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This investigation adds to the burgeoning body of research concerned with discriminating performance and symptom validity tests (SVTs) through examination of their differential relationships with cognitive performance and symptom self-report measures. To the authors' current knowledge, prior studies have not assessed differences between participants who fail either a performance validity test (PVT) or an SVT but not both. As part of their neuropsychological evaluations at four Veterans Affairs medical centers across the United States, participants were administered a fixed, standardized battery that consisted of performance validity, symptom validity, cognitive performance, and symptom self-report measures. Compared with participants who failed a PVT and an SVT, participants who passed both and participants who only passed a PVT demonstrated better cognitive performance and self-reported fewer symptoms. Results support differential clinical utility of performance validity and SVTs when assessing cognitive performance and symptom self-report.

Objective Attention, inhibition, and processing speed are related to functional decline among older adults. This study attempts to clarify the relationships between these cognitive factors and adaptive functioning. Method We examined relationships between attention, inhibition, and processing speed, with scores on the Texas Functional Living Scale (TFLS), a performance-based measure of daily functioning, in a mixed clinical sample of 530 older adults who were referred for an outpatient neuropsychological evaluation. Results The current study used a confirmatory factor analysis (CFA) to derive a three-factor cognitive model consisting of attention, inhibition, and processing speed. Results from a hierarchical regression, which included factor scores from the CFA, revealed that processing speed was the only significant predictor of TFLS performance when all three cognitive factors were included within a single model. Conclusion These results highlight the influence of processing speed as an important indicator of functional decline among a clinical population of older adults.

Objective Prior factor analysis of the Texas Functional Living Scale (TFLS), a performance-based measure of functional abilities, in a military veteran sample supported four factors discrepant from the published subscales. This study analyzed TFLS factor structure in a non-veteran clinical sample. Method Two hundred seventy adult outpatients completed the TFLS during neuropsychological evaluation. Principal axis factor analysis with oblique promax rotation was conducted with age and education effects partialed out. Results Parallel analysis indicated five factors for extraction that accounted for a combined 48% of the variance. The first factor independently explained 26% of the total variance. Inspection of factor loadings suggested the following factor interpretations: complex calculations/time, complex visual search, praxis, memory, and basic calculations/math concepts. Five items did not significantly load onto any of the factors. Conclusions Current results did not entirely correspond to the published subscales or prior results in a veteran sample. Further clarification of the TFLS factor structure is warranted.

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