The Effects of Coaching on the Verbal and Nonverbal Medical Symptom Validity Tests

Abstract

Evaluation of resistance to coaching is an important step in the validation of symptom validity tests (SVTs) for clinical use in neuropsychological evaluations. In the present study coaching effects were evaluated for two recently developed SVTs, the Medical Symptom Validity Test (MSVT) and Nonverbal Medical Symptom Validity Test (NVMSVT) as compared with a well-validated existing SVT, the Test of Memory Malingering (TOMM). This study used a simulation design that included 103 healthy younger study volunteers who were randomly assigned into one of four conditions: Symptom Coaching, Test Coaching, Combined Coaching, or Best Effort Control. Specificity for all SVTs was excellent (96–100%). Test Coaching, either alone or combined with Symptom Coaching, was more effective than Symptom Coaching alone in producing raw scores suggestive of “better” effort for all SVTs. However, there were only modest declines in the obtained sensitivity, which remained above 80% for all SVTs. These results provide empirical support for the classification accuracy of the MSVT and NVMSVT, even when challenged with combined coaching interventions. However, further validation using known-groups designs and clinical samples is needed.

Keywords:

• Neuropsychological assessment
• Symptom validity assessment
• Forensic psychology
• Coaching

Acknowledgments

The authors would like to extend their gratitude to Dr. Paul Green for providing us with the MSVT and NVMSVT, as well as the students enrolled in the research methods unit who assisted with the data collection and processing.