Concurrent validity of three forced-choice measures of symptom validity.

Forced-choice measures of recognition memory are used to assess the validity of an evaluation by using cutoff scores that discriminate individuals demonstrating good effort from those who are intentionally performing suboptimally. The current study evaluated three measures of motivation in a clinical sample of over 150 individuals. The Forced-Choice subtest from the California Verbal Learning Test and the Test of Memory Malingering generated comparable percentages of poor effort at 23% and 21%, respectively, yet they did not have complete concordance. Overall detection of poor performance using the 85% cut score on the three easy subtests from the Medical Symptom Validity Test (MSVT; Green, 2004) fell at 37%. When the MSVT cut score was lowered to 70%, the failure rate dropped to 21%, consistent with the other two measures and embedded measures of effort. The data are discussed in terms of adjusting the MSVT cut score and examining comparability in detection rates across these measures of symptom validity.