Using completion time on a forced choice trial of the Hopkins Verbal Learning Test – Revised (HVLT-R) to measure engagement in a mixed clinical sample

OBJECTIVE: This study examined the clinical utility of a timed Forced Choice Recognition (FCR) trial from the Hopkins Verbal Learning Test-Revised (HVLT-R). We evaluated whether FCR accuracy and completion time (FCompT) were associated with performance on established performance validity tests (PVTs) and embedded validity indicators (EVIs) in a mixed clinical sample, and whether these indices demonstrated classification accuracy under liberal and conservative validity definitions. METHOD: Eighty-five adults referred for neuropsychological evaluation completed the HVLT-R, including an FCR component. Spearman correlations examined associations among variables and standalone PVTs. Receiver operating characteristic analyses evaluated discrimination of invalid performance on ≥1 PVTs (liberal) or ≥2 PVTs (conservative). RESULTS: Lower FCR accuracy and longer FCompT were associated with poor performance on established PVTs. FCR accuracy showed fair discrimination under the liberal criterion (AUC = .70) and excellent discrimination under the conservative criterion (AUC = .92). FCompT showed fair discrimination for liberal criterion (AUC = .74) and good discrimination for conservative criterion (AUC = .89). Estimates were based on a small subset of invalid cases. CONCLUSIONS: Findings provide preliminary evidence of convergent validity and discriminative utility for FCR indices. Larger studies with higher rates of invalid performance are needed to establish stable classification parameters.