Failing The b Test: The influence of cutoff scores and criterion group approaches in a sample of adults referred for psychoeducational evaluation

Abstract

ABSTRACT Objective Previous research has shown that both criterion grouping approaches and cutoff scores can impact PVT classification accuracy statistics. This study aimed to examine the influence of cutoff scores and criterion grouping approaches on The b Test, a measure designed to identify feigned impairment in visual scanning, processing speed, and letter identification. Method Two hundred ninety-seven adults referred for psychoeducational testing were included with the majority of individuals seeking academic accommodations (n = 215). Cutoff scores of ≥82, ≥90, and ≥120 were utilized along with two different criterion group approaches, 0 PVT failures vs. ≥2 PVT failures and 0 PVT failures versus ≥ 1 PVT failures. Results Failure rates for The b Test in the overall sample ranged from 12.5% to 16.2%. Subgroup analyses in those referred specifically for ADHD revealed failure rates for The b Test ranging from 10.5% to 14.2%. ROC curves within the full sample and ADHD subsample demonstrated significant AUCs utilizing both criterion group approaches (AUC = .66 – .78). Sensitivity and specificity varied as a function of criterion group approach and cutoff score, with 0 PVT failures vs. ≥ 2 PVT failures resulting in the greatest sensitivity when maximizing specificity at ≥.90 in the full sample and ADHD sample. Conclusions The results demonstrate that criterion approaches and cutoff scores impact classification accuracy of The b Test with 0 PVT vs. ≥ 2 PVT failures demonstrating the greatest classification accuracy. Special considerations should be made with regard to clinical decision making in the context of psychoeducational evaluations given that a large portion of individuals seeking accommodations fail only one PVT. Limitations of this study are also discussed.