The current study aimed to clarify the relationship among the constructs involved in neuropsychological assessment, including cognitive performance, symptom self-report, performance validity, and symptom validity. Participants consisted of 120 consecutively evaluated individuals from a veteran's hospital with mixed referral sources. Measures included the Wechsler Adult Intelligence Scale-Fourth Edition Full Scale IQ (WAIS-IV FSIQ), California Verbal Learning Test-Second Edition (CVLT-II), Trail Making Test Part B (TMT-B), Test of Memory Malingering (TOMM), Medical Symptom Validity Test (MSVT), WAIS-IV Reliable Digit Span (RDS), Post-traumatic Check List-Military Version (PCL-M), MMPI-2 F scale, MMPI-2 Symptom Validity Scale (FBS), MMPI-2 Response Bias Scale (RBS), and the Postconcussive Symptom Questionnaire (PCSQ). Six different models were tested using confirmatory factor analysis (CFA) to determine the factor model describing the relationships between cognitive performance, symptom self-report, performance validity, and symptom validity. The strongest and most parsimonious model was a three-factor model in which cognitive performance, performance validity, and self-reported symptoms (including both standard and symptom validity measures) were separate factors. The findings suggest failure in one validity domain does not necessarily invalidate the other domain. Thus, performance validity and symptom validity should be evaluated separately.

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Previous literature suggests that women evidence more bilateral cerebral organization, particularly in language processing, whereas men show greater left hemisphere dominance for language. This study examined the magnitude of these gender differences in a lateralized lexical decision task and the implications of such differences to semantic processing and cerebral organization. As predicted, women, as compared to men, recruited greater bilateral hemispheric resources, as evidenced by greater contralateral hemispheric priming. Spatial skills predicted less priming in women, but not in men. Implications for laterality research in aging populations as well as future directions are discussed.

The Post-concussive Symptom Questionnaire (PCSQ) and its short forms were evaluated to determine their utility in measuring symptom validity as brief self-report measures in 112 individuals referred for a neuropsychological evaluation. First, the relationships between the PCSQ forms and measures of cognitive performance (Wechsler Adult Intelligence Scale-Fourth Edition Full-Scale IQ, California Verbal Learning Test-Second Edition Trials 1-5 Total T-score, Trails B, FAS), general distress (Minnesota Multiphasic Personality Inventory [MMPI]-2 M8), and self-report symptom validity (MMPI-2 FBS Symptom Validity Scale [FBS] and Response Bias Scale [RBS]) were investigated to determine construct validity. Measures of self-report symptom validity explained the greatest amount of variance. Second, receiver operating characteristics curve analyses were conducted to determine the predictive value of the PCSQ forms in detecting over reporting on the FBS and the RBS in addition to establishing optimal cutoff scores. On the basis of the proposed cutoff scores, sensitivity, specificity, positive predictive power, negative predictive power, and hit rates were calculated.