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A link between noncredible responding and low scores on the Grooved Pegboard Test (GPB) is well documented in the clinical literature. However, no specific validity cutoffs have emerged in previous research. This study was designed to examine the classification accuracy of various demographically adjusted cutoffs on the GPB against established meas...
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... Two of these occurred on measures of motor speed and fine motor skills. Multivariate models of performance validity clear his scores on the latter (i.e., he passed the criterion for failing T ≤ 31; Erdodi, Seke, et al., 2017;. Failing the former can be attributed to the residual effects of his orthopedic injuries, whereas the third failure (TMT-B) reflects a level impairment that is disproportionate to his injury parameters or level of adaptive functioning and cannot be readily explained by other factors. ...
Objective: This paper describes a clinical case illustrating the limitations of the Complex Ideational Material (CIM) as an embedded performance validity test (PVT). Method: A comprehensive neuropsychological battery was administered to a 19-year-old male to evaluate the residual effects of a motor vehicle collision. Results: The patient passed all free-standing PVTs and the majority of embedded validity indicators. Failing the CIM (≤9) in the context of long-standing, documented deficits in semantic processing and following the difficulty gradient inherent in the task (i.e. all errors occurred on later items) likely represents a false positive. Conclusions: Future research on CIM as PVT should include an item-level analysis in addition to the overall score to reduce the risk of misidentifying bona fide deficits as non-credible responding. More broadly, genuine impairment and invalid performance may be psychometrically indistinguishable in individual embedded PVTs. Failures on embedded validity cutoffs should be interpreted in the context of the patient's clinical history. Routinely administering a comprehensive battery of neuropsychological tests can aid the interpretation of isolated atypical scores.
... entories (M BDI-II = 16.2, SD = 11.5; M BAI = 13.1, SD = 10.6) and visual analog scales (M V-5Depression = 28.2, SD = 29.3; M V-5 Anxiety = 38.2, SD = 31.3; Sirianni et al., 2021). Parts of the sample were included in previous publications investigating different topics (Boucher et al., 2023;L. A. Erdodi, Hurtubise, et al., 2018;L. A. Erdodi, 2019;L. A. Erdodi, Seke, et al., 2017;, 2021Tyson et al., 2018). ...
Objective: This study was designed to replicate previous research on the clinical utility of the Verbal Paired Associates (VPA) and Visual Reproduction (VR) subtests of the WMS-IV as embedded performance validity tests (PVTs) and perform a critical item (CR) analysis within the VPA recognition trial. Method: Archival data were collected from a mixed clinical sample of 119 adults (MAge = 42.5, MEducation = 13.9). Classification accuracy was computed against psychometrically defined criterion groups based on the outcome of various free-standing and embedded PVTs. Results: Age-corrected scaled scores ≤6 were specific (.89−.98) but had variable sensitivity (.36−.64). A VPA recognition cutoff of ≤34 produced a good combination of sensitivity (.46−.56) and specificity (.92−.93), as did a VR recognition cutoff of ≤4 (.48−.53 sensitivity at .86−.94 specificity). Critical item analysis expanded the VPA’s sensitivity by 3.5%–7.0% and specificity by 5%–8%. Negative learning curves (declining output on subsequent encoding trials) were rare but highly specific (.99–1.00) to noncredible responding. Conclusions: Results largely support previous reports on the clinical utility of the VPA and VR as embedded PVTs. Sample-specific fluctuations in their classification accuracy warrant further research into the generalizability of the findings. Critical item analysis offers a cost-effective method for increasing confidence in the interpretation of the VPA recognition trial as a PVT.
... Although PVTs and SVTs are conceptually dissimilar, and they do exhibit divergent validity Van Dyke et al., 2013), there is also considerable correlation between PVT failure and SVT elevation (Copeland et al., 2016;Erdodi et al., 2017;Giromini et al., 2020b;Nguyen et al., 2015;Sabelli et al., 2021). ...
... Less attention has been given to adapting the Grooved Pegboard test (GPB) as a PVT, despite its relatively wide use. Recently, Erdodi et al. (2017) found that GPB performance could distinguish non-credible from credible performance with a specificity of .85-.91, when compared to the Warrington Recognition Memory Test (Warrington, 1984) and composites produced from nine other embedded or derived performance validity measures. To achieve specificity in this range, Erdodi et al. (2017) recommended GPB T-score cutoffs of 29 for either hand or 31 for both hands. ...
... Recently, Erdodi et al. (2017) found that GPB performance could distinguish non-credible from credible performance with a specificity of .85-.91, when compared to the Warrington Recognition Memory Test (Warrington, 1984) and composites produced from nine other embedded or derived performance validity measures. To achieve specificity in this range, Erdodi et al. (2017) recommended GPB T-score cutoffs of 29 for either hand or 31 for both hands. Using Erdodi et al.'s cutoffs, Link et al. (2022) Green, 2008). ...
The present study evaluated whether Grooved Pegboard (GPB), when used as a performance validity test (PVT), can incrementally predict psychiatric symptom report elevations beyond memory-apparent PVTs. Participants (N = 111) were military personnel and were predominantly White (84%), male (76%), with a mean age of 43 (SD = 12) and having on average 16 years of education (SD = 2). Individuals with disorders potentially compromising motor dexterity were excluded. Participants were administered GPB, three memory-apparent PVTs (Medical Symptom Validity Test, Non-Verbal Medical Symptom Validity Test, Reliable Digit Span), and a symptom validity test (Personality Assessment Inventory Negative Impression Management [NIM]). Results from the three memory-apparent PVTs were entered into a model for predicting NIM, where failure of two or more PVTs was categorized as evidence of non-credible responding. Hierarchical regression revealed that non-dominant hand GPB T-score incrementally predicted NIM beyond memory-apparent PVTs (F(2,108) = 16.30, p < .001; R2 change = .05, β = -0.24, p < .01). In a second hierarchical regression, GPB performance was dichotomized into pass or fail, using T-score cutoffs (≤29 for either hand, ≤31 for both). Non-dominant hand GPB again predicted NIM beyond memory-apparent PVTs (F(2,108) = 18.75, p <.001; R2 change = .08, β = -0.28, p < .001). Results indicated that noncredible/failing GPB performance adds incremental value over memory-apparent PVTs in predicting psychiatric symptom report.
... Note. EI-7: Erdodi Index Seven; Animals: Category fluency (demographically adjusted T-score based on norms by Heaton et al., 2004;Hayward et al., 1987;Hurtubise et al., 2020;Sugarman & Axelrod, 2015); BNT-15: Boston Naming Test -Short Form ; T2C: Time to completion (seconds); CDWAIS-III : Coding subtest of the Wechsler Adult Intelligence Scale -Third Edition (age-corrected scaled score; Ashendorf et al., 2017;Etherton et al., 2006;Inman & Berry, 2002;Kim et al., 2010;Trueblood, 1994); CIM: Raw score on the Complex Ideational Material subtest of the Boston Diagnostic Aphasia Battery Erdodi, 2019;Erdodi et al., 2016;; FAS: Letter fluency (demographically adjusted T-score based on norms by Heaton et al., 2004;Curtis et al., 2008;Hurtubise et al., 2020;Sugarman & Axelrod, 2014;Whiteside et al., 2015); GPBDominant : Grooved Pegboard Test dominant hand (demographically adjusted T-score based on norms by Heaton et al., 2004;Erdodi, Kirsch, et al., 2018;Erdodi, Seke et al., 2017); RDS: Reliable Digit Span (Greiffenstein et al., 1994;Pearson, 2009;Reese, et al., 2012;Schroeder et al., 2012;Webber & Soble, 2018). ...
... An EI-7 score ≤1 is considered an overall Pass, while scores ≥4 are considered an overall Fail (Erdodi, 2019). EI-7 scores 2 and 3 are considered Borderline and excluded from analyses requiring a dichotomous outcome, as they are significantly different from both Pass and Fail (Erdodi & Abeare, 2020;Erdodi, Seke et al., 2017;Erdodi, Tyson et al., 2018;Lichtenstein et al., 2019). The majority (61.2%) of the sample produced valid profiles, while 20% had psychometric evidence of non-credible performance. ...
This study sought to provide a direct comparison between old and new versions of the Trail Making Test (TMT). Eighty-five undergraduate student volunteers were administered the old and new TMT. A third of them were instructed to feign neuropsychiatric deficits. The classification accuracy of the TMTs was evaluated against experimentally induced and psychometrically defined invalid performance. Results showed that the old TMT demonstrated superior psychometric properties, both as a measure of cognitive ability and performance validity. In conclusion, newer and more sophisticated versions of a test are not necessarily better than older, established instruments. Replications in clinical samples are needed to verify the findings.
... Finally, previous research suggests that acute emotional distress can be associated with PVT failures on measures of psychomotor speed (Erdodi, Seke, et al., 2017), although subsequent investigations failed to replicate this relationship (Erdodi, 2021). The psychogenic interference hypothesis (Tarachow, 1947) has been used to explain cognitive deficits not attributable to identifiable neurological conditions (Boone, 2017;Tyson et al., 2018). ...
... Results were also consistent with the final prediction: Failing validity cutoffs embedded in letter fluency tasks was unrelated to symptom report, whereas failing free-standing PVTs was associated with elevated anxiety and depression (medium effect). This is a notable deviation from previous reports that failing embedded PVTs within measures of manual dexterity (Erdodi, Seke, et al., 2017) or sustained attention (Erdodi, Pelletier, et al., 2018) was associated with elevated symptom report. However, these results are consistent with This document is copyrighted by the American Psychological Association or one of its allied publishers. ...
Objective: This study was designed to compare different versions of the letter fluency test (FAS/CFL), evaluate the effect of repeat administration and the classification accuracy of traditional and novel cutoffs as performance validity tests (PVTs). Method: Archival data were collected from a mixed clinical sample (n = 64) of patients physician-referred for neuropsychological assessment (MAge = 43.2; MEducation = 14.1). Sensitivity and specificity of various letter fluency cutoffs were calculated against various psychometric definitions of invalid performance. Results: There was no difference between the FAS and CFL on total score and phonemic clusters. Learning effects were small and limited to the CFL. A T score of ≤33 on the FAS and ≤35 on CFL was specific (.89–.98), but relatively insensitive (.27–.45). Likewise, ≤4 phonemic clusters were associated with high specificity (.88–.94) but variable sensitivity (.22–.60) and were orthogonal to self-reported anxiety and depression. A raw score of ≤7 (FAS) or ≤8 (CFL) on the trial F had comparable classification accuracy (.18–.44 sensitivity at .91–.98 specificity). Failure on multiple validity cutoffs had near-ceiling specificity (.92–1.00). Declining output was similar in valid and invalid response sets. Conclusions: FAS and CFL are psychometrically equivalent versions of the letter fluency test and are relatively robust to learning effects on serial testing. Both can function as effective embedded PVTs, although they are limited by low and variable sensitivity. Process variables had mixed results as predictors of performance validity.
... A.Abeare et al., 2021;Deloria et al., 2021;Hurtubise et al., 2020); BNT: Boston Naming Test (L. A.Deloria et al., 2021;Nussbaum et al., 2022;Whiteside et al., 2015); CIM BDAE : Complex Ideational Material subtest of the Boston Diagnostic Aphasia ExaminationErdodi, 2019;Erdodi & Lichtenstein, 2017;Erdodi, Tyson, et al., 2016); DS WAIS-IV : Digit Span subtest of the Wechsler Adult Intelligence Scale -Fourth Edition(Babikian et al., 2006;Erdodi & Abeare, 2020;Greve et al., 2007;Heinly et al., 2005;Iverson & Tulsky, 2003;Shura et al., 2020;Young et al., 2012;Whitney et al., 2009); GPB-DH: Grooved Pegboard Test dominant handErdődi et al., 2017;Link et al., 2021); LM Recog : Logical Memory recognition trial(Bortnik et al., 2010;Dunn et al., 2021;Langeluddecke & Lucas, 2003;Pearson, 2009;J. S. Ord et al., 2008); TMT-B: Part B of the Trail Making Test (C.Abeare et al., 2019;Ashendorf et al., 2017;Erdodi, Hurtubise, et al., 2021;. ...
This study was designed to evaluate the classification accuracy of the Memory module for the Inventory of Problems (IOP-M) in a sample of real-world patients. Archival data were collected from a mixed clinical sample of 90 adults clinically referred for neuropsychological testing. The classification accuracy of the IOP-M was computed against psychometrically defined invalid performance. IOP-M ≤30 produced a good combination of sensitivity (.46-.75) and specificity (.86-.95). Lowering the cutoff to ≤29 improved specificity (.94-1.00) at the expense of sensitivity (.29-.63). The IOP-M correctly classified between 73% and 91% of the sample. Given its low cost, ease of administration/scoring in combination with robust classification accuracy, the IOP-M has the potential to expand the existing toolkit for the evaluation of performance validity during neuropsychological assessments.
... In a mixed clinical sample of 234 adults referred for neuropsychological assessment, the Borderline range was significantly different from both Pass (i.e., stronger evidence of non-credible responding) and Fail (i.e., weaker evidence of non-credible responding). These findings are consistent with the results of previous (Erdodi & Rai, 2017;Erdodi, Sagar, et al., 2018;Erdodi, Seke, et al., 2017) and subsequent Cutler et al., 2021;Dunn et al., 2021;Erdodi, Hurtubise, et al., 2020) investigations. ...
This study was designed to examine the classification accuracy of the Erdodi Index (EI-5), a novel method for aggregating validity indicators that takes into account both the number and extent of performance validity test (PVT) failures. Archival data were collected from a mixed clinical/forensic sample of 452 adults referred for neuropsychological assessment. The classification accuracy of the EI-5 was evaluated against established free-standing PVTs. The EI-5 achieved a good combination of sensitivity (.65) and specificity (.97), correctly classifying 92% of the sample. Its classification accuracy was comparable to that of another free-standing PVT. An indeterminate range between Pass and Fail emerged as a legitimate third outcome of performance validity assessment, indicating that the underlying construct is an inherently continuous variable. Results support the use of the EI-model as a practical and psychometrically sound method of aggregating multiple embedded PVTs into a single-number summary of performance validity. Combining free-standing PVTs with the EI-5 resulted in a better separation between credible and non-credible profiles, demonstrating incremental validity. Findings are consistent with recent endorsements of a three-way outcome for PVTs (Pass, Borderline and Fail).
... Given that all patients were referred by treating physicians and assessed in a clinical context, there was no information available on external incentive status (i.e., motivation to appear impaired). Parts of the sample were used in previous publications focused on different topics (Erdodi, 2019;Erdodi, Pelletier, et al., 2018;Erdodi, Seke, et al., 2017;. ...
Objective
: Replicate previous research on Logical Memory Recognition (LMRecog) and perform a critical item analysis.
Method
: Performance validity was psychometrically operationalized in a mixed clinical sample of 213 adults. Classification of the LMRecog and nine critical items (CR-9) was computed.
Results
: LMRecog ≤20 produced a good combination of sensitivity (.30-.35) and specificity (.89-.90). CR-9 ≥5 and ≥6 had comparable classification accuracy. CR-9 ≥5 increased sensitivity by 4% over LMRecog ≤20; CR-9 ≥6 increased specificity by 6–8% over LMRecog ≤20; CR-9 ≥7 increased specificity by 8–15%.
Conclusions
: Critical item analysis enhances the classification accuracy of the optimal LMRecog cutoff (≤20).
... The multidimensional aspect of the updated MND criteria highlights the need for PVTs that can assess non-credible performance in all areas of functioning, including motor performance.While limited, investigations on the use of motor tasks as embedded PVTs have been promising. The majority of these studies have focused on the Finger Tapping Test (Arnold et al., 2005;Arnold & Boone, 2007;Backhaus et al., 2004;Greiffenstein et al., 1996;Larrabee, 2003;) and despite common use of the Grooved Pegboard (GPB), the test has not been routinely considered as a potential PVT (Arnold & Boone, 2007;Ashendorf et al., 2009;Erdodi et al., 2017;Tolle et al., 2020). ...
... To address this gap, Erdodi et al. (2017) evaluated the utility of the GPB as an embedded PVT and sought to establish demographically adjusted T-score cutoffs. ...
... T-score cutoffs set at ≥ 29 for either hand or ≥ 31 for both handsyieldedsensitivity and specificity values that were consistent with minimum levels generally accepted within the field (Boone, 2013;Larrabee, 2003Larrabee, , 2008Lichtenstein et al., 2017;Sherman et al., 2020). Table 1 provides a summary of Erdodi et al. (2017) classification statistics for the recommended T-score cutoffs. Erdodi et al., concluded that their recommended GPB cutoffs were sufficient in detecting non-credible performance in a clinical sample. ...
Objective
Using embedded performance validity (PVT) comparisons, Erdodi et al. suggested that Grooved Pegboard (GPB) T-score cutoffs for either hand (≤ 29) or both hands (≤ 31) could be used as additional embedded PVTs. The current study evaluated the relationship between these proposed cutoff scores and established PVTs (Medical Symptom Validity Test [MSVT]; Non-Verbal Medical Symptom Validity Test [NV-MSVT], and Reliable Digit Span [RDS]).
Method
Participants (N = 178) were predominately Caucasian (84%) males (79%) with a mean age and education of 41 (SD = 11.7) and 15.8 years (SD = 2.3), respectively. Participants were stratified as “passing” or “failing” the GPBviaErdodi’s proposed criteria. “Failures” on the MSVT, NV-MSVT, and RDS were based on conventional recommendations.
Results
Moderate correlations between GPB classification and a condition of interest (COI; i.e. at least two failures on reference PVTs) were observed for dominant (χ² (1, n = 178) = 34.72, ϕ = .44, p < .001), non-dominant (χ² (1, n = 178) = 16.46, ϕ = .30, p = .001), and both hand conditions (χ² (1, n = 178) = 32.48, ϕ = .43, p < .001). Sensitivity, specificity, and predictive power were generally higher than Erdodi et al.’s initial findings.
Conclusion
These findingsprovide supportfor the clinical utility of the GPB as an additional embedded PVT. More specifically, dominant and both hand cutoffs were found to be more robust measures ofnon-genuine performance in those without motor deficits. While promising, sensitivity continues to be low; therefore, it is ill-advised to use the GPB as a sole measure of performance validity.
... see Supplementary Table 2). Finally, we scored three embedded performance validity measures within the dataset using the CVLT-II (Wolfe et al., 2010), grooved Pegboard (Erdődi et al., 2017), and Trail-Making Test (Iverson et al., 2002). Only 29 individuals (13.4%) scored below cut-offs on any single index and zero participants failed two or more of these embedded measures. ...
Objective
Black Americans are at high risk for HIV disease and associated morbidity. The impact and clinical correlates of HIV-associated neurocognitive impairment among Black Americans is not fully understood. The current study uses a full factorial design to examine the independent and combined effects of race and HIV disease on neurocognitive functioning, including its associations with everyday functioning and clinical disease markers in Black and White persons with HIV (PWH).
Method
Participants included 40 Black PWH, 83 White PWH, 28 Black HIV- and 64 White HIV- individuals. Neurocognition was measured by raw sample-based z-scores from a clinical battery. Everyday functioning was assessed using self- and clinician-rated measures of cognitive symptoms and activities of daily living. HIV-associated neurocognitive disorders were also classified using demographically adjusted normative standards and the Frascati criteria.
Results
We observed a significant three-way interaction between HIV, race, and domain on raw neurocognitive z-scores. This omnibus effect was driven by medium and large effect size decrements in processing speed and semantic memory, respectively, in Black PWH compared to other study groups. Black PWH also demonstrated higher frequencies of HIV-associated neurocognitive disorders as compared to White PWH. Unexpectedly, global neurocognitive performance was negatively related to everyday functioning impairments for White PWH, but not for Black PWH.
Conclusions
Systemic disadvantages for Black Americans may combine with HIV disease to compound some neurocognitive impairments in this under-served population. Prospective studies are needed to identify better ways to prevent, measure, diagnose, and manage HIV-associated neurocognitive disorders among Black Americans.
