Base rates of failure on various performance validity tests as a function of age in adults referred for neuropsychological assessment.

Abstract

This study aimed to investigate the relationship between age and base rates of failure (BRFail) on various performance validity tests (PVTs) administered in medical–legal settings. Archival data were analyzed from 3,297 adults (Mage = 42.3 years; Meducation = 11.2) referred for psychological or neuropsychological assessments in a medical–legal or forensic civil disability context who passed the Word Memory Test. BRFail on 10 PVTs (three freestanding and seven embedded) were reported at multiple cutoffs across five age groups ranging from 16 years to 69 years. BRFail increased with age on most embedded PVTs, with a couple of notable exceptions. Reliable Digit Span was unrelated to age at ≤6 but produced elevated BRFail among older examinees at ≤7. Within freestanding PVTs, a positive relationship emerged between age and BRFail on most instruments/cutoffs. Older age is associated with an increased risk of false positive errors on many embedded PVTs that rely on raw scores. Although freestanding PVTs tend to be more resistant to the effects of age, several commonly used cutoffs may still produce increased false positive rates in older examinees. Taken together, results suggest that PVT scores should be interpreted in the context of patient characteristics, in an evidence-based manner, rather than by rigidly applying omnibus cutoffs.