Concordance validity of PVTs in a sample of veterans referred for mild TBI

ABSTRACT

Concordance validity of commonly used performance validity tests (PVTs) was assessed in a sample of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans referred to an mTBI screening clinic in a south-eastern Veterans Affairs hospital. Veteran service members (total n = 184) completed the Rey-15, Repeatable Battery of the Assessment for Neuropsychological Status Effort Index (RBANS EI), and Reliable Digit Span (RDS) from the Wechsler Intelligence Scales. Kappa coefficients and percentage of agreement were established to determine the level of concordance between the three measures. PVT failure rate ranged from 7.4% of the sample (Rey-15) to 26.1% (RBANS EI Liberal). The highest concordance was found between the Rey 15 and RBANS EI “highly suspicious” cut-off, with the lowest agreement noted between all PVTs and the RBANS EI “liberal” cut-score. All concordance coefficients fell within the fair to moderate levels. Overall, the observed agreement between the explored measures was generally consistent with or greater than other studies of PVT concordance. Given the rates of concordance, the current results continue to suggest that PVTs are likely to measure a construct separate from the typical cognitive domains.

KEYWORDS:

• Concordance validity
• mild TBI
• performance validity
• veterans