title: Detection of inadequate effort on the California Verbal Learning Test-Second edition: forced choice recognition and critical item analysis.
abstract: The Forced Choice Recognition (FCR) and the Critical Item Analysis (CIA) indices of the California Verbal Learning Test-II (CVLT-II) have been identified by the CVLT-II test developers as potentially useful, brief screening indicators of effort in neuropsychological assessment. This retrospective study analyzes performance on these measures in three groups: (1) clinically referred individuals; (2) forensically referred individuals not suspected of inadequate effort; and (3) forensically referred individuals whose performance on freestanding tests of effort suggested inadequate effort. Performances on FCR were analyzed for their relation to actual memory impairment and with regard to concrete and abstract distractor endorsement. FCR and CIA performances were analyzed for agreement with formal tests of inadequate effort and their test characteristics. Incremental validity was assessed by hierarchical logistic regression with previously identified indices for detection of inadequate effort on the CVLT. Results indicate that (1) FCR and CIA performances are not related to decreased memory performance; (2) FCR and CIA indices exhibit higher specificity and lower sensitivity, with higher positive predictive value than negative predictive value; and (3) FCR and CIA indices exhibit modest incremental validity with previously identified indices. Implications for use of FCR and CIA indices in inadequate effort detection are discussed
authors.affiliation: Department of Psychiatry, Weill Medical College of Cornell University, 1300 York Avenue, Manhattan, NY 10021, USA. jcr2003@med.cornell.edu
authors.forename: James C
authors.initials: JC
authors.lastname: Root
authors.forename: Reuben N
authors.initials: RN
authors.lastname: Robbins
authors.forename: Luke
authors.initials: L
authors.lastname: Chang
authors.forename: Wilfred G
authors.initials: WG
authors.lastname: VAN Gorp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002755:Choice Behavior / Q000502:physiology*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008306:Malingering; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D011594:Psychometrics; D021641:Recognition, Psychology / Q000502:physiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014706:Verbal Learning / Q000502:physiology*