Cross-Validation of Multiple Embedded Performance Validity Indices in the Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-Revised in an Adult Attention Deficit/Hyperactivity Disorder Clinical Sample

Phillips, Matthew S.; Wisinger, Amanda M; Lapitan-Moore, Franchezka; Ausloos-Lozano, Jenna E.; Bing-Canar, Hanaan; Durkin, Nicole M; Ovsiew, Gabriel P.; Resch, Zachary J; Jennette, Kyle J; Soble, Jason R.

doi:10.1007/s12207-022-09443-3

Cited by 20 publications

(10 citation statements)

References 44 publications

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“…Excluding patients with dementia from the neuropsychiatric sample improved the overall classification accuracy; nonetheless, the optimal cutoff (≤5) remained considerably lower than the ADHD sample. These findings are highly consistent with prior studies (e.g., Boone et al, 2005; Phillips et al, 2022; Pliskin et al, 2021; Whitney & Davis, 2015), which similarly reported optimal ES cut scores in the ≤12–≤13 range when this PVT was examined among clinical samples with no to minimal cognitive impairment, whereas the optimal cut score decreased to ≤3–≤4 among mixed clinical populations with cognitive impairment. This suggests that additional interpretative considerations are warranted when using ES among patients with known or suspected cognitive impairment.…”

Section: Discussionsupporting

confidence: 91%

“…Similarly, Whitney and Davis (2015) found an ES cutoff of ≤12 had unacceptable specificity (i.e., 65%) in a mixed clinical veteran sample, whereas a lower cutoff of ≤4 resulted in acceptable specificity of 92% with 37% sensitivity. Together, the current evidence consistently supports ES as an effective EVI, albeit with the caveat that the most appropriate cut score varies based on the clinical characteristics of the individual being assessed with an optimal cutoff of ≤12/13 among populations with more minimal cognitive impairment (Boone et al, 2005; Phillips et al, 2022; Pliskin et al, 2021), and ≤3/4 among cognitively impaired populations (Pliskin et al, 2021; Whitney & Davis, 2015).…”

Section: The Present Studymentioning

confidence: 64%

“…Both the RAVLT-ES and RAVLT-FC have been independently cross-validated across multiple, diverse clinical samples and have generally been found to be effective EVIs with robust classification accuracy, even in the context of bona fide cognitive impairment (Boone et al, 2005(Boone et al, , 2022Phillips et al, 2022;Pliskin et al, 2021;Poreh et al, 2016;Soble, Sharp, et al, 2021;Whitney & Davis, 2015). However, a head-to-head comparison of these two RAVLT EVIs is missing from the extant PVT literature.…”

Section: The Present Studymentioning

confidence: 99%

“…Subsequent cross-validation studies continue to support the RAVLT-ES as an EVI across various clinical populations but highlight the need for alternative cut scores among certain examinees with bona fide cognitive impairment. For instance, Phillips et al (2022) similarly reported an optimal ES cutoff of ≤12 (43% sensitivity/90% specificity) among adults undergoing evaluation for attention-deficit/hyperactivity disorder (ADHD). By contrast, Pliskin et al (2021) reported an optimal cutoff of ≤13 among patients without cognitive impairment (80% sensitivity/90% specificity), although a more conservative cut score of ≤3 was needed among patients with mild neurocognitive disorder (32% sensitivity/94% specificity) to maintain acceptable specificity (i.e., ≥90%; Boone, 2013).…”

Section: The Present Studymentioning

confidence: 99%

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Cross-validating the embedded performance validity indicators in the Rey Auditory Verbal Learning Test in mixed neuropsychiatric and attention-deficit/hyperactivity disorder clinical samples.

Tse¹,

Finley²,

Frick³

et al. 2023

Psychology & Neuroscience

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Objective: The Rey Auditory Verbal Learning Test (RAVLT) is a common test of learning and memory with established embedded validity indicators (EVIs), including the Effort Score (ES) and Forced Choice (FC) recognition. Currently, the literature lacks a head-to-head comparison of the classification accuracy of ES and FC for detecting invalid test performance. This study aimed to cross-validate ES and FC in two large, diverse, independent samples. Method: This cross-sectional study included a mixed neuropsychiatric (n = 209) and attention-deficit/hyperactivity disorder (ADHD) sample (n = 544). Validity groups were established using multiple criterion performance validity tests (PVTs), resulting in 242 valid/57 invalid and 480 valid/64 invalid performances in the neuropsychiatric and ADHD samples, respectively. Results: ES and FC both demonstrated robust classification accuracy. The optimal ES cut score was significantly higher for the ADHD (≤13; 41% sensitivity/90% specificity) than the neuropsychiatric (≤3; 33% sensitivity/89% specificity) sample. Classification accuracies of FC ranged from weak in the ADHD (area under the curve [AUC] = 0.67) to excellent in the neuropsychiatric (AUC = 0.80) sample. The FC cut score was ≤12 (54% sensitivity/91% specificity) in the neuropsychiatric and ≤14 in the ADHD (41% sensitivity/93% specificity) sample. Both EVIs were significant predictors of validity status when examined in combination. Conclusions: Both the RAVLT-ES and RAVLT-FC were effective as PVTs; however, their relative utility varied by sample such that FC had stronger classification statistics in the neuropsychiatric sample (which included a higher incidence of cognitive impairment and dementia), whereas ES was more robust in the adult ADHD sample. Moreover, considering both EVIs may result in greater accuracy than isolation.

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Section: Discussionsupporting

confidence: 91%

Section: The Present Studymentioning

confidence: 64%

Section: The Present Studymentioning

confidence: 99%

Section: The Present Studymentioning

confidence: 99%

See 2 more Smart Citations

Cross-validating the embedded performance validity indicators in the Rey Auditory Verbal Learning Test in mixed neuropsychiatric and attention-deficit/hyperactivity disorder clinical samples.

Tse¹,

Finley²,

Frick³

et al. 2023

Psychology & Neuroscience

Self Cite

View full text Add to dashboard Cite

show abstract

“…RAVLT scores are presented as age-corrected T-scores, WMI and PSI as age-corrected standard scores; TMT as age/education/sex/race-corrected T-scores; and SCWT as age/education-corrected T-scores. As part of the test battery, all patients were administered two freestanding PVTs: Dot Counting Test (Abramson et al, 2023) and Rey 15-Item/Recognition (Poynter et al, 2019), and three embedded PVTs: RAVLT Effort Scale (Phillips et al, 2023); Reliable Digit Span (Bing-Canar, Phillips, et al, 2022); and Stroop Word Reading T-score (Khan et al, 2022), all of which have been cross-validated in ADHD clinical samples. Consistent with current practice guidelines and empirical findings (e.g., Jennette et al, 2022; Rhoads et al, 2021), patients with two or more PVT failures ( n = 9) were classified as having invalid neuropsychological test performance and excluded from analyses.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Adverse Childhood Experiences on ADHD Symptom Reporting, Psychological Symptoms, and Cognitive Performance Among Adult Neuropsychological Referrals

Alfonso,

Basurto,

Guilfoyle

et al. 2023

J Atten Disord

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Objective: Adverse childhood experiences (ACEs) are early life experiences that influence mental health outcomes, though there are mixed findings reported in relation to attention deficit hyperactivity disorder (ADHD) symptoms. The current study compared adults who experienced ACEs on measures of ADHD symptom reporting, psychological symptoms, and neurocognitive test performance. Method: The sample ( n = 115) had mean age of 28.42 ( SD = 6.46); educational attainment of 16.47 years ( SD = 1.99); and was 35% male/65% female and racially/ethnically diverse. Participants completed measures of ACEs, ADHD symptoms, psychopathology, and perceived stress, as well as neuropsychological tests. Results: The high ACEs group endorsed higher levels of childhood/adulthood inattentive, impulsive, and hyperactive symptoms, and overall childhood symptoms when compared to the low ACEs group. Conclusions: This study provides a more comprehensive understanding of the association between ACEs and cognitive/mental health outcomes. Greater ACEs resulted in higher ADHD symptom reporting but not significantly greater psychological symptoms or worse neurocognitive performance.

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Detecting Noncredible Responding in College Student ADHD Assessment: A Comparison of Several Brief Symptom Validity Tests

Weis,

Costenbader

2024

Psychol. Inj. and Law

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A diagnosis of attention-deficit/hyperactivity disorder (ADHD) offers tangible and psychological benefits to college students. These incentives lead some students to exaggerate symptoms on self-report rating scales. Although validity tests can detect noncredible responding, they are seldom used by clinicians who conduct adult ADHD evaluations. Many validity tests require considerable time, are expensive to administer, or are not accessible to many clinicians. We conducted a between-subjects simulation study examining the ability of several brief symptom validity tests to differentiate college students with self-reported ADHD (n = 229) and students without ADHD randomly assigned to honest control (n = 260) or simulator (n = 239) conditions. All participants completed the Conners’ Adult ADHD Rating Scales (CAARS) with several embedded validity indicators (i.e., CAARS Inconsistency Index, CAARS Infrequency Index [CII], Dissociative Experiences Scale, Exaggeration Index [EI]), and the Subtle ADHD Malingering Screener. Results showed that students without ADHD could easily simulate this condition. Simulators earned significantly higher scores than participants in the ADHD and control conditions on all the validity tests that we examined, except the CAARS Inconsistency Index. Elevated scores on the CAARS hyperactive-impulsive scale, the CII, or the EI yielded the best classification statistics with specificity to controls ranging from 98.5 to 100%, sensitivity to simulators ranging from 35.6 to 42.7%, and low positive cases among participants in the ADHD condition. Associations between these validity scales were moderate. Requiring elevated scores on multiple validity scales yielded perfect specificity to controls, sensitivities to simulators between 27.2 and 31.8%, and few positive cases among participants in the ADHD condition (0 to 3.1%). These tests may offer clinicians a time- and cost-effective way to evaluate the validity of students’ self-reports, especially when integrated with objective information from other sources.

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Cross-Validation of Multiple Embedded Performance Validity Indices in the Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-Revised in an Adult Attention Deficit/Hyperactivity Disorder Clinical Sample

Cited by 20 publications

References 44 publications

Cross-validating the embedded performance validity indicators in the Rey Auditory Verbal Learning Test in mixed neuropsychiatric and attention-deficit/hyperactivity disorder clinical samples.

Cross-validating the embedded performance validity indicators in the Rey Auditory Verbal Learning Test in mixed neuropsychiatric and attention-deficit/hyperactivity disorder clinical samples.

The Effect of Adverse Childhood Experiences on ADHD Symptom Reporting, Psychological Symptoms, and Cognitive Performance Among Adult Neuropsychological Referrals

Detecting Noncredible Responding in College Student ADHD Assessment: A Comparison of Several Brief Symptom Validity Tests

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