A-311 WMS-IV Visual Reproduction Recognition as a Performance Validity Test (PVT) in Clinical and Forensic Settings

Abstract

Abstract Objective: This study examined WMS-IV Visual Reproduction Recognition (VRRec) as an embedded PVT in clinical and forensic samples. Methods: VRRec was analyzed as a PVT in a forensic sample and in a hospital-based, outpatient clinical sample. Neither sample included any major neurocognitive disorders and well-established PVTs determined valid and invalid categories. T-tests (parametric and nonparametric) and ROCs were used to assess how accurately VRRec classified valid and invalid group-membership. Results: Forensic and clinical (n=265, 84) samples differed in context (incentivized, non-incentivized), age (m=49.1, 60.6), race (Caucasian=17%, 89%), and gender (males=100%, 29%), respectively. VRRec scores were significantly different between valid and invalid groups in both the forensic sample (U=2404.0, p<.0001, d=-1.26; n=196, 69; m=5.57, 3.33; sd=1.29, 1.91) and the clinical sample (t=-2.39, p=.019, d=-.93; n=76, 8; m=4.99, 3.50; sd=1.68, 1.51). A cutoff score of < 3 yielded the following: Forensic: AUC=.822, sensitivity=.551, specificity=.944, 95%CI=.76-.88, p<.0001; and Clinical: AUC=.752, sensitivity=.500, specificity=.816, 95%CI=.61-.89, p=.019. For the clinical sample, < 2 improved specificity (.908) but decreased sensitivity (.250). When using a 15% estimated invalidity base rate in the clinical sample for < 3 and < 2 cutoffs, positive predictive power equaled .324 and .324 and negative predictive power equaled .902 and .873, respectively. Conclusion: VRRec adequately differentiated validity groups in a forensic sample but was less valuable in a clinical sample. Its use as a PVT should only be considered within a larger group of multiple PVTs. Primary limitations included differences in demographics and specific criterion-PVTs used between samples. Future studies should assess VRRec as a PVT in similar populations.