Clinical utility of the Rey 15-Item Test, recognition trial, and error scores for detecting noncredible neuropsychological performance in a mixed clinical sample of veterans

K. Chase Bailey, Jason R. Soble, Justin J.F. O’Rourke

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: This cross-sectional study examined the Rey 15-Item Test (RFIT), Recognition Trial, and Error Scores for identifying noncredible performance in a mixed clinical veteran sample compared to another widely used validity measure, the Test of Memory Malingering (TOMM). Method: Sixty-two veterans who completed the RFIT (Recall/Recognition Trials), TOMM, and Word Memory Test (WMT) during clinical evaluation were included. Using the WMT as the criterion, 71% (N = 44) were classified as valid and 29% (N = 18) as invalid. Results: Among valid participants, 25% failed the RFIT Recall, whereas 78% of invalid participants passed (sensitivity: 22%; specificity: 75%; diagnostic odds ratio [DOR]:.86). The Recognition Trial increased sensitivity to 39% for identifying invalid performance, but 25% of valid participants still scored below cut-off (specificity: 75%; DOR: 1.91). RFIT Recall and Recognition Trial logistic regression and receiver operating characteristic (ROC) analyses were nonsignificant, with respective classification accuracies of 71 and 72.6% and areas under the curve (AUCs) of.52 and.55. RFIT Error Scores also failed to differentiate validity groups. In contrast, TOMM had stronger psychometric properties (sensitivity: 50%; specificity: 97.7%; DOR: 43; classification accuracy: 82.3%; AUC:.91). Moreover, RFIT Recall and Recognition failure rates were 14 and 22% greater, respectively, among those with cognitive impairment, whereas 95% of those with impairment and 100% without passed the TOMM. Conclusion: Despite frequent use among VA neuropsychologists, the RFIT displayed limited ability to detect noncredible performance and misclassified a large percentage of valid participants in this mixed clinical veteran sample, suggesting limited utility with this population.

Original languageEnglish (US)
Pages (from-to)119-131
Number of pages13
JournalClinical Neuropsychologist
Volume32
Issue number1
DOIs
StatePublished - Jan 2 2018

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Veterans
Malingering
Odds Ratio
Area Under Curve
Aptitude
Psychometrics
ROC Curve
Recognition (Psychology)
Cross-Sectional Studies
Logistic Models
Population
Specificity
Diagnostics

Keywords

  • Performance Validity Assessment
  • psychometrics
  • Rey 15-Item Test
  • Test of Memory Malingering (TOMM)
  • veterans

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Developmental and Educational Psychology
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health

Cite this

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title = "Clinical utility of the Rey 15-Item Test, recognition trial, and error scores for detecting noncredible neuropsychological performance in a mixed clinical sample of veterans",
abstract = "Objective: This cross-sectional study examined the Rey 15-Item Test (RFIT), Recognition Trial, and Error Scores for identifying noncredible performance in a mixed clinical veteran sample compared to another widely used validity measure, the Test of Memory Malingering (TOMM). Method: Sixty-two veterans who completed the RFIT (Recall/Recognition Trials), TOMM, and Word Memory Test (WMT) during clinical evaluation were included. Using the WMT as the criterion, 71{\%} (N = 44) were classified as valid and 29{\%} (N = 18) as invalid. Results: Among valid participants, 25{\%} failed the RFIT Recall, whereas 78{\%} of invalid participants passed (sensitivity: 22{\%}; specificity: 75{\%}; diagnostic odds ratio [DOR]:.86). The Recognition Trial increased sensitivity to 39{\%} for identifying invalid performance, but 25{\%} of valid participants still scored below cut-off (specificity: 75{\%}; DOR: 1.91). RFIT Recall and Recognition Trial logistic regression and receiver operating characteristic (ROC) analyses were nonsignificant, with respective classification accuracies of 71 and 72.6{\%} and areas under the curve (AUCs) of.52 and.55. RFIT Error Scores also failed to differentiate validity groups. In contrast, TOMM had stronger psychometric properties (sensitivity: 50{\%}; specificity: 97.7{\%}; DOR: 43; classification accuracy: 82.3{\%}; AUC:.91). Moreover, RFIT Recall and Recognition failure rates were 14 and 22{\%} greater, respectively, among those with cognitive impairment, whereas 95{\%} of those with impairment and 100{\%} without passed the TOMM. Conclusion: Despite frequent use among VA neuropsychologists, the RFIT displayed limited ability to detect noncredible performance and misclassified a large percentage of valid participants in this mixed clinical veteran sample, suggesting limited utility with this population.",
keywords = "Performance Validity Assessment, psychometrics, Rey 15-Item Test, Test of Memory Malingering (TOMM), veterans",
author = "Bailey, {K. Chase} and Soble, {Jason R.} and O’Rourke, {Justin J.F.}",
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AB - Objective: This cross-sectional study examined the Rey 15-Item Test (RFIT), Recognition Trial, and Error Scores for identifying noncredible performance in a mixed clinical veteran sample compared to another widely used validity measure, the Test of Memory Malingering (TOMM). Method: Sixty-two veterans who completed the RFIT (Recall/Recognition Trials), TOMM, and Word Memory Test (WMT) during clinical evaluation were included. Using the WMT as the criterion, 71% (N = 44) were classified as valid and 29% (N = 18) as invalid. Results: Among valid participants, 25% failed the RFIT Recall, whereas 78% of invalid participants passed (sensitivity: 22%; specificity: 75%; diagnostic odds ratio [DOR]:.86). The Recognition Trial increased sensitivity to 39% for identifying invalid performance, but 25% of valid participants still scored below cut-off (specificity: 75%; DOR: 1.91). RFIT Recall and Recognition Trial logistic regression and receiver operating characteristic (ROC) analyses were nonsignificant, with respective classification accuracies of 71 and 72.6% and areas under the curve (AUCs) of.52 and.55. RFIT Error Scores also failed to differentiate validity groups. In contrast, TOMM had stronger psychometric properties (sensitivity: 50%; specificity: 97.7%; DOR: 43; classification accuracy: 82.3%; AUC:.91). Moreover, RFIT Recall and Recognition failure rates were 14 and 22% greater, respectively, among those with cognitive impairment, whereas 95% of those with impairment and 100% without passed the TOMM. Conclusion: Despite frequent use among VA neuropsychologists, the RFIT displayed limited ability to detect noncredible performance and misclassified a large percentage of valid participants in this mixed clinical veteran sample, suggesting limited utility with this population.

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