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CVLT-II Forced Choice Recognition Trial as an Embedded Validity Indicator: A Systematic Review of the Evidence

Published online by Cambridge University Press:  13 September 2016

Eben S. Schwartz ,
Laszlo Erdodi ,
Nicholas Rodriguez ,
Jyotsna J. Ghosh ,
Joshua R. Curtain ,
Laura A. Flashman  and
Robert M. Roth
Eben S. Schwartz*
Affiliation:
Neuroscience Center, Waukesha Memorial Hospital, Waukesha, Wisconsin
Laszlo Erdodi
Affiliation:
Department of Psychology, University of Windsor, Windsor ON, Canada
Nicholas Rodriguez
Affiliation:
Department of Psychology, University of Windsor, Windsor ON, Canada
Jyotsna J. Ghosh
Affiliation:
Neuropsychology Program, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
Joshua R. Curtain
Affiliation:
Department of Neurology and Neurological Sciences, Stanford Health Care, Stanford, California
Laura A. Flashman
Affiliation:
Neuropsychology Program, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
Robert M. Roth
Affiliation:
Neuropsychology Program, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
*
Correspondence and reprint requests to: Eben S. Schwartz, Department of Neuroscience, ProHealth Waukesha Memorial Hospital, 721 American Avenue; Suite 406, Waukesha, WI 53188. E-mail: [email protected]
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Abstract

Objectives: The Forced Choice Recognition (FCR) trial of the California Verbal Learning Test, 2nd edition, was designed as an embedded performance validity test (PVT). To our knowledge, this is the first systematic review of classification accuracy against reference PVTs. Methods: Results from peer-reviewed studies with FCR data published since 2002 encompassing a variety of clinical, research, and forensic samples were summarized, including 37 studies with FCR failure rates (N=7575) and 17 with concordance rates with established PVTs (N=4432). Results: All healthy controls scored >14 on FCR. On average, 16.9% of the entire sample scored ≤14, while 25.9% failed reference PVTs. Presence or absence of external incentives to appear impaired (as identified by researchers) resulted in different failure rates (13.6% vs. 3.5%), as did failing or passing reference PVTs (49.0% vs. 6.4%). FCR ≤14 produced an overall classification accuracy of 72%, demonstrating higher specificity (.93) than sensitivity (.50) to invalid performance. Failure rates increased with the severity of cognitive impairment. Conclusions: In the absence of serious neurocognitive disorder, FCR ≤14 is highly specific, but only moderately sensitive to invalid responding. Passing FCR does not rule out a non-credible presentation, but failing FCR rules it in with high accuracy. The heterogeneity in sample characteristics and reference PVTs, as well as the quality of the criterion measure across studies, is a major limitation of this review and the basic methodology of PVT research in general. (JINS, 2016, 22, 851–858)

Keywords

Symptom evaluationValidity of resultsReviewSystematicMemory deficitsMalingeringNeuropsychology
Type
Brief Communications
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 8 , September 2016 , pp. 851 - 858
Copyright
Copyright © The International Neuropsychological Society 2016 

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