The A-Test: A Symptom Validity Indicator Embedded Within a Mental Status Examination for Social Security Disability

Abstract

During the Psychological Consultative Examination (PCE) for Social Security Disability evaluations, there is a need for symptom validity measures to validate the findings for claims of disability (Chafetz, 2010). The “A” Random Letter Test of Auditory Vigilance (A-Test) is a simple auditory continuous performance test utilized as part of a comprehensive mental status examination (Strub & Black, 1993). The present study validates the use of the A-Test as a symptom validity measure easily administered as part of the PCE for Social Security Disability evaluations. This study shows that the A-Test is well correlated with other symptom validity measures, discriminates multiple symptom validity failure from nonmultiple failure, and has good classification accuracy statistics in two different studies of these claimants. The A-Test can thus easily be used as a symptom validity measure in professional psychological examinations of Social Security claimants without additional cost or much added time to the evaluation.

Key words:

• assessment/diagnosis
• disabilities
• embedded measures
• Social Security
• symptom validity testing

ACKNOWLEDGEMENTS

I would like to thank F. William Black, Richard Root, and Christina Binder for helpful and insightful commentary on an earlier draft of this article. I am also grateful for their support of these ideas.

Notes

¹The starting and ending (analyzed) sample sizes in each study after subjects with missing data removed (TOMM and MSVT studies) and truly impaired profile subjects removed (MSVT study only). The final (second number) sample sizes were analyzed.

Notes. TOMM Study (n = 113); MSVT Study (n = 44); RDS-T (TOMM study); RDS-M (MSVT-study); IR = Immediate Recognition; DR = Delayed Recognition; Con = Consistency.

*p < .05. **p < .01. ***p < .001.

Note. Means (±SD) [n].

*p < .05. **p < .01.

Note. Means (±SD) [n].

*p < .05. **p < .01. ***p < .001.

Sens = Sensitivity; Spec = Specificity; PP+/– = Positive and Negative Predictive Power.