The Impact of Increasing Material-Specific Verbal and Visual Memory Impairment Severity on Embedded Performance Validity Tests in the Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-Revised

• Published in: Psychological injury and law 2024-06, Vol.17 (2), p.174-186
• Main Authors: Carter, Dustin A., Resch, Zachary J., Ovsiew, Gabriel P., Soble, Jason R.
• Format: Article
• Language: English
• Subjects: Accuracy; Behavioral Science and Psychology; Classification; Clinical Psychology; Cognition; Cognitive ability; Dementia; Demography; Discrimination; Failure; Law and Psychology; Learning; Memory; Neuropsychology; Psychology; Spatial memory; Tests; Validity; Verbal learning; Verbal memory; Visual memory
• ISSN: 1938-971X; 1938-9728
• DOI: 10.1007/s12207-024-09512-9

Performance on some freestanding performance validity tests (PVTs) is adversely affected by specific cognitive processes/abilities, notably genuine memory impairment; however, this has not been well-researched in the context of memory-based embedded PVTs. This cross-sectional study evaluated the Rey Auditory Verbal Learning Test (RAVLT) Effort Score (ES) and Brief Visuospatial Memory Test-Revised (BVMT-R) Recognition Discrimination (RD) for classifying validity status across three levels of visual and verbal learning and memory performance (i.e., no, mild, and severe impairment). Data for this known-groups study were gathered from 292 mixed clinical neuropsychiatric patients who completed a comprehensive evaluation and classified into valid ( n  = 235) or invalid ( n  = 57) groups by four independent criterion PVTs. Overall, ES had 33% sensitivity/89% specificity and RD had 37% sensitivity/95% specificity at optimal cutoffs. ES had good classification accuracy, with 60–74% sensitivity/88–89% specificity for patients with normal performance and 30–33% sensitivity/ ≥ 89% specificity for those with mildly impaired verbal learning/memory performance. However, ES was unable to accurately differentiate those with severely impaired material-specific verbal learning/memory performance. RD had excellent classification accuracy, with 61% sensitivity/ ≥ 95% specificity for those with normal visual learning/memory performance and 37% sensitivity/ ≥ 93% specificity for those with mildly impaired performance. Contrasting ES, RD remained able to accurately differentiate invalidly performing patients from those with severely impaired visual learning/memory performance, with 26% sensitivity/84–87% specificity. Both RAVLT ES and BVMT-R RD were useful PVTs, even among patients with material-specific verbal and visual memory deficits. That said, ES did not accurately differentiate invalid performance from valid-impaired performance with severely impaired verbal learning/memory performance.