Exploration of PCL-5 symptom validity indices for detection of exaggerated and feigned PTSD.

INTRODUCTION: There are very few symptom validity indices directly examining overreported posttraumatic stress disorder (PTSD) symptomatology, and, until recently, there were no symptom validity indices embedded within the PTSD Checklist for the DSM-5 (PCL-5), which is one of the most commonly used PTSD measures. Given this, the current study sought to develop and cross-validate symptom validity indices for the PCL-5. METHOD: Multiple criterion groups comprised of Veteran patients were utilized (N = 210). Patients were determined to be valid or invalid responders based on Personality Asessment Inventory symptom validity indices. Three PCL-5 symptom validity indices were then examined: the PCL-5 Symptom Severity scale (PSS), the PCL-5 Extreme Symptom scale (PES), and the PCL-5 Rare Items scale (PRI). RESULTS: Area under the curve statistics ranged from .78 to .85. The PSS and PES both met classification accuracy statistic goals, with the PES achieving the highest sensitivity rate (.39) when maintaining specificity at .90 or above across all criterion groups. When an ad hoc analysis was performed, which included only patients with exceptionally strong evidence of invalidity, sensitivity rates increased to .60 for the PES while maintaining specificity at .90. CONCLUSIONS: These findings provide preliminary support for new PTSD symptom validity indices embedded within one of the most frequently used PTSD measures.

Clinical utility of the memory complaints inventory to detect invalid test performance.

OBJECTIVE: This investigation was designed to examine the classification statistics of Memory Complaints Inventory (MCI) scores relative to the Medical Symptom Validity Test (MSVT) and the Non-Verbal Medical Symptom Validity Test (NV-MSVT), as well as various validity scales on the Personality Assessment Inventory (PAI) and Minnesota Multiphasic Personality Inventory-2 Restructured Form(MMPI-2-RF). METHOD: The sample consisted of 339 active duty service members with a history of concussion who completed performance validity tests (PVTs), symptom validity tests (SVTs), and the MCI. RESULTS: Those who failed the MSVT and NV-MSVT had significantly higher scores across all MCI scales. In addition, those who scored above specified cut scores on the evaluated PAI and MMPI-2-RF validity scales also had significantly higher MCI scale scores. Receiver operator characteristics analysis demonstrated acceptable area under the curve (AUC) across the evaluated SVTs for the mean of all MCI subtests with values ranging from (.77 to .86), with comparable findings for PVTs (MSVT AUC = .75; NV-MSVT AUC = .72). CONCLUSIONS: In general the MCI scales demonstrated better classification statistics relative to SVTs vs. PVTs, which is consistent with the nature of the MCI as a self-report instrument.