The Predictive Utility of Neuropsychological Symptom Validity Testing as It Relates to Psychological Presentation

Abstract

The present study examined the relationship between multiple neuropsychological symptom validity tests (SVTs) and psychological presentation. More formally, we set out to determine if performance on neuropsychological SVTs was related to psychological symptom credibility and which specific neuropsychological SVTs were most associated with noncredible psychological presentation. Archival records from 106 litigating examinees were utilized in this study. Our results illustrate that neuropsychological SVTs are modestly related to psychological symptom credibility and that specific neuropsychological SVTs are variably associated to this end. We conclude that when multiple, but not independent, neuropsychological SVTs are employed within the context of a neuropsychological examination, they do have clinical utility as it relates to credibility of psychological presentation and these constructs do share variance reciprocally in clinically meaningful ways. When independently employed, however, the observed relationship is modest at best. Hence, to place clinical opinion on firmer scientific grounds within the context of a neuropsychological examination, multiple cognitive SVTs, in hand with psychological test instruments that include validity indexes, are essential to derive opinion that is based on science rather than faith in the instance of litigation when an incentive to manifest disability for the sake of an external reward holds probable.

Key words:

• malingering
• mild traumatic brain injury
• neuropsychology
• Personality Assessment Inventory
• symptom validity testing

Notes

ns =Not significant; PAI (NIM) = Personality Assessment Inventory (Negative Impression Management Scale); PAI (ICN) = Personality Assessment Inventory (Inconsistency Scale); PAI (INF) = Personality Assessment Inventory (Infrequency Scale); PAI (PIM) = Personality Assessment Inventory (Positive Impression Management Scale); TOMM T1 = Test of Memory Malingering Trial 1; TOMM T2 = Test of Memory Malingering Trial 2; TOMM RT = Test of Memory Malingering Retention Trial; TMT-A (time) = Trail-Making Test Part A, time to completion (in seconds); TMT-A (error) = Trail-Making Test Part A errors; Rey-15 = Rey 15-Item Test; RDS (total) = Reliable Digit Span total score; RDS (forward) = Reliable Digit Span forward; RDS (backward) = Reliable Digit Span backward.

PAI (NIM) = Personality Assessment Inventory (Negative Impression Management Scale); PAI (ICN) = Personality Assessment Inventory (Inconsistency Scale); PAI (INF) = Personality Assessment Inventory (Infrequency Scale); PAI (PIM) = Personality Assessment Inventory (Positive Impression Management Scale); TOMM T1 = Test of Memory Malingering Trial 1; TOMM T2 = Test of Memory Malingering Trial 2; TOMM RT = Test of Memory Malingering Retention Trial; Rey-15 = Rey 15-Item Test; TMT-A (time) = Trail-Making Test Part A, time to completion (in seconds); TMT-A (error) = Trail-Making Test Part A errors; RDS (total) = Reliable Digit Span total score; RDS (forward) = Reliable Digit Span forward; RDS (backward) = Reliable Digit Span backward.

*Correlation is significant at the .05 level (two-tailed).

**Correlation is significant at the .01 level (two-tailed).