Evaluation of the classification accuracy of multiple performance validity tests in a mixed clinical sample

Abstract

The Test of Memory Malingering (TOMM) and Word Memory Test (WMT) are among the most well-known performance validity tests (PVTs) and regarded as gold standard measures. Due to the many factors that impact PVT selection, it is imperative that clinicians make informed clinical decisions with respect to additional or alternative PVTs that demonstrate similar classification accuracy as these well-validated measures. The present archival study evaluated the agreement/classification accuracy of a large battery consisting of multiple other freestanding/embedded PVTs in a mixed clinical sample of 126 veterans. We examined failure rates for all standalone/embedded PVTs using established cut-scores and calculated pass/fail agreement rates and diagnostic odds ratios for various combinations of PVTs using the TOMM and WMT as criterion measures. TOMM and WMT demonstrated the best agreement, followed by Word Choice Test (WCT). The Rey Fifteen Item Test had an excessive number of false-negative errors and reduced classification accuracy. The Digit Span age-corrected scaled score (DS-ACSS) had highest agreement. Findings lend further support to the use of a combination of embedded and standalone PVTs in identifying suboptimal performance. Results provide data to enhance clinical decision making for neuropsychologists who implement combinations of PVTs in a larger clinical battery.

Keywords:

• Classification accuracy
• performance validity tests
• Test of Memory Malingering
• Word Memory Test

Acknowledgments

This material is the result of work supported with resources and the use of facilities at the South Texas Veteran Health Care System (STVHCS) in San Antonio, TX. The authors acknowledge the contribution of the staff, trainees, and technicians who have contributed and the veterans who agreed to have their information included in the study.

Disclosure statement

The authors have no conflicts of interest to report, and none have any financial interest with the subject matter discussed in the manuscript. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.