Comparison of various RAVLT scores in the detection of noncredible memory performance

Abstract

Sixty-one noncredible patients (as documented by psychometric and behavioral criteria) scored significantly below 25 controls and 88 credible clinic patients with no motive to feign on most RAVLT scores, including added indices of implicit and “automatic” memory. A combination of true recognition (i.e., recognition minus false positives) + implicit memory score (i.e., the number of word stems completed with RAVLT items) + “automatic” memory score (i.e., the number of correct temporal order judgments) ≤22 was associated with 75.7% sensitivity with specificity at 91.5%. However, sensitivity was nearly as high when scores available from the standard RAVLT administration alone (i.e., no word stem or temporal order trials) were combined. Specifically, a cut-off of ≤12 for true recognition (recognition minus false positives) + primacy recognition (i.e., number of words recognized from the first third of the test) was associated with 73.8% sensitivity at 90% specificity. These results indicate that combined indices of recognition memory from the RAVLT are effective in identifying noncredible memory performance in “real world” samples and are modestly superior to the 67.2% sensitivity obtained with the standard recognition score.