Time and money: Exploring enhancements to performance validity research designs
Publications
Model System:
TBI
Reference Type:
Journal article
Accession No.:
J90287
Journal:
Applied Neuropsychology: Adult
Year, Volume, Issue, Page(s):
, , ,
Publication Website:
Abstract:
Study examined the effect of preparation time and financial incentives on healthy adults' ability to simulate traumatic brain injury (TBI) during neuropsychological evaluation. It was hypothesized that providing both preparation time and incentive would result in poorer PVT classification accuracies and a more believable (i.e., successful) simulation than observed for a traditional analog simulation design. A retrospective comparison of two TBI simulator group designs: a traditional design employing a single session of standard coaching immediately before participation (SIM-SC) and a novel design that provided financial incentive and preparation time (SIM-IP). Both groups completed an ecologically valid neuropsychological test battery that included widely used cognitive tests and five common performance validity tests (PVTs). Compared to SIM-SC, SIM-IP performed significantly worse and had higher rates of impairment on tests of processing speed and executive functioning. SIM-IP were more likely than SIM-SC to avoid detection on one of the PVTs and performed somewhat better on three of the PVTs, but the effects were small and non-significant. SIM-IP did not demonstrate significantly higher rates of successful simulation (i.e., performing impaired on cognitive tests with <2 PVT failures). Overall, the rate of the successful simulation was approximately 40 percent with a liberal criterion, requiring cognitive impairment defined as performance >1 standard deviation below the normative mean. At a more rigorous criterion defining impairment (>1.5 standard deviation below the normative mean), successful simulation approached 35 percent. Incentive and preparation time appear to add limited incremental effect over traditional, single-session coaching analog studies of TBI simulation. these design modifications did not translate to meaningfully higher rates of successful simulation and avoidance of detection by PVTs.
