Using the California Verbal Learning Test, Second Edition as an embedded performance validity measure among individuals with TBI and individuals with psychiatric disorders

Abstract

Objective: Among embedded performance validity tests (PVTs), little research addresses the use of Total Hits and Total False Positives from the California Verbal Learning Test, Second Edition (CVLT-II) in spite of low sensitivity, particularly in psychiatric samples. Method: This study examined the classification accuracy of these two measures in individuals with psychiatric disorders or mild traumatic brain injury (MTBI). These samples were separated into two groups using the criteria of passing all PVTs versus failing 2 or more PVTs. They were also compared to a criterion group of moderate to severe traumatic brain injury (M-STBI) patients who passed all PVTs. The sample included 176 individuals consecutively referred for neuropsychological testing (mean age = 46.31, SD = 15.30; mean education = 13.07, SD = 2.50, 52.3% males; 91.2% Caucasian) who met study criteria. Results: For classification accuracy, Total Hits in the psychiatric group had excellent classification accuracy (Area Under the Curve [AUC] = .82; Sensitivity = .47; Specificity = .90), whereas Total False Positives (AUC = .49) demonstrated poor classification accuracy. The MTBI group had similar results, with Total Hits having excellent classification accuracy (AUC = .88; Sensitivity = .60; Specificity = .90), whereas Total False Positive (AUC = .62) did not. Conclusions: Results provide preliminary support for using Total Hits; however, Total False Positives were ineffective in identifying non-credible patients with psychiatric disorders or MTBI. Total Hits also compared favorably to other embedded CVLT measures.