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Performance Validity and Symptom Validity in Neuropsychological Assessment

Published online by Cambridge University Press:  08 May 2012

Glenn J. Larrabee
Glenn J. Larrabee*
Affiliation:
Independent Practice, Sarasota, Florida.
*
Correspondence and reprint requests to: Glenn J. Larrabee, 2650 Bahia Vista Street, Suite 308, Sarasota, FL 34239. E-mail: glarrabee@aol.com
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Abstract

Failure to evaluate the validity of an examinee's neuropsychological test performance can alter prediction of external criteria in research investigations, and in the individual case, result in inaccurate conclusions about the degree of impairment resulting from neurological disease or injury. The terms performance validity referring to validity of test performance (PVT), and symptom validity referring to validity of symptom report (SVT), are suggested to replace less descriptive terms such as effort or response bias. Research is reviewed demonstrating strong diagnostic discrimination for PVTs and SVTs, with a particular emphasis on minimizing false positive errors, facilitated by identifying performance patterns or levels of performance that are atypical for bona fide neurologic disorder. It is further shown that false positive errors decrease, with a corresponding increase in the positive probability of malingering, when multiple independent indicators are required for diagnosis. The rigor of PVT and SVT research design is related to a high degree of reproducibility of results, and large effect sizes of d=1.0 or greater, exceeding effect sizes reported for several psychological and medical diagnostic procedures. (JINS, 2012, 18, 1–7)

Keywords

MalingeringFalse positive errorsSensitivitySpecificityDiagnostic probabilityResearch design
Type
Dialogue
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 4 , July 2012 , pp. 625 - 630
Copyright
Copyright © The International Neuropsychological Society 2012

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