Detection of inadequate effort on the California Verbal Learning Test-Second edition: Forced choice recognition and critical item analysis

Abstract

The Forced Choice Recognition (FCR) and the Critical Item Analysis (CIA) indices of the California Verbal Learning Test-II (CVLT-II) have been identified by the CVLT-II test developers as potentially useful, brief screening indicators of effort in neuropsychological assessment. This retrospective study analyzes performance on these measures in three groups: (1) clinically referred individuals; (2) forensically referred individuals not suspected of inadequate effort; and (3) forensically referred individuals whose performance on freestanding tests of effort suggested inadequate effort. Performances on FCR were analyzed for their relation to actual memory impairment and with regard to concrete and abstract distractor endorsement. FCR and CIA performances were analyzed for agreement with formal tests of inadequate effort and their test characteristics. Incremental validity was assessed by hierarchical logistic regression with previously identified indices for detection of inadequate effort on the CVLT. Results indicate that (1) FCR and CIA performances are not related to decreased memory performance; (2) FCR and CIA indices exhibit higher specificity and lower sensitivity, with higher positive predictive value than negative predictive value; and (3) FCR and CIA indices exhibit modest incremental validity with previously identified indices. Implications for use of FCR and CIA indices in inadequate effort detection are discussed (JINS, 2006, 12, 688-696.)

Use of the Tower of London – Drexel University, Second Edition (TOLDX) in Adults With Traumatic Brain Injury

“…16 years and 60 years at the time of assessment; (3) evaluation 1-12 months after injury; (4) absence of any prior history of major neurological (e.g., brain tumor), psychiatric (e.g., psychosis), or developmental (e.g., autism spectrum) condition; (5) not currently seeking financial compensation (e.g., disability application or civil litigation); and (6) acceptable performance on a well-established test of symptom validity, the Test of Memory Malingering (TOMM), according to published criteria (Tombaugh, 1996). With respect to assessment of response or symptom validity, various additional measures of effort were often used in our clinic, including the Reliable Digit Span (Mathias, Greve, Bianchini, Houston, & Crouch, 2002) and the Forced Choice condition on the California Verbal Learning Test, Second Edition (Root, Robbins, Chang, & Van Gorp, 2006), but only the TOMM was administered to all patients. Consequently only the TOMM was considered in establishing response validity for the purpose of this study.…”

Classification Accuracy of Multiple Visual Spatial Measures in the Detection of Suspect Effort

“…The CVLT-II FCR was chosen because it is a symptom validity measure embedded within the CVLT-II. Additionally, the FRC has demonstrated good classification accuracy and does not correlate with memory functioning (Delis et al, 2000;Root, Robbins, Chang, & van Gorp, 2006). Thus, it provides some independent information on symptom validity from the TOMM (Moore & Donders, 2004).…”

Embedded Measures of Performance Validity Using Verbal Fluency Tests in a Clinical Sample

“…Participants who failed only one PVT were excluded from the analyses. The PVTs used to assess effort included: (a) Test of Memory Malingering (Tombaugh & Tombaugh, 1996) with a score of less than 40 on Trial 1 and=or less than 45 on Trial 2; (b) Trail-Making Test Part A (Reitan, 1958), with total completion time greater than 62 s (Iverson, Lange, Green, & Franzen, 2002); (c) Wechsler Adult Intelligence Scale-Fourth Edition (Wechsler, 2008) Reliable Digit Span, with a raw score of less than 7 (Axelrod et al, 2006); (d) California Verbal Learning Test-Second Edition (Delis, Kramer, Kaplan, & Ober, 2000), with a Forced-Choice Recognition raw score less than 15 (Root, Robbins, Chang, & Van Gorp, 2006); (e) Meyer's Estimated Finger Tapping (Meyers & Volbrecht, 2003), with a score of less than À10; and (f) Green's Medical Symptom Validity Test (MSVT; Green, 2004), with a score of 85% or less on Immediate Recall, Delayed Recall, or Consistency. However, individuals who scored at 85% or lower on one or more of these three MSVT indexes but met criteria for the ''Dementia Profile'' (Green, 2004), also known as the Genuine Memory Impairment Profile, were not considered to have failed the test.…”