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Abstract Objective Data on performance invalidity in neuropsychological evaluations among patients with SARS-CoV-2-related cognitive concerns is limited. This study investigated the base rates of performance validity test (PVT) failure among a sample of neuropsychological referrals with persistent cognitive concerns following SARS-CoV-2 infection. Method Data were collected from 62 patients (27% male, 73% female) with subjective cognitive concerns following SARS-Cov-2 infection. The sample included ethnoracially diverse adult patients (M = 44.1 years, SD = 12.53) with an average of 15 years of education (SD = 2.97) who underwent comprehensive neuropsychological evaluations including freestanding (Test of Memory Malingering, Trial 1 TOMM T1) and embedded (Wechsler Adult Intelligence Scale-4th Edition Digit Span Reliable Digit Span WAIS-IV DS RDS; California Verbal Learning Test-Brief Form Forced Choice CVLT-BF FC; Brief Visuospatial Memory Test Recognition-Discrimination BVMT RD; Stroop Word Reading T-Score Stroop Word T) PVTs. Results A majority of the sample (63%) passed all PVTs, 9.7% of the sample failed ≥2 PVTs suggesting invalidity, and 27.4% of the sample failed exactly one PVT. On embedded PVTs, failure rates were as follows: WAIS-IV DS RDS: 11.3%, CVLT-BF FC: 1.6%, BVMT Rec-Dis: 8.1%, and Stroop Word T: 8.1%. The failure rate on TOMM Trial 1 was 19.4%. Conclusions Patients presenting with persistent cognitive concerns following SARS-CoV-2 infection demonstrated relatively low overall invalidity rates using an empirically established cut-off (≥2). Further research is needed to confirm the generalizability of the present findings, as well as to explore the implications of failure on one PVT and the implications of failure on embedded versus freestanding PVTs in this population.
Sedgwick et al. (Thu,) studied this question.