title: The Rey AVLT Serial Position Effect: a useful indicator of symptom exaggeration?
abstract: This investigation explored the usefulness of serial position patterns during word recall on the Rey Auditory Verbal Learning Test (RAVLT; Rey, 1964) as an indicator of poor effort. Significantly better recall for early (primacy) and recent (recency) material defines the serial position effect (SPE; Rundus, 1971). The SPE on the RAVLT was examined in four groups: normal controls (NC), symptom-coached simulators (SC), test-coached simulators (TC), and a group of moderate to severe subacute traumatic brain injury (TBI) patients. Normal control participants and TBI patients demonstrated the expected SPE. Only the SC simulators clearly suppressed the primacy effect. The SPE appears neither sensitive nor specific enough to be used independently of more sensitive symptom validity tests in the detection of suboptimal effort. It may be especially problematic when used with clients presenting with sophisticated styles of exaggeration and in settings with lower base rates of compromised effort.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA. powell.matthew@mayo.edu
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Powell
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Gfeller
authors.forename: Michael V
authors.initials: MV
authors.lastname: Oliveri
authors.forename: Shannon
authors.initials: S
authors.lastname: Stanton
authors.forename: Bryan
authors.initials: B
authors.lastname: Hendricks
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000175:diagnosis* / Q000503:physiopathology; D011939:Mental Recall / Q000502:physiology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000379:methods / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012691:Serial Learning / Q000502:physiology*; D014706:Verbal Learning / Q000502:physiology*