A-183 Base Rates of Performance and Symptom Validity Test Failures in Active Duty and Veteran Samples Referred for Attention-Deficit/Hyperactivity Disorder Evaluation

Objective To evaluate base rates of abnormal MMPI-2-RF symptom validity test (SVT) and stand-alone performance validity test (PVT) scores in active duty (ad) service member and Veterans Affairs clinical samples referred for neuropsychological assessment of ADHD. Method MMPI-2-RF SVT scores and various PVTs were evaluated in two samples referred specifically for assessment of ADHD: service members (N = 82) and Veterans (N = 355). SVT and PVT outcomes were then compared to published data establishing invalid base rates in larger, more general samples. Results Elevated MMPI-2-RF overreport scales (F-r ≥ 79; FS, RBS, and FBS-r ≥ 80; & Fp-r ≥ 70) ranged from 14.6% (FBS-r) to 40.0% (RBS) in the ad sample and 12.0% (FBS-r) and 28.9% (RBS) in the veteran sample. MMPI-2-RF profiles that were invalidated due to overreport (e.g., F-r = 120, all others ≥100) were under 5% on the veteran sample and no greater than 6.1% in the ad sample. Elevations on underreport scales were higher in the veteran sample (L-r = 12.9%, K-r = 2.0%) than the ad sample (L-r = 3.7%, K-r = 1.2%). In the ad sample, 21.5% failed one PVT and 6.3% failed two. In the Veteran sample, 23.4% failed one PVT. Conclusions Elevated MMPI-2-RF overreport scales were relatively common on ad and Veterans referred for ADHD evaluations. However, frequencies of elevated and invalidated scales were diminished relative to overall base rates reported in national data. Regarding PVT failure, both samples were lower than national average invalid rates. Despite the incentive inherent in ADHD exams, invalidity in both samples were consistently lower for both SVTs and PVTs.

Comparability and Validity of the Online and In-Person Administrations of the Inventory of Problems-29

While the psychometric equivalence of computerized versus paper-and-pencil administration formats has been documented for some tests, so far very few studies have focused on the comparability and validity of test scores obtained via in-person versus remote administrations, and none of them have researched a symptom validity test (SVT). To contribute to fill this gap in the literature, we investigated the scores of the Inventory of Problems-29 (IOP-29) generated by various administration formats. More specifically, Study 1 evaluated the equivalence of scores from nonclinical individuals administered the IOP-29 remotely (n = 146) versus in-person via computer (n = 140) versus in-person via paper-and-pencil format (n = 140). Study 2 reviewed published IOP-29 studies conducted using remote/online versus in-person, paper-and-pencil test administrations to determine if remote testing could adversely influence the validity of IOP-29 test results. Taken together, our findings suggest that the effectiveness of the IOP-29 is preserved when alternating between face-to-face and online/remote formats.

A Known-Groups Validation of the Medical Symptom Validity Test and Analysis of the Genuine Memory Impairment Profile

This study cross-validated the Medical Symptom Validity Test (MSVT) in a mixed neuropsychiatric sample and examined its accuracy for identifying invalid neuropsychological performance using a known-groups design. Cross-sectional data from 129 clinical patients who completed the MSVT were examined. Validity groups were established using six, independent criterion performance validity tests, which yielded 98 patients in the valid group and 31 in the invalid group. All MSVT subtest scores were significantly lower in the invalid group (η p2=.22-.39). Using published cut-scores, sensitivities of 42% to 71% were found among the primary effort subtests, and 74% sensitivity/90% specificity was observed for the overall MSVT. Among this sample, the MSVT component validity scales produced areas under the curve of .78-.86, suggesting moderate classification accuracy. At optimal cut-scores, the MSVT primary effort validity scales demonstrated 55% to 71% sensitivity/91% to 93% specificity, with the Consistency subtest exhibiting the strongest psychometric properties. The MSVT exhibited relatively robust sensitivity and specificity, supporting its utility as a briefer freestanding performance validity test to its predecessor, the Word Memory Test. Finally, the Genuine Memory Impairment Profile appears promising for patients with Major Neurocognitive Disorder, but is cautioned against for those without significant functional decline in activities of daily living at this time.

A-13 Demographic Differences in Performance Validity Test Failures

Objective The present study aimed to investigate demographic differences in performance validity test (PVT) failure in a Veteran sample. Method Data were extracted retrospectively from neuropsychological evaluations at a southeastern Veterans Affairs (VA) Medical Center. Only male Veterans who were either European American/White (EA) or African American/Black (AA), and for whom complete data were available were included in the study (N = 1271). We investigated whether performance on two frequently used PVTs, the Test of Memory Malingering (TOMM) and the Medical Symptom Validity Test (MSVT), significantly differed by age, education, race, and VA service connection using separate logistic regressions. Results Veterans with younger age, less education, and VA service-connected disability were significantly more likely to fail both PVTs. Race was not a significant predictor of MSVT failure, but AA patients were significantly more likely than EA patients to fail the TOMM. For all significant demographic predictors in the models, effects were small. In a subsample of patients who were given both PVTs (n = 467), the pattern of differences based on race remained; 46% of AA patients and 36% of EA patients failed the TOMM, while 44% of AA patients and 43% of EA patients failed the MSVT. Conclusions Performance on the TOMM and MSVT systematically differed based on demographics. Results were not consistent across PVTs, with performance on the TOMM differing between EA and AA patients, but performance on the MSVT did not differ by race. These results suggest that demographic factors may play a small but measurable role in performance on specific PVTs.

A-224 Clinical Utility of Grooved Pegboard as an Additional Embedded Measure of Performance Validity

Objective Previously, the Grooved Pegboard Test (GPB) has shown potential as an embedded measure of performance validity (PVT) using a T-score cutoff for either hand (≤ 29) or both hands (≤ 31). This study sought to validate these cutoffs with established PVTs (Medical Symptom Validity Test [MSVT], Non-Verbal Medical Symptom Validity Test [NV-MSVT], and Reliable Digit Span [RDS]). Method Subjects (N = 190) were primarily Caucasian (85%) and male (81%). Average age and education were 41 (SD = 11.62) and 16 years (SD = 2.35), respectively. Participants were stratified as GPB “pass or fail” based on previously proposed cutoff criteria. MSVT, NV-MSVT, and RDS were also dichotomized as pass or fail based on manual or conventional recommendations. Results Chi-Square analyses revealed significant associations between GPB “fails” for both hands and MSVT, NV-MSVT, and RDS (χ2 (1, n = 190) ranging from 5.80 to 15.98, Phi ranging from .18 to .29, p ranging from < .05 to < .0001). Similar findings were observed for dominant hand “fails”; however, non-dominant hand was only related to the MSVT. Sensitivity and specificity values from the GPB measures ranged from .47 to .58 and from .89 to .92, respectively. Positive and negative predictive power ranged from .38 to .45 and .93 to .94, respectively. Conclusion These data demonstrate the relative utility of the GPB as an embedded PVT. In particular, dominant and both hand cutoffs are likely to be more clinically useful in determining sub-optimal performance. However, as sensitivity is relatively low, this measure should not be employed as the sole PVT administered.