Cutoff Scores for the Morel Emotional Numbing Test for PTSD: Considerations for Use in VA Mental Health Examinations

Abstract

The use of cutoff scores on symptom validity measures has been applied to determine the authenticity of posttraumatic stress disorder (PTSD) in U.S. Department of Veterans Affairs compensation and pension examinations. This approach is controversial due to variations in the interpretation and application of cutoff scores from symptom validity testing. In response to the proposal that the cutoff score on the Morel Emotional Numbing Test for Posttraumatic Stress Disorder (MENT) be increased, the diagnostic accuracy of the standard cutting score for identifying simulated symptoms of PTSD was compared to the proposed alternate cutoff score. The results of decision matrix tables (true positive, true negative, false positive, and false negative) comparing the sensitivity and specificity and deriving confidence intervals for the standard cutoff score and proposed alternate cutoff score are presented. In addition, analyses using binomial probability theory to determine whether the outcome of increasing the cutoff score on the MENT meets reasonable standards for types I and II errors are presented.