Development of the Poor Validity Profile Analysis for the Medical Symptom Validity Test.

OBJECTIVES: The Medical Symptom Validity Test (MSVT) offers a profile analysis for performance validity, but individuals performing with suboptimal performance validity are frequently misidentified by current profile rules. The aim of this study was to develop and validate a new profile analysis for the MSVT. METHOD: This study utilized 2 phases to investigate current profile analyses and construct a new analysis. Phase I compared graduate students and adult volunteers asked to simulate dementia to individuals with dementia in long-term care facilities. Phase I included development of a logistic equation with a logit model correction and introduced 4 new profiles. Phase II investigated the 4 proposed profiles using a new sample of graduate students asked to simulate dementia and outpatient dementia referrals. RESULTS: The 4 proposed profiles showed high specificity (94%-96%) and acceptable sensitivity (79.5%-95.5%) in Phase I. In Phase II, 1 profile out performed others by demonstrating 95.7% specificity and 86% sensitivity. High sensitivity (84%) and specificity (96%) were obtained for aggregate samples using this profile. CONCLUSIONS: This research provides an alternative profile analysis for the MSVT that outperforms the available analysis in identifying poor performance validity from genuine impairment.

Comparison of the repeatable battery for the assessment of neuropsychological status effort scale and effort index in a dementia sample.

The aim of the current study was to compare two embedded measures of effort for the repeatable battery for the assessment of neuropsychological status (RBANS). Sensitivity and specificity of the Effort Index (EI) and Effort Scale (ES) were compared in a sample of individuals with genuine memory impairment (MI) and individuals coached to simulate MI. Overall, the EI yielded a sensitivity of 0.89 and specificity of 0.41, while the ES yielded a sensitivity of 0.88 and specificity of 0.81. When those in the MI group were separated by level of impairment, the EI was more specific when RBANS Total Scores were in the average or mildly impaired range, and the ES had greater specificity when RBANS Total Scores were in the severely impaired range. These results suggest that the embedded measure should be selected based on the level of impairment on the RBANS.

An Improved Measure of Handedness: The Fazio Laterality Inventory.

The Edinburgh Handedness Inventory (EHI) is the most widely used handedness inventory. The EHI has some weaknesses: it has been suggested it is outdated; the instructions are frequently misunderstood by participants; and the response format produces skewed responses in those who avoid extreme responding. This study introduces the Fazio Laterality Inventory (FLI) as an alternative that addresses these limitations. In an initial development study, the 12-item instrument showed acceptable internal reliability (Cronbach's alpha =.921), and a one-component solution explained 55.5% of the variance. After removal of two items, a validation study revealed the instrument again had good internal reliability (Cronbach's alpha =.943) with a one-component solution explaining 65.8% of the variance. The FLI did not correlate as strongly as expected with the EHI, likely due to its lack of an "Oldfield Admonition" as well as the finer scaling of the response format. Additional analyses of the FLI as a whole and each item are offered. A scoring procedure and cutoffs for utilizing the FLI in clinical and research settings are suggested.