A-178 Might Tip-of-the-Tongue Responses on the Auditory and Visual Naming Test be a Useful Embedded Performance Validity Measure in the Language Domain?

Objective This study examined whether responses on the Auditory and Visual Naming Test (ANT/VNT) would discriminate between veterans with invalid and valid test performance, thus suggesting a novel embedded performance validity test (PVT) for a language task. Method Veterans who completed the ANT/VNT and failed two or more PVTs were selected for inclusion, resulting in a sample of 9 veterans (8 males; Mage = 55.8, SD = 11.5; Medu = 12.7, SD = 2.1). An age-and education-matched group of 9 cognitively unimpaired veterans who passed PVTs (7 males; Mage = 56.1, SD = 11.5; Medu = 14.0, SD = 2.4) were selected from a database of patients from the same clinical setting. Variables of interest included tip-of-the-tongue (TOT) responses (responses with a latency between 2 and 20 seconds) and Total Correct responses for the ANT/VNT. Results Groups were comparable on demographic characteristics and there were no statistical differences in Total Correct responses on ANT/VNT. The invalid group had more TOT on both the visual (M = 4.2, SD = 3.8) and auditory (M = 14.4,SD = 9.7) tasks, as compared to the valid group (Mvisual = 0.7, SD = 0.7; Mauditory = 4.9,SD = 2.7). ROC curve analysis for detecting invalid performance was significant for both VNT-TOT (AUC = 0.79, p = 0.038) and ANT-TOT (AUC = 0.88, p = 0.006). A cutoff of 1 was optimal for VNT-TOT (sensitivity = 0.67, specificity = 0.89), while 6 was optimal for ANT-TOT (sensitivity = 0.89, specificity = 0.89). Conclusions Despite the small sample size, findings are promising regarding the utility of ANT/VNT TOT responses as embedded PVTs. These should be further explored since the field is in need of validity measures embedded within language/naming tasks. Visual Naming Test may be particularly useful given that it can take less than 5 minutes to administer.

A-182 Development of a PTSD-Specific Embedded Validity Measure in the Personality Assessment Inventory

Objective/Background The present study investigated the feasibility of developing a PTSD-specific malingering scale embedded within the Personality Assessment Inventory (PAI). Methods Participants consisted of 489 individuals [mean age = 20.0 (SD = 3.29); 71% female; 73.0% Caucasian, 17.6% African American, 3.5%, 9.4% Other] who completed PAI. 274 individuals were in the control group and instructed to answer normally while 215 were instructed to simulate PTSD with intent to successfully feign PTSD in the context of a legal case. The following were identified as candidate PAI subscales for logistic regression to identify feigned PTSD: ARD-T, BOR-A, SCZ-T, ANX-P, and DEP-P. Results Logistic regression analysis was performed with known group as the dependent variable and PAI subtest normed T-scores as predictor variables. The final full model of five predictor variables significantly predicted group status (χ2 = 384.9, df = 5, N = 489, p < 0.001). The model accounted for 54.5% to 73.0% of the variance (Cox and Snell R2 = 0.545; Nagelkerke R2 = 0.730) in performance classification with overall 89.4% of individuals correctly predicted to their known group. At a cut value of 0.65 the specificity was 94.9%, and the sensitivity was 82.3%. Within the model, the following variables were incrementally predictive of group membership: ARD-T (B = 0.05, p < 0.001), BOR-A (B = 0.04, p < 0.05), and ANX-P (B = 0.04, p < 0.05). Conclusions Preliminary evidence for use of an embedded PAI malingering scale within the PAI was found. Further replication is needed in clinical populations prior to use in practice.

A-113 Evaluation of a Recognition Trial for the Symbol Digit Modalities Test as a Performance Validity Measure in Monolingual and Bilingual Traumatic Brain Injury Survivors

Objective Research shows that traumatic brain injury (TBI) patients perform worse than healthy comparisons (HC) on the Symbol Digit Modalities Test (SDMT). We evaluated cut-off scores for a newly developed recognition trial of the SDMT as a performance validity assessment in monolingual and bilingual TBI survivors and HC adults. Method The sample consisted of 43 acute TBI (ATBI; 24 monolinguals; 19 bilinguals), 32 chronic TBI (CTBI; 13 monolinguals; 19 bilinguals), and 57 HC (24 monolinguals; 33 bilinguals) participants. All participants received standardized administration of the SDMT. None of the participants displayed motivation for feigning cognitive deficits. Results The HC group outperformed both TBI groups on the demographically adjusted SDMT scores, p = 0.000, ηp2 = 0.24. An interaction emerged in SDMT scores where monolingual ATBI outperformed bilingual ATBI and bilingual CTBI outperformed monolingual CTBI, p = 0.017, ηp2 = 0.06. No differences were found in the SDMT recognition trial. Both Bichlmeier and Boone’s suggested cut-off scores had different failure rates in ATBI (Bichlmeier: 77%; Boone: 37%), CTBI (Bichlmeier: 69%; Boone: 19%), and HC (Bichlmeier: 56%; Boone: 26%). For the monolingual group (Bichlmeier: 66%; Boone: 36%) and the bilingual group (Bichlmeier: 66%; Boone: 21%). Finally, chi-squared analysis revealed monolingual TBI had greater failure rates than the bilingual ATBI. Conclusion Bichlmeier’s proposed cut-off score resulted in greater failure rates in TBI survivors compared to Boone’s suggested cut-off score. Furthermore, monolingual ATBI were influenced more by Bichlmeier’s cut-off score than the bilingual ATBI group, although the reason for this finding is unclear and requires additional study with a larger sample size.

Supporting Persons With Severe Dementia in Communicating Their Preferences

Government mandates require US nursing homes to provide preference-based, person-centered care. Persons with dementia (PWD) are less likely to have a role in preference assessments (PAs) used for care planning due to communication challenges associated with the disease. Thus, PWD are at risk of receiving de-personalized treatments. External supports (photograph and text cues) are known to improve communication in PWD. Yet these cues have never been studied with widely used PAs, such as the MDS 3.0 Section F and Preferences for Everyday Living Inventory (PELI). This study examined the effect of two PA conditions (externally supported; standard verbal) on preference consistency and response types (off-topic, clarification requests, elaboration) of residents with severe dementia (N=21) (BIMS < 7) when assessed twice, one-week apart. PA questions were derived from the MDS 3.0 Section F and PELI. As a social validity measure, naïve judges (N=10) listened to interviews and rated residents’ communication clarity and their confidence understanding residents’ preferences. Results showed that neither condition promoted significantly greater levels of consistency over time. Residents’ ‘clarification requests’ were significantly fewer with use of external supports. Other response types were not significantly different across conditions. Judges’ ratings were not significantly different across conditions; however, they rated residents’ communication as clear and understandable overall. This study addresses a gap in current research and holds important implications for helping providers meet government mandates and enhance care plan participation by residents with severe dementia and other communication challenges.

Validating Accelerometers for the Assessment of Body Position and Sedentary Behavior

There is growing evidence that sedentary behavior is a risk factor for somatic and mental health. However, there is still a lack of objective field methods, which can assess both components of sedentary behavior: the postural (sitting/lying) and the movement intensity part. The purpose of the study was to compare the validity of different accelerometers (ActivPAL [thigh], ActiGraph [hip], move [hip], and move [thigh]). 20 adults (10 females; age 25.68 ± 4.55 years) participated in a structured protocol with a series of full- and semistandardized sessions under laboratory conditions. Direct observation via video recording was used as a criterion measure of body positions (sitting/lying vs. nonsitting/lying). By combining direct observation with metabolic equivalent tables, protocol activities were also categorized as sedentary or nonsedentary. Cohen’s kappa was calculated as an overall validity measure to compare accelerometer and video recordings. Across all conditions, for the measurement of sitting/lying body positions, the ActivPAL ([thigh], ĸ = .85) and Move 4 ([thigh], ĸ = .97) showed almost perfect agreement, whereas the Move 4 ([hip], ĸ = .78) and ActiGraph ([hip], ĸ = .67) showed substantial agreement. For the sedentary behavior part, across all conditions, the ActivPAL ([thigh], ĸ = .90), Move 4 ([thigh], ĸ = .95) and Move 4 ([hip], ĸ = .84) revealed almost perfect agreement, whereas the ActiGraph ([hip], ĸ = .69) showed substantial agreement. In particular, thigh-worn devices, namely the Move and the ActivPAL, achieved up to excellent validity in measuring sitting/lying body positions and sedentary behavior and are recommended for future studies.

A-72 Cross Validation of the Automated Neuropsychological Assessment Metrics (ANAM) Performance Validity Measure in Active Duty Service Members

Objective The Automated Neuropsychological Assessment Metrics (ANAM) is the currently mandated Neurocognitive Assessment Tool (NCAT) for the Department of Defense for pre-deployment baseline testing and is the recommended tool for post-concussion evaluation and return to duty decision making. An ANAM performance validity measure has undergone initial validation (Roebuck-Spencer, Vincent, Gilliland, Johnson and Cooper, 2013). However, cross validation in other samples is warranted, particularly in order to establish cut-points for utilization in the evaluation of mTBI/concussion. The current study retrospectively examined the operating characteristics of the ANAM PVI relative to a more established performance validity test (PVT) in a sample of active duty Service Members referred for neurocognitive screening postconcussion in an Army brain injury clinic. Method Retrospective review of 172 US Service Members referred for neurocognitive screen for possible mild traumatic brain injury/concussion on average 3.8 years post injury (range = 8 days to 27 years) and administered the ANAM, Word Memory Test (WMT), and Neuropsychological Assessment Battery Screening Module (NAB-S). Results Utilizing the WMT as the criterion measure, ROC analysis was significant with AUC = 0.894 (p < 0.001). At 90.09% specificity (95% CI = 83.0% - 94.9%), the optimal cut-point was ANAM PVM ≥ 6, and resulted in 67.21% sensitivity (95% CI = 54.0% - 78.7%). Conclusions The standard ANAM PVI clinical report utilizes a cut-point of 14; however, the current data indicate a cut-point of ≥ 6 may be better suited for patients with mTBI/concussion.

An Assessment of Group Size in Interteaching

A key component of interteaching, as described by Boyce and Hineline (2002), is the opportunity for students to participate in "dyadic" or pair discussions. Although the rationale for pair discussions is evident, only one study to date has evaluated the relative effectiveness of student performance when group size is manipulated. The present investigation was designed to further evaluate the effect of group size during pair discussions on student quiz scores in an introductory psychology course with a diverse group of learners. An alternating treatments design was implemented whereby students were assigned to work in a dyad or in groups of 4-5 students to discuss a preparation guide. All of the major components of interteaching were in effect during both conditions (i.e., availability of prep guides and quality points, clarifying lectures, and frequent test probes). Results showed a small advantage for performance following discussion in dyads, although a social validity measure indicated students favored discussion in larger groups. Implications of these findings and suggestions for future work will be discussed.