The Relationship Between the Self-Report BASC-2 Validity Indicators and Performance Validity Test Failure After Pediatric Mild Traumatic Brain Injury

Abstract

In adult populations, research on methodologies to identify noncredible performance and exaggerated symptoms during neuropsychological evaluations has grown exponentially in the past two decades. Far less work has focused on methods appropriate for children. Although several recent studies have used stand-alone performance validity tests with younger populations, a near absence of pediatric work has investigated other indices to identify response bias. The present study examined the relationship between the validity scales from the self-report Behavior Assessment System for Children, Second Edition (BASC-2) and performance on the Medical Symptom Validity Test (MSVT), a stand-alone performance validity test. The sample consisted of 274 clinically referred patients with mild traumatic brain injuries aged 8 through 17 years. Fifty patients failed the MSVT based on actuarial criteria. The majority of these patients (92%) provided valid self-report BASC-2 profiles, with only three patients (6%) producing an invalid profile due to an elevated F index. Analysis of valid/invalid self-report BASC-2 profiles and MSVT pass/fail did not reveal a significant relationship (p = 0.471, two-tailed Fisher's exact test). These findings suggest that performance validity tests like the MSVT provide substantively different information about the validity of a neuropsychological profile than that provided by the self-report validity scales of the BASC-2.