Performance validity and symptom validity tests: Are they measuring different constructs?

Abstract

Objective: To evaluate the relationships among performance validity, symptom validity, symptom self-report, and objective cognitive testing. Method: Combat Veterans (N = 338) completed a neurocognitive assessment battery and several self-report symptom measures assessing depression, posttraumatic stress disorder (PTSD) symptoms, sleep quality, pain interference, and neurobehavioral complaints. All participants also completed two performance validity tests (PVTs) and one stand-alone symptom validity test (SVT) along with two embedded SVTs. Results: Results of an exploratory factor analysis revealed a three-factor solution: performance validity, cognitive performance, and symptom report (SVTs loaded on the third factor). Results of t tests demonstrated that participants who failed PVTs displayed significantly more severe symptoms and significantly worse performance on most measures of neurocognitive functioning compared to those who passed. Participants who failed a standalone SVT also reported significantly more severe symptomatology on all symptom report measures, but the pattern of cognitive performance differed based on the selected SVT cutoff. Multiple linear regressions revealed Key Points Question: Are performance validity tests (PVTs) and symptom validity tests (SVT) measuring different constructs, and are they differentially related to cognition and clinical symptoms? Findings: Symptom validity and performance validity are distinct but related constructs, and both are associated with cognitive performance and with symptom self-report. Importance: A comprehensive neuropsychological assessment battery should include both SVT and PVTs because they provide unique information about an examinee's performance. Next Steps: Further evaluation of specific symptom validity measures is necessary to assess distinct differences between symptom validity and symptom selfreport, as well as to determine whether higher cutoffs would be more appropriate for various populations, such as combat-exposed Veterans.

Comprehensive Analysis of MMPI-2-RF Symptom Validity Scales and Performance Validity Test Relationships in a Diverse Mixed Neuropsychiatric Setting

“…To our knowledge, no previous study has explored these relationships within a mixed neuropsychiatric sample with PVTs derived from (or appearing to be derived from) diverse cognitive modalities. By addressing gap in the literature, these findings can be generalized to populations beyond the VA and forensic/medicolegal contexts where most of this research has been conducted (e.g., Copeland et al, 2015;Gervais et al, 2007;Ord et al, 2021;Van Dyke et al, 2013;Whitney et al, 2008). Additionally, results were consistent with previous research showing that performance on SVTs and PVTs provide nonredundant validity information, even within diverse populations.…”

“…To date, prior studies examining general relationships between SVT and PVT performance have yielded equivocal findings. Similarly, some recent studies have also demonstrated that symptom and performance validity represent distinct constructs in the context of adult ADHD evaluations (e.g., Leib et al, 2021;White et al, 2022) and neuropsychological evaluations in Veteran Affairs (VA) settings (e.g., Bomyea et al, 2020;Ingram et al, 2019Ingram et al, , 2020Ord et al, 2021). For instance, Aase et al (2021) and Shura et al (2021) found that PVTs and SVTs were largely dissociable among post-deployment veterans with conditions including posttraumatic stress disorder (PTSD) and concussion/mild traumatic brain injury (TBI).…”

Motor Reaction Times as an Embedded Measure of Performance Validity: a Study with a Sample of Austrian Early Retirement Claimants

“…In contrast, associations between performance-based validity measures and self-report scales are usually only moderate or, in some studies, even absent (e.g., Grossi et al, 2017;Ingram et al, 2020;Whiteside et al, 2020). Performance validity and symptom validity appear to constitute two related but distinct concepts (Ord et al, 2021;van Dyke et al, 2013).…”

Examining the effect of repeat administration, alternate versions, and performance validity on letter fluency tests in a mixed clinical sample.

“…However, these results are consistent with subsequent studies by the same research group (Erdodi, 2021; Erdodi, Kirsch, et al, 2018). The divergence of the evidence on the psychogenic interference hypothesis (Tarachow, 1947) applied to PVT research has a number of potential explanations: methodological, instrumentation, or sampling artifacts, a diagnosis- or context-specific relationship or an imperfect and poorly understood association between performance and symptom validity (Abeare, Razvi, et al, 2021; Carvalho et al, 2021; Cutler, Sirianni, et al, 2022; Gaasedelen et al, 2019; Gegner et al, 2022; Ord, Shura, et al, 2021; Sabelli et al, 2021).…”