Posttraumatic stress disorder and noncredible symptom reporting on the Trauma Symptom Inventory-2

Abstract

This archival study sought to investigate the ability of raw scores on the Atypical Response scale (ATR) and TRAUMA Factor of the Trauma Symptom Inventory-2 to predict noncredible cognitive performance validity testing (PVTs) in personal injury litigants and disability claimants with posttraumatic stress disorder (PTSD). Participants included 51 adults diagnosed with PTSD who underwent comprehensive neuropsychological examination. Criterion groups were formed based upon passing (Credible Group) or failing (Noncredible Group) cognitive performance validity tests (PVTs). Participants failing PVTs scored significantly higher on the ATR and TRAUMA Factor raw scores compared to those passing PVTs. Bivariate logistic regression analyses revealed that ATR scores ≥7 and TRAUMA Factor scores ≥75 were associated with failure on cognitive performance validity measures at ≥ 90% specificity. We conclude that PTSD in a forensic context is associated with a high rate of exaggerated neurocognitive dysfunction as well as symptom over reporting. The proposed ATR cutoff of ≥15 for forensic contexts in the TSI-2 test manual is methodologically flawed and needs to be adjusted downward. Cutscores for the ATR and TRAUMA Factor are presented at various base rates to assist clinicians examining claims of PTSD in a forensic context.