Victoria Symptom Validity Test Research Articles

78 Utility of the D-KEFS Color Word Interference Test as a Measure of Performance Validity in Adults Referred for a Psychoeducational Evaluation

Objective:Previous investigations have demonstrated the clinical utility of the Delis-Kaplan Executive Function System (D-KEFS) Color Word Interference Test (CWIT) as an embedded validity indicator in mixed clinical samples and traumatic brain injury. The present study sought to cross-validate previously identified indicators and cutoffs in a sample of adults referred for psychoeducational testing.Participants and Methods:Archival data from 267 students and community members self-referred for a psychoeducational evaluation at a university clinic in the South were analyzed. Referrals included assessment for attention-deficit hyperactivity disorder, specific learning disorder, autism spectrum disorder, or other disorders (e.g., anxiety, depression). Individuals were administered subtests of the D-KEFS including the CWIT and several standalone and embedded performance validity indicators as part of the evaluation. Criterion measures included The b Test, Victoria Symptom Validity Test, Medical Symptom Validity Test, Dot Counting Test, and Reliable Digit Span. Individuals who failed 0 criterion measures were included in the credible group (n = 164) and individuals failing 2 or more criterion measures were included in the non-credible group (n = 31). Because a subset of the sample were seeking external incentives (e.g., accommodations), individuals who failed only 1 of the criterion measures were excluded (n = 72). Indicators of interest included all test conditions examined separately, the inverted Stroop index (i.e., better performance on the interference trial than the word reading or color naming trials), inhibition and inhibition/switching composite, and sum of all conditions.Results:Receiver Operating Characteristics (ROC) curves were significant for all four conditions (p < .001) and the inverted stroop index (p = .032). However, only conditions 2, 3 and 4 met minimal acceptable classification accuracy (AUC = .72 - 81). ROC curves with composite indicators were also significant (p < .001), with all three composite indicators meeting minimal acceptable classification accuracy (AUC = .71- .80). At the previously identified cutoff of age corrected scale score of 6 for all four conditions, specificity was high (.88 -.91), with varying sensitivity (.23 - .45). At the previously identified cutoff of .75 for the inverted stroop index, specificity was high (.87) while sensitivity was low (.19). Composite indicators yielded high specificity (.88 - .99) at previously established cutoffs with sensitivity varying from low to moderate (.19 - .48). Increasing the cutoffs (i.e., requiring higher age corrected scale score to pass) for composite indicators increased sensitivity while still maintaining high specificity. For example, increasing the total score cutoff from 18 to 28 resulted in moderate sensitivity (.26 vs .52) with specificity of .91.Conclusions:While a cutoff of 6 resulted in high specificity for most conditions, the sum of all four conditions exhibited the strongest classification accuracy and appears to be the most robust indicator which is consistent with previous research (Eglit et al., 2019). However, a cutoff of 28 as opposed to 18 may be most appropriate for psychoeducational samples. Overall, the results suggest that the D-KEFS CWIT can function as a measure of performance validity in addition to a measure of processing speed/executive functioning.

Standalone Performance Validity Tests May Be Differentially Related to Measures of Working Memory, Processing Speed, and Verbal Memory in Patients With Multiple Sclerosis.

Cognitive functioning may account for minimal levels (i.e., 5%-14%) of variance of performance validity test (PVT) scores in clinical examinees. The present study extended this research twofold: (a) by determining the variance cognitive functioning explains within three distinct PVTs (b) in a sample of patients with multiple sclerosis (pwMS). Seventy-five pwMS (Mage = 48.50, 70.6% female, 80.9% White) completed the Victoria Symptom Validity Test (VSVT), Word Choice Test (WCT), Dot Counting Test (DCT), and three objective measures of working memory, processing speed, and verbal memory as part of clinical neuropsychological assessment. Regression analyses in credible groups (ns ranged from 54 to 63) indicated that cognitive functioning explained 24% to 38% of the variance in logarithmically transformed PVT variables. Variance from cognitive testing differed across PVTs: verbal memory significantly influenced both VSVT and WCT scores; working memory influenced VSVT and DCT scores; and processing speed influenced DCT scores. The WCT appeared least related to cognitive functioning of the included PVTs. Alternative plausible explanations, including the apparent domain/modality specificity hypothesis of PVTs versus the potential sensitivity of these PVTs to neurocognitive dysfunction in pwMS were discussed. Continued psychometric investigations into factors affecting performance validity, especially in multiple sclerosis, are warranted.

Classification of performance validity and symptom validity using the Trauma Symptom Inventory-2

The Trauma Symptom Inventory-Second Edition (TSI-2) is garnering research interest as a symptom validity test in the evaluation of trauma-related disorders. However, there has been limited empirical validation of its validity scales in clinical and forensic real-world settings. This study evaluated the ability of the TSI-2 Atypical Response (ATR) scale to discriminate response bias in cognitive performance and symptom reporting in a large sample of disability and compensation-seeking claimants. This retrospective chart review included 296 adults with a known history of trauma exposure or claimed trauma-related psychological injury who underwent neuropsychological and/or comprehensive psychological assessment in a private neuropsychology clinic. The discriminability of the ATR scale to classify credible versus non-credible cognitive profiles and symptom reporting were analyzed by AUC-ROCs. Overall, the ATR scale demonstrated poor discriminability of assessment validity based on the Word Memory Test, Victoria Symptom Validity Test, and Minnesota Multiphasic Personality Inventory-2-Restructured Form. The ATR scale had fair discriminatory ability of only one of the over-reporting scales (F-r), with an ROC area of .73, p = .001. However, the test publisher’s proposed ATR cut-offs of ≥8 for screening, research, and normal groups, and ≥15 in forensic and clinical settings revealed significant issues with sensitivity and specificity. These results suggest that the TSI-2 should be paired with other established performance validity and symptom validity tests in clinical assessments and not be used as the primary or sole indicator of assessment validity.

The impact of visual memory impairment on Victoria Symptom Validity Test performance: A known-groups analysis

Objective We assessed the effect of visual learning and recall impairment on Victoria Symptom Validity Test (VSVT) accuracy and response latency for Easy, Difficult, and Total Items. Method A sample of 163 adult patients administered the VSVT and Brief Visuospatial Memory Test-Revised were classified as valid (114/163) or invalid (49/163) groups via independent criterion performance validity tests (PVTs). Classification accuracies for all VSVT indices were examined for the overall sample, and separately for subgroups based on visual memory functioning. Results In the overall sample, all indices produced acceptable classification accuracy (areas under the curve [AUCs] ≥ 0.79). When stratified by visual learning/recall impairment, accuracy indices yielded acceptable classification for both the unimpaired (AUCs ≥0.79) and impaired subsamples (AUCs ≥0.75). Latency indices had acceptable classification accuracy for the unimpaired subsample (AUCs ≥0.74), but accuracy and sensitivity dropped for the impaired sample (AUCs ≥0.67). Conclusions VSVT accuracy and response latency yielded acceptable classification accuracies in the overall sample, and this effect was maintained in those with and without visual learning/recall impairment for the accuracy indices. Findings indicate that the VSVT is a psychometrically robust PVT with largely invariant cut-scores, even in the presence of bona fide visual learning/recall impairment.

Optimal per test cutoff scores and combinations of failure on multiple embedded performance validity tests in detecting performance invalidity in a mixed clinical sample

We tested the usefulness of six embedded performance validity tests (EPVTs) in identifying performance invalidity in a mixed clinical sample. Using a retrospective design, 181 adults were classified as valid (n = 146) or invalid (n = 35) performance based upon their performance on one of three standalone PVTs (Test of Memory Malingering, Victoria Symptom Validity Test, Dot Counting Test). Multiple cutoffs were identified corresponding to predetermined false positive rates of 0, 5, 10, and 15% for each of six EPVTs. EPVT cutoffs corresponding to the predetermined false positive benchmarks were generally more conservative than currently established scores. Sensitivity was low (.0%–42.9%) for individual EPVTs across these cutoffs and was moderately improved by the combination of multiple EPVT failures. The optimal number of EPVT failures using the 10% false positive rate was ≥ 2. Although the overall classification accuracy of 80.7% and specificity of 89.0% were comparable to prior research, the sensitivity of 45.7% was more modest than previous estimates. Low sensitivities indicate that this combination of EPVTs failed to detect a majority of invalid performers.

Victoria Symptom Validity Test: A Systematic Review and Cross-Validation Study.

The Victoria Symptom Validity Test (VSVT) is a performance validity test (PVT) with over two decades of empirical backing, although methodological limitations within the extant literature restrict its clinical and research generalizability. Chief among these constraints includes limited consensus on the most accurate index within the VSVT and the most appropriate cut-scores within each VSVT validity index. The current systematic review synthesizes existing VSVT validation studies and provides additional cross-validation in an independent sample using a known-groups design. We completed a systematic search of the literature, identifying 17 peer-reviewed studies for synthesis (7 simulation designs, 7 differential prevalence designs, and 3 known-groups designs). The independent cross-validation sample consisted of 200 mixed clinical neuropsychiatric patients referred for outpatient neuropsychological evaluation. Across all indices, Total item accuracy produced the strongest psychometric properties at an optimal cut-score of ≤ 40 (62% sensitivity/88% specificity). However, ROC curve analyses for all VSVT indices yielded statistically significant areas under the curve (AUCs; .73-81), suggestive of moderate classification accuracy. Cut-scores derived using the independent cross-validation sample converged with some previous findings supporting cut-scores of ≤ 22 for Easy item accuracy and ≤ 40 for Total item accuracy, although divergent findings were noted for Difficult item accuracy. Overall, VSVT validity indicators have adequate diagnostic accuracy across populations, with the current study providing additional support for its use as a psychometrically sound PVT in clinical settings. However, caution is recommended among patients with certain verified clinical conditions (e.g., dementia) and those with pronounced working memory deficits due to concerns for increased risk of false positives.

Mean response latency indices on the Victoria Symptom Validity Test do not contribute meaningful predictive value over accuracy scores for detecting invalid performance

The utility of the Victoria Symptom Validity Test (VSVT) as a performance validity test (PVT) has been primarily established using response accuracy scores. However, the degree to which response latency may contribute to accurate classification of performance invalidity over and above accuracy scores remains understudied. Therefore, this study investigated whether combining VSVT accuracy and response latency scores would increase predictive utility beyond use of accuracy scores alone. Data from a mixed clinical sample of 163 patients, who were administered the VSVT as part of a larger neuropsychological battery, were analyzed. At least four independent criterion PVTs were used to establish validity groups (121 valid/42 invalid). Logistic regression models examining each difficulty level revealed that all VSVT measures were useful in classifying validity groups, both independently and when combined. Individual predictor classification accuracy ranged from 77.9 to 81.6%, indicating acceptable to excellent discriminability across the validity indices. The results of this study support the value of both accuracy and latency scores on the VSVT to identify performance invalidity, although the accuracy scores had superior classification statistics compared to response latency, and mean latency indices provided no unique benefit for classification accuracy beyond dimensional accuracy scores alone.

The Modified Somatic Perception Questionnaire: Operating characteristics in non-pain forensic samples

The objective of the current archival study was to investigate the ability of the Modified Somatic Perception Questionnaire (MSPQ) to discriminate between noncredible and credible neurocognitive dysfunction in a large mixed non-pain forensic sample comprised of personal injury litigants and disability claimants. Participants included 149 adults who underwent comprehensive neuropsychological examination. Criterion groups were formed, i.e., Credible Group (CG), or Noncredible Group (NCG) based upon their performance on stand-alone performance validity tests (PVT) including the Word Memory Test (WMT), and/or Test of Memory Malingering (TOMM), and Victoria Symptom Validity Test (VSVT). After excluding examinees with evidence of somatization participants in the NCG scored significantly higher on the MSPQ compared to participants in the CG. Scores on the MSPQ were not only related to cognitive performance validity but also amplified by the co-existence of somatization. There were no significant effects of gender, age, or race on MSPQ scores. We conclude that the MSPQ demonstrates external validity as a self-report measure of symptom validity that is sensitive to somatic and autonomic complaints in non-pain forensic samples. Future research is needed to develop MSPQ cutscores with external validity pertinent to other non-pain populations.

Validation of the Test of Memory Malingering in a Clinical Population from Singapore

The present research aims to establish the predictive validity of the Test of Memory Malingering (TOMM) in a Singaporean sample with mood and psychotic disorders. Its clinical utility was compared against other performance validity tests: Dot Counting Test (DCT), Rey 15-Item Memory Test II (Rey II), Medical Symptom Validity Test (MSVT), Nonverbal Medical Symptom Validity Test (NV-MSVT), Word Memory Test (WMT) and Victoria Symptom Validity Test (VSVT). Findings revealed that TOMM, MSVT, NV-MSVT, WMT and VSVT preserved the ability to distinguish between Clinical participants' simulation groups, and TOMM outperformed all tests except NVMSVT. Overall, findings supported continued use of TOMM.

Performance Validity Testing in Multiple Sclerosis.

Performance validity tests (PVTs) are designed to detect nonvalid responding on neuropsychological testing, but their associations with disease-specific and other factors are not well understood in multiple sclerosis (MS). We examined PVT performance among MS patients and associations with clinical characteristics, cognition, mood, and disability status. Retrospective data analysis was conducted on a sample of patients with definite MS (n = 102) who were seen for a clinical neuropsychological evaluation. Comparison samples included patients with intractable epilepsy seen for presurgical workup (n = 102) and patients with nonacute mild traumatic brain injury (mTBI; n = 50). Patients completed the Victoria Symptom Validity Test (VSVT) and validity cutoffs were defined as <16/24 and <18/24 on the hard items. In this MS cohort, 14.4% of patients scored <16 on the VSVT hard items and 21.2% scored <18. VSVT hard item scores were associated with disability status and depression, but not with neuropsychological scores, T2 lesion burden, atrophy, disease duration, or MS subtype. Patients applying for disability benefits were 6.75 times more likely to score <18 relative to those who were not seeking disability. Rates of nonvalid scores were similar to the mTBI group and greater than the epilepsy group. This study demonstrates that nonvalid VSVT scores are relatively common among MS patients seen for clinical neuropsychological evaluation. VSVT performance in this group relates primarily to disability status and psychological symptoms and does not reflect factors specific to MS (i.e., cognitive impairment, disease severity). Recommendations for future clinical and research practices are provided.

Working Memory, Processing Speed, and Memory Functioning Are Minimally Predictive of Victoria Symptom Validity Test Performance.

A sound performance validity test is accurate for detecting invalid neuropsychological test performance and relatively insensitive to actual cognitive ability or impairment. This study explored the relationship of several cognitive abilities to several performance indices on the Victoria Symptom Validity Test (VSVT), including accuracy and response latency. This cross-sectional study examined data from a mixed clinical sample of 88 adults identified as having valid neurocognitive test profiles via independent validity measures, and who completed the VSVT along with objective measures of working memory, processing speed, and verbal memory during their clinical neuropsychological evaluation. Results of linear regression analyses indicated that cognitive test performance accounted for 5% to 14% of total variance for VSVT performance across indices. Working memory was the only cognitive ability to predict significant, albeit minimal, variance on the VSVT response accuracy indices. Results show that VSVT performance is minimally predicted by working memory, processing speed, or delayed verbal memory recall.

Optimization of Performance Validity Test (PVT) Cutoffs across Healthy and Non-Referred Clinical Research Samples

Performance validity tests (PVTs) effectively detect suboptimal test performance, but cutoff scores for a given test may differ between populations. This research examines how optimal PVT cutoffs differ in a collegiate research population when mental health and clinical conditions are considered. Healthy controls (n = 328) and non-referred students with self-reported clinical conditions (n = 42) were assigned to perform their best while others simulated ADHD symptoms (n = 123). PVT indices were derived from a stand-alone measure (Victoria Symptom Validity Test) and embedded measures (California Verbal Learning Test – Second Edition; Wechsler Adult Intelligence Scale – Fourth Edition, Digit Span). PVT cutoffs with the highest sensitivity, while maintaining adequate specificity, were identified when the control groups were considered together, and when students with reported clinical conditions were considered separately. Mean differences in PVT performances were found between the simulation group and control groups, but not between clinical and nonclinical controls. The optimized cutoffs differed for five of eight PVT indices when all controls were considered together versus the clinical control group, only. When discordance was observed, cutoffs tended to be lower (less stringent) for the non-referred clinical control group. Together, these optimized cutoffs tended to be more stringent than previously established cutoffs. This study suggests that PVT cutoffs may be responsibly altered in a research context in the presence of a clinical condition. Future research should investigate if PVT classification accuracies can be improved in clinical and forensic samples while considering clinical conditions.

The Coin in Hand-Extended Version: Development and Validation of a Multicultural Performance Validity Test.

The number of computerized and reliable performance validity tests are scarce. This study aims to address this issue by validating a free and computerized performance validity test: the Coin in Hand-Extended Version (CIH-EV). The CIH-EV test was administered in four countries (Colombia, Spain, Portugal, and the United States) and performance was compared with other commonly used validated tests. Results showed that the CIH-EV has at least 95% specificity and 62% sensitivity, and performance was highly correlated with scores on the Test of Memory Malingering, Victoria Symptom Validity Test, and Digit Span of the Wechsler Adult Intelligence Scale. There were no significant differences in scores across countries, suggesting that the CIH-EV performs similarly in a variety of cultures. Our findings suggest that the CIH-EV has the potential to serve as a valid validity test either alone or as a supplement to other commonly used validity tests.

A Comparison of Performance Validity Measures in Predicting MMPI-2 Lie Scale Results

Objective: This study examined the relationship between tests of performance validity (PVT) and symptom validity (SVT) among claimants undergoing independent neuropsychological evaluations. Previous research comparing PVTs with SVTs has examined symptom validity with respect to overreporting impairment, whereas the current study focused on how PVTs predict underreporting of psychological symptoms and minimization of negative personality characteristics.Method: The sample included 99 claimants presenting with psychological and cognitive complaints who were assessed in a private practice setting. Participants were administered several SVTs (MMPI-2 Lie Scale (L), Superlative Self Presentation Scale (S), Correction Scale (K)) and PVTs, including Reliable Digit Span (RDS), California Verbal Learning Test forced choice recognition, the Victoria Symptom Validity Test (VSVT), and the Test of Memory Malingering (TOMM).Results: Analyses revealed moderate yet significant (p<.001) negative correlations between the L Scale and PVTs with exception of the VSVT. These relationships were substantiated by moderate to large effect sizes (d = 0.56–0.81) when comparing L Scale scores in above and below PVT cutoff conditions. Significant relationships between PVTs and the K and S Scales were not observed. Exploratory analyses revealed that PVT/L Scale relationships were not significantly moderated by presenting concern.Conclusions: Claimants exhibiting invalid PVT performance were more likely to endorse virtuous personality characteristics on the L Scale, supporting the idea that PVT and SVT constructs are interrelated, particularly in the domain of underreporting moral flaws.

Compliance on neuropsychological performance validity testing in patients with borderline personality disorder.

Complaints of cognitive dysfunction are common in patients with borderline personality disorder (BPD), and they are often accompanied by deficits on neuropsychological testing. Prior studies of BPD, however, did not evaluate compliance on neuropsychological performance validity testing, which could partially account for cognitive deficits observed in patients. The aims of the current study were to evaluate the frequency at which patients with BPD show less than adequate compliance on performance validity testing, and whether patients showing less compliance perform lower on standardized neuropsychological measures. Fifty outpatients with BPD completed the Victoria Symptom Validity Test, a 2-alternative, forced-choice recognition test as part of a larger neuropsychological test battery for research on cognitive functioning in BPD. As a group, patients with BPD made more errors and had longer response latencies on seemingly difficult items as compared to healthy individuals. Based on established guidelines for interpretation of performances on the Victoria Symptom Validity Test, 2% of the sample was classified as probably not compliant, 10% questionably compliant, and 88% compliant. Patients with questionably or probably not compliant performances had lower estimated premorbid intellectual functioning and displayed poorer response control on neuropsychological testing than compliant patients. These findings highlight the value of incorporating performance validity testing in neuropsychological studies of patients with BPD and suggest that prior research on the disorder should be interpreted with caution because the results may not be based on valid performances.

Validation of Victoria Symptom Validity Test Cutoff Scores among Mild Traumatic Brain Injury Litigants Using a Known-Groups Design.

The Victoria Symptom Validity Test (VSVT) is one of the most accurate performance validity tests. Previous research has recommended several cutoffs for performance invalidity classification on the VSVT. However, only one of these studies used a known groups design and no study has investigated these cutoffs in an exclusively mild traumatic brain injury (mTBI) medico-legal sample. The current study used a known groups design to validate VSVT cutoffs among mild traumatic brain injury litigants and explored the best approach for using the multiple recommended cutoffs for this test. Cutoffs of <18 Hard items correct, <41 Total items correct, an Easy - Hard items correct difference >6, and <5 items correct on any block yielded the strongest classification accuracy. Using multiple cutoffs in conjunction reduced classification accuracy. Given convergence across studies, a cutoff of <18 Hard items correct is the most appropriate for use with mTBI litigants.

Performance Invalidity Base Rates Among Healthy Undergraduate Research Participants

Few studies have examined base rates of suboptimal effort among healthy, undergraduate students recruited for neuropsychological research. An and colleagues (2012, Conducting research with non-clinical healthy undergraduates: Does effort play a role in neuropsychological test performance? Archives of Clinical Neuropsychology, 27, 849-857) reported high rates of performance invalidity (30.8%-55.6%), calling into question the validity of findings generated from samples of college students. In contrast, subsequent studies have reported much lower base rates ranging from 2.6% to 12%. The present study replicated and extended previous work by examining the performance of 108 healthy undergraduates on the Dot Counting Test, Victoria Symptom Validity Test, Word Memory Test, and a brief battery of neuropsychological measures. During initial testing, 8.3% of the sample scored below cutoffs on at least one Performance Validity Test, while 3.7% were classified as invalid at Time 2 (M interval = 34.4 days). The present findings add to a growing number of studies that suggest performance invalidity base rates in samples of non-clinical, healthy college students are much lower than An and colleagues initial findings. Although suboptimal effort is much less problematic than suggested by An and colleagues, recent reports as high as 12% indicate including measures of effort may be of value when using college students as participants. Methodological issues and recommendations for future research are presented.

The role of low cognitive effort and negative symptoms in neuropsychological impairment in schizophrenia.

Two experiments were conducted to examine whether insufficient effort, negative symptoms (e.g., avolition, anhedonia), and psychological variables (e.g., anhedonia and perception of low cognitive resources) predict generalized neurocognitive impairment in individuals with schizophrenia (SZ). In Experiment 1, participants included 97 individuals with SZ and 63 healthy controls (CN) who completed the Victoria Symptom Validity Test (VSVT), the MATRICS Consensus Cognitive Battery (MCCB), and self-report anhedonia questionnaires. In Experiment 2, participants included 46 individuals with SZ and 33 CN who completed Green's Word Memory Test (WMT), the MCCB, and self-reports of anhedonia, defeatist performance beliefs, and negative expectancy appraisals. RESULTS indicated that a low proportion of individuals with SZ failed effort testing (1.0% Experiment 1; 15.2% Experiment 2); however, global neurocognitive impairment was significantly predicted by low effort and negative symptoms. Findings indicate that low effort does not threaten the validity of neuropsychological test results in the majority of individuals with schizophrenia; however, effort testing may be useful in SZ patients with severe negative symptoms who may be more likely to put forth insufficient effort due to motivational problems. Although the base rate of failure is relatively low, it may be beneficial to screen for insufficient effort in SZ and exclude individuals who fail effort testing from pharmacological or cognitive remediation trials.

C-83 * The Role of IQ in Effort Test Performance in Schizophrenia

Objective: Intelligence has recently been shown to predict performance on effort testing in healthy individuals, with lower IQ associated with higher rates of effort test failure. Similar results have been found in patients with epilepsy. However, the relationship between IQ and effort test performance has yet to be examined in psychiatric populations, including schizophrenia (SZ). The current study sought to address this question across two experiments. Method: Participants in Experiment 1 included 97 outpatients with SZ and 63 healthy controls who completed the Victoria Symptom Validity Test (VSVT). Experiment 2 included 46 outpatients with SZ and 33 CN. A very low rate of SZ failed effort testing (VSVT = 1%; WMT = 15%). Patients were separated into WASI full-scale IQ groups (60–79, 80–89, 90–99, 100+) and compared on demographics and effort test performance. Results: Higher current full-scale IQ was associated with higher personal and parental education, higher premorbid IQ, and greater likelihood of being male and Caucasian. IQ in the 60–79 or 80–89 range was associated with greater rates of failure on the WMT and lower scores on the VSVT difficult items. Patients falling above the 90 IQ range did not fail the WMT and had nearly perfect scores on the VSVT. Conclusion(s): Consistent with findings in healthy individuals and individuals with epilepsy, low IQ is a significant predictor of effort test performance in SZ. Our findings indicate that performance on effort tests, which are presumed to be relatively stable even in the face of intellectual deficits, may actually be influenced by intelligence.

Can brief measures effectively screen for pain and somatic malingering? Examination of the Modified Somatic Perception Questionnaire and Pain Disability Index

Background contextRecent rise in fraudulent disability claims in the United States has resulted in psychologists being increasingly called upon to use psychological tests to determine whether disability claims based on psychological or somatic/pain complaints are legitimate. PurposeTo examine two brief measures, Modified Somatic Perception Questionnaire (MSPQ) and the Pain Disability Index (PDI), and their ability to screen for malingering in relation to the Bianchini et al. criteria for malingered pain-related disability published in The Spine Journal (2005). Study designExamined brief self-report measures between litigating and nonlitigating pain samples. Patient sampleWe compared 144 disability litigants, predominantly presenting a history of musculoskeletal injuries with psychiatric overlay, with 167 nonlitigating pain patients who were predominantly in treatment for chronic back pain issues and other musculoskeletal conditions. Outcome measuresModified Somatic Perception Questionnaire, Pain Disability Index, Minnesota Multiphasic Personality Inventory-2 Restructured Form, Test of Memory Malingering, Letter Memory Test, Victoria Symptom Validity Test, Structured Interview of Reported Symptoms-second edition, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders somatoform disorders module. MethodsWe examined a sample of 144 individuals undergoing compensation-seeking evaluations in relation to 167 nonlitigating pain patients. ResultsGroup differences on both the MSPQ and PDI were calculated, as well as sensitivities, specificities, and positive and negative predictive powers for both measures at selected cutoffs. ConclusionsThe results suggest that both the MSPQ and PDI are useful to screen for pain malingering in forensic evaluations, especially the MSPQ, which performed the best in differentiating between the groups.