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Objective: Performance Validity Tests (PVTs) have been used to identify non-credible performance in clinical, medicolegal, forensic, and, more recently, academic settings. The inclusion of PVTs when administering psychoeducational assessments is essential given that specific accommodation such as flexible deadlines and increased writing time can provide an external incentive for students without disabilities to feign symptoms. Method: The present study used archival data to establish base rates of non-credible performance in a sample of post-secondary students (n = 1045) who underwent a comprehensive psychoeducational evaluation for the purposes of obtaining academic accommodations. In accordance with current guidelines, non-credible performance was determined by failure on two or more freestanding or embedded PVTs. Results: 9.4% of participants failed at least two of the PVTs they were administered, of which 8.5% failed two PVTs, and approximately 1% failed three PVTs. Base rates of failure for specific PVTs ranged from 25% (b Test) to 11.2% (TOVA). Conclusions: The present study found a lower base rate of non-credible performance than previously observed in comparable populations. This likely reflects the utilization of conservative criteria in detecting non-credible performance to avoid false positives. By contrast, inconsistent base rates previously found in the literature may reflect inconsistent methodologies. These results further emphasize the importance of administering multiple PVTs during psychoeducational assessments. The implications of these findings can further inform clinicians administering assessments in academic settings and aid in the appropriate utilization of PVTs in psychoeducational evaluation to determine accessibility accommodations. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study examined the effect of number of Performance Validity Test (PVT) failures on neuropsychological test performance among a demographically diverse Veteran (VA) sample (n = 76) and academic medical sample (AMC; n = 128). A secondary goal was to investigate the psychometric implications of including versus excluding those with one PVT failure when cross-validating a series of embedded PVTs. Method: All patients completed the same six criterion PVTs, with the AMC sample completing three additional embedded PVTs. Neurocognitive test performance differences were examined based on number of PVT failures (0, 1, 2+) for both samples, and effect of number of criterion failures on embedded PVT performance was analyzed among the AMC sample. Results: Both groups with 0 or 1 PVT failures performed better than those with ≥2 PVT failures across most cognitive tests. There were nonsignificant differences between those with 0 or 1 PVT failures except for one test in the AMC sample. Receiver operator characteristic curve analyses found no differences in optimal cut score based on number of PVT failures when retaining/excluding one PVT failure. Conclusion: Findings support the use of ≥2 PVT failures as indicative of performance invalidity. These findings strongly support including those with one PVT failure with those with zero PVT failures in diagnostic accuracy studies, given that their inclusion reflects actual clinical practice, does not reduce sample sizes, and does not artificially deflate neurocognitive test results or inflate PVT classification accuracy statistics. [ABSTRACT FROM AUTHOR]

Objective We sought to determine the accuracy of embedded performance measures for the D–KEFS Color Word Interference Test that were recently proposed by Eglit et al. In particular, we wanted to determine if these indices would be associated with a specificity of at least.90, an Area Under the Curve of at least.70 and a positive likelihood ratio of at least 2. Method: We used logistic regression to investigate how well these indices could distinguish persons with traumatic brain injury (n = 169) who were evaluated within 1-12 months after injury. All participants had been classified on the basis of at least three independent performance validity tests as valid performance (n = 145) or invalid performance (n = 24). Results: None of the three indices that Eglit et al. had proposed as embedded performance measures for the D–KEFS Color Word Interference Test achieved the a priori defined minimally acceptable level of specificity. One of them did meet the criteria for Area Under the Curve as well as positive likelihood ratio. Conclusion: The current results do not support the application of the Eglit et al. embedded performance validity measures for the D–KEFS Color Word Interference Test in the clinical evaluation of patients with traumatic brain injury. [ABSTRACT FROM AUTHOR]

Objective: Clinical evaluation for attention-deficit/hyperactivity disorder (ADHD) not only requires assessment of symptoms, but also consideration of the degree to which symptoms lead to impairment within various functional domains. However, ADHD evaluations in adulthood often rely on self-reported functional impairment, which might be vulnerable to malingering/noncredible responding. The present study utilized a clinical sample/known groups design to examine the relationship of noncredible presentation to functional impairment ratings by analyzing differential associations with both symptom and performance validity tests (SVTs and PVTs). Method: Participants were 168 postsecondary students who completed psychoeducational assessments for ADHD to determine their eligibility for academic accommodations and/or medications. Impairment ratings on the Weiss Functional Impairment Rating Scale (WFIRS) of 71 students who presented in a noncredible fashion were compared to 72 students who appeared to present credibly (controls) and 25 students diagnosed with ADHD who appeared to present credibly (clinical controls). Results: Relative to both control groups, individuals who presented noncredibly reported higher levels of disability on most functional domains and a higher percentage provided responses that fell in the impaired range on all functional domains of the WFIRS. Conclusions: Findings provide additional evidence that ADHD-related functional impairment ratings are susceptible to noncredible presentation and highlight the need for assessors to include both SVTs and PVTs in ADHD evaluations. [ABSTRACT FROM AUTHOR]

Objective: Prior research has suggested that treatment-resistant psychosis (TRP) may be a categorically distinct subtype from treatment-responsive psychotic disorders. However, relatively few studies have investigated the cognitive profile of individuals with TRP. Moreover, no prior studies have investigated the effectiveness of using the NIH Toolbox Cognition Battery (NTCB) for assessing cognition among psychiatric inpatients despite its promising efficiency and practicality in such settings. The current study aimed to investigate the validity of the NTCB and the associated cognitive profile of inpatients with TRP. Methods: Participants (N = 38) were administered the NTCB and a neuropsychological test battery. The Positive and Negative Syndrome Scale and the Routine Assessment of Patient Progress measured psychosis symptomatology and daily functioning, respectively. Results: Results showed deficits relative to normative values in fluid cognitive abilities using the NTCB, as predicted. There was strong convergent validity and adequate divergent validity between the NTCB subtests and corresponding neuropsychological measures, though no NTCB subtest correlated with performance on the Wisconsin Card Sorting Task. NTCB performance correlated with positive and disorganized symptoms of psychosis as well as daily functioning. Conclusions: Taken together, the NTCB appears to be a relatively strong tool for cognitive screening among psychiatric inpatients and may be used to identify which patients might benefit from further neuropsychological evaluation. [ABSTRACT FROM AUTHOR]

Objective: Apathy is a prominent syndrome across neurodegenerative diseases. The Dimensional Apathy Scale (DAS) assesses three apathy subtypes—executive, emotional, and initiation—and is sensitive and valid in amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD), and Parkinson's disease. This study describes the development of the brief DAS (b-DAS), which will enable apathy to be swiftly detected in the clinic. Method: 102 ALS and 102 AD patients' previously collected data were used. Mokken analyses were performed on item-level data of each informant/carer-rated DAS subscale (executive, emotional, and initiation) for the initial scale reduction. Item-total correlational analyses against standard apathy (convergent validity criteria) and depression (divergent validity criteria) measures and qualitative examination of items aided final item selection. Receiver operating curve analysis determined optimal cutoffs for the reduced subscales. Results: Mokken analyses suggested unidimensionality of each DAS subscale. Three items were removed that failed to satisfy monotone homogeneity model requirements, three items were removed due to validity criteria not being met, and six items were removed due to a combination of lower item scalability and item-total correlations. Item-theme examination further reduced the b-DAS to nine items, three per subscale, with a supplemental awareness deficit assessment being added. Sensitivity- and specificity-based optimal cutoffs were calculated for each b-DAS subscale. Conclusions: This study presents the b-DAS, an informant/carer-based robust yet short multidimensional apathy instrument with good convergent and divergent validity, with recommended clinical cutoffs. The b-DAS is appropriate for use in the clinic and for research to quickly and comprehensively screen for apathy subtype impairments. [ABSTRACT FROM AUTHOR]

Objective: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) assesses neurocognitive functioning in sports-related concussion. Previous work demonstrates ImPACT's validity indices detect poor effort at disproportionately higher rates in athletes with histories of attention deficit hyperactivity disorder (ADHD) or academic difficulties. The present study examines whether previously suggested 'dormant' validity indices, Word Memory Correct Distractors (WMCD), and Design Memory Correct Distractors (DMCD), reduce disproportionate invalidity in collegiate athletes with such histories.Method: Six seasons of ImPACT protocols were examined (n = 1727). Athletes were grouped by self-reported histories of ADHD, academic difficulties, or comorbid ADHD and academic difficulties. Chi-square analyses compared invalidity rates using existing validity indices and both standard and conservative cutoffs for WMCD and DMCD.Results: Using standard cutoffs for dormant indices (WMCD < 22, DMCD < 16) produced significant differences in rates of athletes identified as having an invalid protocol, with the comorbid group exhibiting the highest invalidity rate (63.2%) and the no history group producing the lowest (42.0%), χ2 (3) = 11.57, p <.01, Cramer's V = 0.08. This difference remained when utilizing conservative cutoffs (WMCD < 18, DMCD < 10), with the comorbid group again producing the highest (26.3%) and the no history group producing the lowest (10.4%), χ2 (3) = 15.64, p <.005, Cramer's V = 0.10.Conclusions: Student-athletes with self-reported histories of ADHD and academic difficulties are more likely to produce invalid protocols, even with dormant indices. These findings emphasize the difficulty in assessing validity in special populations of athletes and encourage further work in this area. [ABSTRACT FROM AUTHOR]