Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest

Abstract

Neuropsychological assessment must include determinants of validity. This study sought to develop an embedded performance validity indicator for the Child and Adolescent Memory Profile (ChAMP) Lists verbal memory subtest. Children and adolescents (N = 103; mean age = 14.6 years, SD = 2.4, range = 8–18) who were on average 25 weeks (SD = 15.1) post-traumatic brain injury (TBI; 85% mild and 15% moderate-severe) were administered ChAMP Lists and two stand-alone performance validity tests (PVTs; Test of Memory Malingering; Medical Symptom Validity Test). Nineteen patients were deemed to have invalid performance defined as failure on both PVTs. Binary logistic regression and classification statistics were used to determine a cutoff score for invalid performance on ChAMP Lists using failure on two PVTs as the criterion. Invalid performance was not associated with demographics, injury type, or time since injury, but was significantly correlated with ChAMP Lists scaled scores. Only ChAMP Lists Recognition predicted validity grouping and had excellent discrimination (area under the curve of 93%). A cutoff scaled score of 7 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 79% while maintaining specificity at 91%. A more stringent cutoff score of 5 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 63% with specificity at 95%. This study yields a promising embedded performance validity indicator for ChAMP Lists Recognition with good sensitivity and excellent specificity for detecting invalid performance in youth with TBI.