C - 49The Relationship Between Performance Validity Measures and Health Factors that Influence Overall Effort in Veterans During Neuropsychological Evaluations

Abstract Objective The number of women veterans seeking Veterans Health Administration services has substantially increased over the past decade. Neuropsychology remains an understudied area in the examination of gender differences. The present study sought to delineate similarities and differences in men and women veterans presenting for neuropsychological evaluation in terms of demographics, referral, medical conditions, effort, and outcome diagnosis. Method A database collected from an outpatient VA neuropsychology clinic from 2013 to 2019 was analyzed (n = 232 women, 2642 men). Additional analyses examined younger (n = 836 men, 155 women) and older (n = 1805 men, 77 women) age cohorts. Results Women veterans were younger and more educated than men, whereas men had higher prevalence of vascular risk factors. Both groups were most often referred from mental health clinics and memory was the most common referral question. Although men performed worse on performance validity measures, clinicians rated women as evidencing poorer effort on a cumulative rating based on formal and embedded performance validity measures, behavioral observations, and inconsistent test patterns. Older women reported more depressive symptoms than older men and were more commonly diagnosed with depression. Conclusions This exploratory study fills a gap in the understanding of gender differences in veterans presenting for neuropsychological evaluations. Findings emphasize consideration for the intersection of gender with demographics, medical factors, effort, and psychological symptoms by VA neuropsychologists. A better understanding of relationships between gender and these factors may inform neuropsychologists’ test selection, interpretation of behavioral observations, and diagnostic considerations to best treat women veterans.

Download Full-text

They’re not just little adults: The utility of adult performance validity measures in a mixed clinical pediatric sample

Applied Neuropsychology Child ◽

10.1080/21622965.2019.1685522 ◽

2019 ◽

pp. 1-11

Author(s):

Lea M. Ventura ◽

Samantha DeDios-Stern ◽

Alison Oh ◽

Jason R. Soble

Keyword(s):

Performance Validity ◽

Clinical Pediatric ◽

Adult Performance ◽

Validity Measures ◽

Performance Validity Measures

Download Full-text

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

10.31234/osf.io/64ucw ◽

2021 ◽

Author(s):

J. Cobb Scott ◽

Tyler M. Moore ◽

David R Roalf ◽

Theodore D. Satterthwaite ◽

Daniel H. Wolf ◽

...

Keyword(s):

Simulated Data ◽

Real Data ◽

Response Patterns ◽

Performance Validity ◽

Neurocognitive Tests ◽

Validity Measures ◽

Novel Method ◽

Performance Validity Measures ◽

Validity Tests ◽

Performance Validity Tests

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.

Download Full-text

Performance validity measures in clinical patients with aphasia

Journal of Clinical and Experimental Neuropsychology ◽

10.1080/13803395.2019.1579783 ◽

2019 ◽

Vol 41 (5) ◽

pp. 476-483 ◽

Cited By ~ 5

Author(s):

Thomas Bodner ◽

Thomas Merten ◽

Thomas Benke

Keyword(s):

Performance Validity ◽

Validity Measures ◽

Performance Validity Measures

Download Full-text

PGR - 2 Neuropsychology’s Role in Identifying Functional Neurological Disorder

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz036.02 ◽

2019 ◽

Vol 34 (6) ◽

pp. 828-828

Author(s):

J Mietchen ◽

A Kessler-Jones ◽

P Mission

Keyword(s):

Neurological Disorder ◽

Neuropsychological Evaluation ◽

Performance Validity ◽

Appropriate Treatment ◽

Increased Risk ◽

History Of ◽

Neuropsychological Evaluations ◽

Performance Validity Measures ◽

One Year ◽

Functional Neurological Disorder

Abstract Objective To outline the usefulness of neuropsychological evaluation in identifying functional neurological disorder. Functional neurological disorder accounts for an estimated 16% of neurology referrals and is a “crisis of neurology” (Edwards & Bhatia, 2012). Adolescents with a history of neurologic compromise, including autoimmune disorders, are at increased risk for comorbid functional neurological disorder (Reuber, Mitchell, Howlett, Crimlisk, & Grünewald, 2005). Method 16-year-old female with a history of Hoshimoto’s encephalopathy referred by her neurologist. Following diagnosis and treatment, she developed a constellation of symptoms, including wide set gait, nystagmus, incontinence, and dystonic episodes. She also reported lapses in memory that lasted a few minutes at a time. During these episodes, she forgot who her mother was and forgot details about her home, which resulted in panic. Results Two neuropsychological evaluations were completed over two years. Psychometric intelligence declined by two standard deviations compared to previous testing one year before. Her performance on memory tasks declined dramatically as well. Despite these declines, there was no decline in activities of daily living. She failed embedded and stand-alone performance validity measures (RDS = 4; TOMM = 29, 30, 28). These findings were described to her neurologist and psychiatrist and we discussed the importance of identifying functional symptoms in the context of her medical history. Conclusions Our evaluation identified significant discrepancies between neuropsychological performance and daily cognitive functioning. The memory lapses she described were inconsistent with any known etiology or illness. Neuropsychological evaluation identified symptoms of a functional nature and assisted in appropriate treatment planning.

Download Full-text