Aggregating Validity Indicators Embedded in Conners' CPT-II Outperforms Individual Cutoffs at Separating Valid from Invalid Performance in Adults with Traumatic Brain Injury

Continuous performance tests (CPT) provide a useful paradigm to assess vigilance and sustained attention. However, few established methods exist to assess the validity of a given response set. The present study examined embedded validity indicators (EVIs) previously found effective at dissociating valid from invalid performance in relation to well-established performance validity tests in 104 adults with TBI referred for neuropsychological testing. Findings suggest that aggregating EVIs increases their signal detection performance. While individual EVIs performed well at their optimal cutoffs, two specific combinations of these five indicators generally produced the best classification accuracy. A CVI-5A ≥3 had a specificity of .92-.95 and a sensitivity of .45-.54. At ≥4 the CVI-5B had a specificity of .94-.97 and sensitivity of .40-.50. The CVI-5s provide a single numerical summary of the cumulative evidence of invalid performance within the CPT-II. Results support the use of a flexible, multivariate approach to performance validity assessment.