Cognitive “success” in the setting of performance validity test failure

ABSTRACT

Background

Although studies have shown unique variance contributions from performance invalidity, it is difficult to interpret the meaning of cognitive data in the setting of performance validity test (PVT) failure. The current study aimed to examine cognitive outcomes in this context.

Method

Two hundred and twenty-two veterans with a history of mild traumatic brain injury referred for clinical evaluation completed cognitive and performance validity measures. Standardized scores were characterized as Within Normal Limits (≥16^th normative percentile) and Below Normal Limits (<16^th percentile). Cognitive outcomes are examined across four commonly used PVTs. Self-reported employment and student status were used as indicators of “productivity” to assess potential functional differences related to lower cognitive performance.

Results

Among participants who performed in the invalid range on Test of Memory Malingering trial 1, Word Memory Test, Wechsler Adult Intelligence Scale-Fourth Edition Digit Span aged corrected scaled score, and the California Verbal Learning Test-Second Edition Forced Choice index, 16–88% earned broadly within normal limits scores across cognitive testing. Depending on which PVT measure was applied, the average number of cognitive performances below the 16^th percentile ranged from 5 to 7 of 14 tasks. There were no differences in the total number of below normal limits performances on cognitive measures between “productive” and “non-productive” participants (T = 1.65, p = 1.00).

Conclusions

Results of the current study suggest that the range of within normal limits cognitive performance in the context of failed PVTs varies greatly. Importantly, our findings indicate that neurocognitive data may still provide important practical information regarding cognitive abilities, despite poor PVT outcomes. Further, given that rates of below normal limits cognitive performance did not differ among “productivity” groups, results have important implications for functional abilities and recommendations in a clinical setting.

KEYWORDS:

• Performance validity tests
• cognition
• test interpretation

Acknowledgments

This material is based upon work supported in part by the United States (U.S.) Department of Veterans Affairs Merit Review Awards Numbers I01 CX001820 (PI Scheibel, RS). The views in this article are those of the authors and do not reflect the official policy or position of the Department of Defense, the Veterans Affairs Administration, nor the United States Government. The authors thank the study volunteers for their participation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

All data and materials (as well as software application or custom code) support the claims herein and comply with field standards. Data sharing may be requested (but cannot be guaranteed, based on institutional polices): The data that support the findings of this study may be available upon submission of a reasonable request and the receipt of necessary approvals. Data were analyzed using JMP, version 14.0.0 statistical program. This study’s design and its analysis were not pre-registered

Additional information

Funding

This work was supported by the Department of Veterans Affairs Merit Review Awards [I01 CX001820].