How Psychologists Communicate about Symptom and Performance Validity Testing in Their Reports: Room for Improvement

Abstract

This archival study sought to determine whether psychological reports adequately communicate the results of Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs). We collected reports from a pool of 469 clinical psychological and neuropsychological assessments conducted across five Dutch hospitals. To be included, the administered SVT (i.e., Structured Inventory of Malingered Symptomatology; SIMS) and/or PVT (Amsterdam Short-Term Memory test, ASTM) needed to be either passed or failed. Additionally, we selected reports from psychologists who, prior to conducting the assessments, anticipated either problematic or unproblematic validity. A total of 146 reports (57 clinical psychological and 89 neuropsychological reports), authored by 36 psychologists from five different hospitals, were analyzed. Invalid range scores on SIMS and/or ASTM occurred in 48% of the sample. Two researchers independently reviewed and coded reports, resolving mismatches through consensus and crosschecking with original test data. The majority of clinical psychological reports (89.5%) did not reference the SIMS or accurately describe the SIMS results, despite its use. In contrast, most neuropsychological reports mentioned the SIMS and ASTM, and adequately described their results (77.5%). Approximately half of the reports with invalid range scores on these instruments included interpretative statements, often suggesting overreporting and/or underperformance. In about one-third of cases, a fail on the validity test was attributed to factors such as anxiety, fatigue, depression, or pain. Other cognitive tests and psychological questionnaires were frequently interpreted without considering these invalid scores. Treatment recommendations seldom took SVT/PVT fails into account. The findings indicate that a non-negligible number of reports do not accurately report and discuss SVT/PVT results, underscoring the need for enhancing the quality and precision of psychological reports concerning validity testing.