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Performance validity test failure in clinical populations-a systematic review.
J Neurol Neurosurg Psychiatry. 2020 Jul 10 [Online ahead of print]JN

Abstract

Performance validity tests (PVTs) are widely used in attempts to quantify effort and/or detect negative response bias during neuropsychological testing. However, it can be challenging to interpret the meaning of poor PVT performance in a clinical context. Compensation-seeking populations predominate in the PVT literature. We aimed to establish base rates of PVT failure in clinical populations without known external motivation to underperform. We searched MEDLINE, EMBASE and PsycINFO for studies reporting PVT failure rates in adults with defined clinical diagnoses, excluding studies of active or veteran military personnel, forensic populations or studies of participants known to be litigating or seeking disability benefits. Results were summarised by diagnostic group and implications discussed. Our review identified 69 studies, and 45 different PVTs or indices, in clinical populations with intellectual disability, degenerative brain disease, brain injury, psychiatric disorders, functional disorders and epilepsy. Various pass/fail cut-off scores were described. PVT failure was common in all clinical groups described, with failure rates for some groups and tests exceeding 25%. PVT failure is common across a range of clinical conditions, even in the absence of obvious incentive to underperform. Failure rates are no higher in functional disorders than in other clinical conditions. As PVT failure indicates invalidity of other attempted neuropsychological tests, the finding of frequent and unexpected failure in a range of clinical conditions raises important questions about the degree of objectivity afforded to neuropsychological tests in clinical practice and research.

Authors+Show Affiliations

Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK laura.mcwhirter@ed.ac.uk.Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32651247

Citation

McWhirter, Laura, et al. "Performance Validity Test Failure in Clinical Populations-a Systematic Review." Journal of Neurology, Neurosurgery, and Psychiatry, 2020.
McWhirter L, Ritchie CW, Stone J, et al. Performance validity test failure in clinical populations-a systematic review. J Neurol Neurosurg Psychiatry. 2020.
McWhirter, L., Ritchie, C. W., Stone, J., & Carson, A. (2020). Performance validity test failure in clinical populations-a systematic review. Journal of Neurology, Neurosurgery, and Psychiatry. https://doi.org/10.1136/jnnp-2020-323776
McWhirter L, et al. Performance Validity Test Failure in Clinical Populations-a Systematic Review. J Neurol Neurosurg Psychiatry. 2020 Jul 10; PubMed PMID: 32651247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Performance validity test failure in clinical populations-a systematic review. AU - McWhirter,Laura, AU - Ritchie,Craig W, AU - Stone,Jon, AU - Carson,Alan, Y1 - 2020/07/10/ PY - 2020/05/08/received PY - 2020/06/03/revised PY - 2020/06/07/accepted PY - 2020/7/12/entrez KW - cognition KW - neuropsychiatry KW - neuropsychology JF - Journal of neurology, neurosurgery, and psychiatry JO - J. Neurol. Neurosurg. Psychiatry N2 - Performance validity tests (PVTs) are widely used in attempts to quantify effort and/or detect negative response bias during neuropsychological testing. However, it can be challenging to interpret the meaning of poor PVT performance in a clinical context. Compensation-seeking populations predominate in the PVT literature. We aimed to establish base rates of PVT failure in clinical populations without known external motivation to underperform. We searched MEDLINE, EMBASE and PsycINFO for studies reporting PVT failure rates in adults with defined clinical diagnoses, excluding studies of active or veteran military personnel, forensic populations or studies of participants known to be litigating or seeking disability benefits. Results were summarised by diagnostic group and implications discussed. Our review identified 69 studies, and 45 different PVTs or indices, in clinical populations with intellectual disability, degenerative brain disease, brain injury, psychiatric disorders, functional disorders and epilepsy. Various pass/fail cut-off scores were described. PVT failure was common in all clinical groups described, with failure rates for some groups and tests exceeding 25%. PVT failure is common across a range of clinical conditions, even in the absence of obvious incentive to underperform. Failure rates are no higher in functional disorders than in other clinical conditions. As PVT failure indicates invalidity of other attempted neuropsychological tests, the finding of frequent and unexpected failure in a range of clinical conditions raises important questions about the degree of objectivity afforded to neuropsychological tests in clinical practice and research. SN - 1468-330X UR - https://www.unboundmedicine.com/medline/citation/32651247/Performance_validity_test_failure_in_clinical_populations-a_systematic_review L2 - http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=32651247 DB - PRIME DP - Unbound Medicine ER -
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