Symptom validity
7 important questions on Symptom validity
Reasons for invalid data
- social desirability (faking good)
- Faking (bad)
- rondom responding (carelessness)
- acquiescence (yes-saying)
- opposition (no saying)
- positional (extremities or mid-point)
Assessment of symptom validity
- Can be tested with inconsistency in answers
- using specific trick questions
- rare symptoms that are infrequent or rarely endorsed
- symptom combination that are seldom observed
- symptom severity, symptoms are often not unbearable
- overly specific symptoms
Scaling of items in assessment of symptom validity
- reverse items to avoid tendency to score always right or left
- use even number of response alternatives to avoid endorsement of middle
- change scaling across items in long batteries of questionnaires
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Assessment of performance validity (PVT)
- embedded and derived PVT's
- Based on pre-existing standard measure of cognition. (WAIS, RCFT,RAVLT etc.) - stand-alone PVT's
- developed specifically to assess noncredible performance (Test of memory malingering TOMM, etc. )
Symptom and performance validity assessment interpretation of test results.
- SVTs/PVTs do not contribute to diagnostic process of disorder at question
- SVTs/PVTs do not tell whether somebody is feigning
- do not accuse an individual of feigning based on SVTs/PVTs failing
- do not make dexisions based on one measure
- Interpretation of SVTs/PVTs
- SVTs/PVTs indicate whether performance in credible or noncredible
- SVTs/PVTs indicate whether routine clinical measures are valid
- there are many reasons to fail SVTs/PVTs, feigning is only one of them
When failing SVTs/PVTs: phase one
- establish effective working relationship with client
- establish and clarify expectations
- Obtain informed consent, incl. consequences of poor effort
- ask about prior exposure to neurospychological tests
- decide whether to use SVTs/PVTs to which examinee was previously exposed
When failing SVTs/PVTs: Phase two
- complete or quit testing when evidence of invalid performance is encountered
- explore patient willingness to acknowledge poor or inconsistent effort
- note if there is a lack of acknowledgement of poor effort
- schedule feedback session separate from that of the test administration
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