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Objectives: This study investigated the Wechsler Adult Intelligence Scale-Fourth Edition Letter-Number Sequencing (LNS) subtest as an embedded performance validity indicator among adults undergoing an attention-deficit/hyperactivity disorder (ADHD) evaluation, and its potential incremental value over Reliable Digit Span (RDS). Method: This cross-sectional study comprised 543 adults who underwent neuropsychological evaluation for ADHD. Patients were divided into valid (n = 480) and invalid (n = 63) groups based on multiple criterion performance validity tests. Results: LNS total raw scores, age-corrected scaled scores, and age- and education-corrected T-scores demonstrated excellent classification accuracy (area under the curve of.84,.83, and.82, respectively). The optimal cutoff for LNS raw score (≤16), age-corrected scaled score (≤7), and age- and education-corrected T-score (≤36) yielded.51 sensitivity and.94 specificity. Slightly lower sensitivity (.40) and higher specificity (.98) was associated with a more conservative T-score cutoff of ≤33. Multivariate models incorporating both LNS and RDS improved classification accuracy (area under the curve of.86), and LNS scores explained a significant but modest proportion of variance in validity status above and beyond RDS. Chaining LNS T-score of ≤33 with RDS cutoff of ≤7 increased sensitivity to.69 while maintaining ≥.90 specificity. Conclusions: Findings provide preliminary evidence for the criterion and construct validity of LNS as an embedded validity indicator in ADHD evaluations. Practitioners are encouraged to use LNS T-score cutoff of ≤33 or ≤36 to assess the validity of obtained test data. Employing either of these LNS cutoffs with RDS may enhance the detection of invalid performance. [ABSTRACT FROM AUTHOR]

Using embedded performance validity (PVT) comparisons, Erdodi et al. suggested that Grooved Pegboard (GPB) T-score cutoffs for either hand ( ≤ 29) or both hands ( ≤ 31) could be used as additional embedded PVTs. The current study evaluated the relationship between these proposed cutoff scores and established PVTs (Medical Symptom Validity Test [MSVT]; Non-Verbal Medical Symptom Validity Test [NV-MSVT], and Reliable Digit Span [RDS]). Participants (N = 178) were predominately Caucasian (84%) males (79%) with a mean age and education of 41 (SD = 11.7) and 15.8 years (SD = 2.3), respectively. Participants were stratified as "passing" or "failing" the GPBviaErdodi's proposed criteria. "Failures" on the MSVT, NV-MSVT, and RDS were based on conventional recommendations. Moderate correlations between GPB classification and a condition of interest (COI; i.e. at least two failures on reference PVTs) were observed for dominant (χ2 (1, n = 178) = 34.72, ϕ =.44, p <.001), non-dominant (χ2 (1, n = 178) = 16.46, ϕ =.30, p =.001), and both hand conditions (χ2 (1, n = 178) = 32.48, ϕ =.43, p <.001). Sensitivity, specificity, and predictive power were generally higher than Erdodi et al.'s initial findings. These findingsprovide supportfor the clinical utility of the GPB as an additional embedded PVT. More specifically, dominant and both hand cutoffs were found to be more robust measures ofnon-genuine performance in those without motor deficits. While promising, sensitivity continues to be low; therefore, it is ill-advised to use the GPB as a sole measure of -performance validity. [ABSTRACT FROM AUTHOR]

Objective: The addition of Sequencing to WAIS-IV Digit Span (DS) brought about new Reliable Digit Span (RDS) indices and an Age-Corrected Scaled Score that includes Sequencing trials. Reports have indicated that these new performance validity tests (PVTs) are superior to the traditional RDS; however, comparisons in the context of known neurocognitive impairment are sparse. This study compared DS-derived PVT classification accuracies in a design that included adults with verified TBI. Methods: Participants included 64 adults with moderate-to-severe TBI (TBI), 51 healthy adults coached to simulate TBI (SIM), and 78 healthy comparisons (HC). Participants completed the WAIS-IV DS subtest in the context of a larger test battery. Results: Kruskal–Wallis tests indicated that all DS indices differed significantly across groups. Post hoc contrasts revealed that only RDS Forward and the traditional RDS differed significantly between SIM and TBI. ROC analyses indicated that RDS variables were comparable predictors of SIM vs. HC; however, the traditional RDS showed the highest sensitivity when approximating 90% specificity for SIM vs. TBI. A greater percentage of TBI scored RDS Sequencing < 1 compared to SIM and HC. Conclusion: In the context of moderate-to-severe TBI, the DS-derived PVTs showed comparable discriminability. However, the Greiffenstein et al. traditional RDS demonstrated the best classification accuracy with respect to specificity/sensitivity balance. This relative superiority may reflect that individuals with verified TBI are more likely to perseverate on prior instructions during DS Sequencing. Findings highlight the importance of including individuals with verified TBI when evaluating and developing PVTs. [ABSTRACT FROM AUTHOR]

Objective: Embedded validity measures are useful in neuropsychological evaluations but should be updated with new test versions and validated across various samples. This study evaluated Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) Digit Span validity indicators in post-deployment veterans. Method: Neurologically-intact veterans completed structured diagnostic interviews, the WAIS-IV, the Medical Symptom Validity Test (MSVT), and the b Test as part of a larger study. The Noncredible group included individuals who failed either the MSVT or the b Test. Of the total sample (N = 275), 21.09% failed the MSVT and/or b Test. Diagnostic accuracy was calculated predicting group status across cutoff scores on two Digit Span variables, four Reliable Digit Span (RDS) variables, and two Vocabulary minus Digit Span variables. Results: Digit Span age-corrected scaled score (ACSS) had the highest AUC (.648) of all measures assessed; however, sensitivity at the best cutoff of <7 was only 0.17. Of RDS measures, the Working Memory RDS resulted in the highest AUC (.629), but Enhanced RDS and Alternate RDS produced the highest sensitivities (0.22). Overall, cutoff scores were consistent with other studies, but sensitivities were lower. Vocabulary minus Digit Span measures were not significant. Conclusions: Digit Span ACSS was the strongest predictor of noncredible performance, and outperformed traditional RDS variants. Sensitivity across all validity indicators was low in this research sample, though cutoff scores were congruent with previous research. Although embedded Digit Span validity indicators may be useful, they are not sufficient to replace standalone performance validity tests. [ABSTRACT FROM AUTHOR]