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To explore whether schizotypal traits may undermine source monitoring for actions, 67 undergraduate participants (21 men) completed the Schizotypal Personality Scale and were then given a source-monitoring task in which some specific acts had to be performed, whereas others only had to be imagined. Next, participants had to complete an old-new recognition task and ascribe the source, i.e., whether they had performed or only imagined the items (i.e., source monitoring). Participants also completed a working memory capacity task (i.e., Operation Span task). We found that the higher the Schizotypal Personality Scale scores, the poorer recognition and source attribution scores. Relative to participants with low levels of schizotypal traits (i.e., controls), those with higher levels of schizotypal traits more often falsely claimed to have performed actions when in fact they had only imagined them. Although participants high and low in schizotypical traits did not differ in their working memory capacity, poor working memory capacity was related to source misattribution (i.e., increase false alarms). The present findings indicate that schizotypal traits undermine source monitoring for action in a healthy population. [ABSTRACT FROM AUTHOR] more...

Objective: Performance below the actual abilities of the examinee can be measured using performance validity tests (PVTs). PVT failure negatively impacts the quality of the neuropsychological assessment. In our study, we addressed this issue by providing a brief corrective statement regarding invalidity to improve test-taking behavior. Methods: This study is a multisite single-blind randomized controlled trial in a consecutive sample of clinically referred adult patients ( N  = 196) in a general hospital setting. Patients who failed a PVT ( n  = 71) were randomly allocated to a corrective statement approach (CS; n  = 39), in which a brief verbal corrective statement was given by the technician, or received no corrective statement upon indications of invalid performance (NO-CS; n  = 32). Both groups (CS and NO-CS) were provided with the same subsequently repeated and newly administered tests. Results: There were no group (CS vs. NO-CS) differences on both the repeated and single-administered PVTs and standard cognitive tests. Furthermore, invalid performing participants benefited significantly less from the repeated test administration compared to the valid performing group. Conclusions: Our study found that a brief corrective within-session statement, to address PVT failure and improve test-taking behavior, did not improve consequent test performance. These results suggest limited value of a brief verbal corrective statement to influence performance below best of capabilities. It highlights the need for more research to identify more effective approaches that can enhance patients test-taking behavior. Ultimately, such efforts are critical in ensuring accurate diagnosis and effective treatment recommendations for patients. more...

Performance validity tests (PVTs) are used to measure the validity of the obtained neuropsychological test data. However, when an individual fails a PVT, the likelihood that failure truly reflects invalid performance (i.e., the positive predictive value) depends on the base rate in the context in which the assessment takes place. Therefore, accurate base rate information is needed to guide interpretation of PVT performance. This systematic review and meta-analysis examined the base rate of PVT failure in the clinical population (PROSPERO number: CRD42020164128). PubMed/MEDLINE, Web of Science, and PsychINFO were searched to identify articles published up to November 5, 2021. Main eligibility criteria were a clinical evaluation context and utilization of stand-alone and well-validated PVTs. Of the 457 articles scrutinized for eligibility, 47 were selected for systematic review and meta-analyses. Pooled base rate of PVT failure for all included studies was 16%, 95% CI [14, 19]. High heterogeneity existed among these studies (Cochran's Q = 697.97, p < .001; I 2  = 91%; τ 2  = 0.08). Subgroup analysis indicated that pooled PVT failure rates varied across clinical context, presence of external incentives, clinical diagnosis, and utilized PVT. Our findings can be used for calculating clinically applied statistics (i.e., positive and negative predictive values, and likelihood ratios) to increase the diagnostic accuracy of performance validity determination in clinical evaluation. Future research is necessary with more detailed recruitment procedures and sample descriptions to further improve the accuracy of the base rate of PVT failure in clinical practice., (© 2023. The Author(s).) more...

Objective: There is limited research examining the impact of the validity of cognitive test performance on treatment outcome. All known studies to date have operationalized performance validity dichotomously, leading to the loss of predictive information. Using the range of scores on a performance validity test (PVT), we hypothesized that lower performance at baseline was related to a worse treatment outcome following cognitive behavioral therapy (CBT) in patients with Chronic Fatigue Syndrome (CFS) and to lower adherence to treatment., Method: Archival data of 1081 outpatients treated with CBT for CFS were used in this study. At baseline, all patients were assessed with a PVT, the Amsterdam Short-Term Memory test (ASTM). Questionnaires assessing fatigue, physical disabilities, psychological distress, and level of functional impairment were administered before and after CBT., Results: Our main hypothesis was not confirmed: the total ASTM score was not significantly associated with outcomes at follow-up. However, patients with a missing follow-up assessment had a lower ASTM performance at baseline, reported higher levels of physical limitations, and completed fewer therapy sessions., Conclusions: CFS patients who scored low on the ASTM during baseline assessment are more likely to complete fewer therapy sessions and not to complete follow-up assessment, indicative of limited adherence to treatment. However, if these patients were retained in the intervention, their response to CBT for CFS was comparable with subjects who score high on the ASTM. This finding calls for more research to better understand the impact of performance validity on engagement with treatment and outcomes. more...

Introduction: A liberal acceptance bias is implicated in the formation and maintenance of delusions in schizophrenia. The present study tested the hypothesis that patients with schizophrenia are more quickly satisfied with their task performance than controls despite poor objective performance. Methods: Fifty patients with schizophrenia and 50 healthy controls performed the newly developed copy figure task in which participants copy a complex geometrical figure up to eight times until they are satisfied with the result. Objective performance was scored blind to group status. Subjective performance was rated on a 10-point scale. Carefulness of the drawing using anchor points served as a proxy for effort. Results: Patients made as many attempts as controls to copy the figure despite their worse subjective and objective performance. The number of attempts was negatively correlated with (persecutory) delusions and the PANSS total score. Neither effort nor possible frustration due to a plateau in performance was a reason for task termination. Conclusions: This exploratory study is in line with predictions based on the liberal acceptance model. For future studies, we recommend further cross-validating this paradigm and testing whether patients' retrospective assessment of their performance is exaggerated relative to controls. We also suggest that researchers pursue this line of research with personally meaningful material where a decreased threshold of acceptance may more easily translate into the subsequent fixation of ideas. more...

Performance Validity Tests (PVTs) are used to measure the credibility of neuropsychological test results. Until now, however, a minimal amount is known about the effects of feedback upon noncredible results (i.e., underperformance) on subsequent neuropsychological test performance. The purpose of this study was to investigate the effects of feedback on underperformance in Chronic Fatigue Syndrome (CFS) patients. A subset of these patients received feedback on Amsterdam Short-Term Memory (ASTM) failure (i.e., feedback [FB] group). After matching, the final sample consisted of two comparable groups (i.e., FB and No FB; both n  = 33). At baseline and follow-up assessment, the patients completed the ASTM and two measurements of information processing speed (Complex Reaction Time [CRT] and Symbol Digit Test [SDT]). Results indicated that the patients in the FB group improved significantly on the CRT, compared to the No FB group. Although not significant, a comparable trend-like effect was observed for the SDT. Independent of the feedback intervention there was a substantial improvement on ASTM performance at re-administration. A limited feedback intervention upon underperformance in CFS patients may result in improvement on information processing speed performance. This implies that such an intervention might be clinically relevant, since it maximizes the potential of examining the patients' actual level of cognitive abilities. more...

Suspects awaiting trial often claim that they cannot remember important parts of their violent crimes. It is not unusual that forensic experts readily accept such claims and interpret them in terms of dissociative amnesia or, more specifically, a "red-out". This interpretation hinges on the assumption that heightened levels of stress implicated in violent crimes interfere with memory. We argue that the notion of red-out is a priori not plausible and that alternative interpretations-primarily malingering and substance-induced organic amnesia-should be considered and ruled out first before concluding that memory loss is dissociative in nature. We illustrate our point with four cases that superficially have the contours of red-out tragedies. We believe that, in such cases, neuropsychological tests and/or psychopharmacological information on dose-response relationships can assist forensic experts to exclude malingering or substance-induced amnesia. There is no reason for not using tests and tools from neuropsychology and psychopharmacology. more...