B - 131 Validation of the California Verbal Learning Test-II-Short Form Forced Choice Paradigm as an Indicator of Performance Validity

Abstract Objective Although the Forced Choice (FC) paradigm of the standard California Verbal Learning Test-Second Edition (CVLT-II) has been extensively validated as an embedded performance validity test (PVT), no studies have validated the CVLT-II Short Form (SF) against a standard battery of external PVTs. Method Participants included 98 veterans (Mage = 69.7 ± 9.0; 86.7% cisgender-male) who completed the CVLT-II-SF FC and the following independent criterion freestanding/embedded PVTS as part of comprehensive outpatient neuropsychological evaluations: the Advanced Clinical Solutions Word Choice Test, Test of Memory Malingering-Trial 1, and Reliable Digit Span from the Wechsler Adult Intelligence Test-Fourth Edition Digit Span subtest. Invalid performance was identified using two different criteria: (1) failing ≥2 PVTs in addition to other clinical indicators of poor engagement, or (2) failing one PVT. Receiver Operator Characteristic (ROC) curves tested the classification accuracy of identifying participants in the invalid group versus those with valid presentations and with or without cognitive impairment. Results Using both criteria, ROC analyses accurately identified invalidity (AUCs = 0.708–0.807) in the total sample, with cut-scores of ≤7 or ≤ 8 on the CVLT-II-SF FC exhibiting adequate specificities (0.900–0.986) and sensitivities of 0.407–0.500. Classification accuracy was acceptable for differentiating the invalid and cognitively intact groups (AUCs = 0.734–0.829) at a cut score of ≤8 (specificities = 0.923–0.958, sensitivities = 0.500–0.704), but was variably acceptable for differentiating the invalid and cognitively impaired groups (AUCs = 0.684–0.794; cut-score of ≤7 with specificities = 0.962–0.978 and sensitivities = 0.229–0.407). Conclusions Our findings support the CVLT-II-SF FC trial as an embedded PVT, particularly when differentiating cognitively intact examinees from those with noncredible presentations.