Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Salisbury, NC, USA.
Salisbury Veterans Affairs Medical Center, Salisbury, NC, USA.
Clin Neuropsychol. 2020 Jul;34(5):1025-1037. doi: 10.1080/13854046.2019.1635209. Epub 2019 Jul 17.
Embedded validity measures are useful in neuropsychological evaluations but should be updated with new test versions and validated across various samples. This study evaluated Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) Digit Span validity indicators in post-deployment veterans. Neurologically-intact veterans completed structured diagnostic interviews, the WAIS-IV, the Medical Symptom Validity Test (MSVT), and the b Test as part of a larger study. The Noncredible group included individuals who failed either the MSVT or the b Test. Of the total sample ( = 275), 21.09% failed the MSVT and/or b Test. Diagnostic accuracy was calculated predicting group status across cutoff scores on two Digit Span variables, four Reliable Digit Span (RDS) variables, and two Vocabulary minus Digit Span variables. Digit Span age-corrected scaled score (ACSS) had the highest AUC (.648) of all measures assessed; however, sensitivity at the best cutoff of <7 was only 0.17. Of RDS measures, the Working Memory RDS resulted in the highest AUC (.629), but Enhanced RDS and Alternate RDS produced the highest sensitivities (0.22). Overall, cutoff scores were consistent with other studies, but sensitivities were lower. Vocabulary minus Digit Span measures were not significant. Digit Span ACSS was the strongest predictor of noncredible performance, and outperformed traditional RDS variants. Sensitivity across all validity indicators was low in this research sample, though cutoff scores were congruent with previous research. Although embedded Digit Span validity indicators may be useful, they are not sufficient to replace standalone performance validity tests.
嵌入式效度测量在神经心理学评估中很有用，但应随着新的测试版本进行更新，并在各种样本中进行验证。本研究评估了韦氏成人智力量表第四版（WAIS-IV）数字跨度效标在部署后退伍军人中的有效性指标。神经完整的退伍军人完成了结构化诊断访谈、WAIS-IV、医学症状效度测试（MSVT）和 b 测试，作为更大研究的一部分。不可信组包括在 MSVT 或 b 测试中失败的个体。在总样本（n=275）中，21.09%的人未能通过 MSVT 和/或 b 测试。在两个数字跨度变量、四个可靠数字跨度（RDS）变量和两个词汇量减去数字跨度变量的临界值上，计算了预测组状态的诊断准确性。数字跨度年龄校正量表分数（ACSS）是所有评估指标中 AUC（.648）最高的；然而，最佳临界值<7 的敏感度仅为 0.17。在 RDS 指标中，工作记忆 RDS 的 AUC 最高（.629），但增强型 RDS 和替代型 RDS 的敏感度最高（0.22）。总体而言，临界值与其他研究一致，但敏感度较低。词汇量减去数字跨度测量结果不显著。数字跨度 ACSS 是不可信表现的最强预测指标，优于传统的 RDS 变体。在这个研究样本中，所有有效性指标的敏感度都较低，尽管临界值与之前的研究一致。尽管嵌入式数字跨度效标指标可能有用，但它们不足以替代独立的表现效度测试。
