The Relationship of Cogniphobia to Performance Validity and Symptom Validity in Neuropsychological Assessment

Objective: Emerging research suggests that fear and avoidance are associated with not only physical symptoms, but also cognitive functioning. The concept of cogniphobia describes the fear and avoidance of cognitively effortful tasks to avoid the onset or worsening of symptoms. Extant studies provide...

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Bibliographic Details
Published in:Neuropsychology 2021-10, Vol.35 (7), p.762-769
Main Authors: Lee, Grace J., Suhr, Julie, Henry, George K., Heilbronner, Robert L., Drane, Daniel L.
Format: Article
Language:English
Subjects:
Adult
Anxiety
Avoidance
Factor Analysis, Statistical
Fear
Female
Human
Humans
Male
Malingering - diagnosis
Measurement
Motivation
Neuropsychological Assessment
Neuropsychological Tests
Phobias
Psychometrics
Reproducibility of Results
Symptoms
Test Validity
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Summary:Objective: Emerging research suggests that fear and avoidance are associated with not only physical symptoms, but also cognitive functioning. The concept of cogniphobia describes the fear and avoidance of cognitively effortful tasks to avoid the onset or worsening of symptoms. Extant studies provide preliminary evidence for associations between cogniphobia and validity testing. However, less is known about the subcomponents of cogniphobia. This study investigated the relationship of cogniphobia subcomponents to validity testing and psychological presentations. Method: Participants included 171 adults from an archival database who had completed measures of cogniphobia and psychological symptom reports as part of a larger neuropsychological study. The sample was classified as scoring above or below published cutoffs on performance validity tests (PVTs) and symptom validity tests (SVTs), consistent with current research/recommendations. Results: Confirmatory factor analysis (CFA) supported a two-factor model of cogniphobia, with Avoidance and Dangerousness as subcomponents. Logistic regression analyses identified Avoidance as the strongest predictor of scores falling in the invalid range on PVTs and SVTs, as well as the presence of external incentives. After excluding participants who fell in the invalid range on SVTs, only Avoidance significantly predicted report of somatic complaints. Conclusions: Cogniphobia, especially the avoidance of cognitive exertion component, is associated with performance in the invalid range on both PVTs and SVTs and is also related to report of somatic concerns when controlling for beliefs that cognitive exertion is dangerous. Key Points Question: The present study examined the relationship between cogniphobia subcomponents to validity testing and psychological presentations in a multi-site, mixed forensic and nonforensic clinical sample. Finding: Our results supported a two-factor model of cogniphobia, with Avoidance and Dangerousness as subcomponents. Compared to beliefs that cognitive exertion is dangerous, avoidance of cognitive exertion was the strongest predictor of scores falling in the invalid range on performance and symptom validity (FBS-r) testing, as well as selF-report of somatic complaints. Importance: Our findings point to a strong relationship between avoidance of cognitive exertion and invalid scores on PVTs and SVTs. The role of cogniphobia is important to consider when interpreting symptom reports and test perf
ISSN:0894-4105
1931-1559
DOI:10.1037/neu0000765