of multiple validity tests. Psychological Injury and the Law.

  • Rey, A. (1941). Psychological examination of traumatic encephalopathy. Archives De Psychologie, 28, 286–340.

    Google Scholar 

  • Rohling, M. L., Meyers, J. E., & Millis, S. R. (2003). Neuropsychological impairment following traumatic brain injury: a dose–response analysis. The Clinical Neuropsychologist, 17, 289–302.

    Article  PubMed  Google Scholar 

  • Schmidt, M. (1996). Rey Auditory and Verbal Learning Test; a handbook. Los Angeles: Western Psychological services.

    Google Scholar 

  • Schutte, C., & Axelrod, B. N. (2013). Use of embedded cognitive symptom validity measures in mild traumatic brain injury cases. In D. A. Carone & S. S. Bush (Eds.), Mild traumatic brain injury: symptom validity assessment and malingering (pp. 151–181). New York: Springer.

    Google Scholar 

  • Schutte, C., Millis, S. R., Axelrod, B. N., & Van Dyke, S. (2011). Derivation of a composite measure of embedded symptom validity indices. The Clinical Neuropsychologist, 25, 454–462.

    Article  PubMed  Google Scholar 

  • Tombaugh, T. N. (1996). Test of memory malingering. Toronto: Multi Health Systems.

    Google Scholar 

  • Victor, T. L., Boone, K. B., Serpa, J. G., Buehler, J., & Ziegler, E. A. (2009). Interpreting the meaning of multiple symptom validity test failure. The Clinical Neuropsychologist, 23, 297–313.

    Article  PubMed  Google Scholar 

  • Warrington, E. K. (1984). Recognition memory test manual. Berkshire: NFER-Nelson.

    Google Scholar 

  • Wechsler, D. (2008). Wechsler Adult Intelligence Scale (4th ed.). San Antonio: Psychological Corporation.

    Google Scholar 

Download references

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All three authors (Schutte, Axelrod, and Montoya) of this manuscript declare that they have no conflict of interest in authoring this manuscript.

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Correspondence to Christian Schutte.

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Gerald Young served as Action Editor for this paper

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Schutte, C., Axelrod, B.N. & Montoya, E. Making Sure Neuropsychological Data Are Meaningful: Use of Performance Validity Testing in Medicolegal and Clinical Contexts. Psychol. Inj. and Law 8, 100–105 (2015). https://doi.org/10.1007/s12207-015-9225-3

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  • DOI: https://doi.org/10.1007/s12207-015-9225-3

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