title: Sensitivity and specificity of a digit symbol recognition trial in the identification of response bias.
abstract: Recently published practice standards recommend that multiple effort indicators be interspersed throughout neuropsychological evaluations to assess for response bias, which is most efficiently accomplished through use of effort indicators from standard cognitive tests already included in test batteries. The present study examined the utility of a timed recognition trial added to standard administration of the WAIS-III Digit Symbol subtest in a large sample of "real world" noncredible patients (n=82) as compared with credible neuropsychology clinic patients (n=89). Scores from the recognition trial were more sensitive in identifying poor effort than were standard Digit Symbol scores, and use of an equation incorporating Digit Symbol Age-Corrected Scaled Scores plus accuracy and time scores from the recognition trial was associated with nearly 80% sensitivity at 88.7% specificity. Thus, inclusion of a brief recognition trial to Digit Symbol administration has the potential to provide accurate assessment of response bias.
authors.affiliation: Pepperdine University, West Los Angeles, CA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kim
authors.forename: Kyle B
authors.initials: KB
authors.lastname: Boone
authors.forename: Tara
authors.initials: T
authors.lastname: Victor
authors.forename: Po
authors.initials: P
authors.lastname: Lu
authors.forename: Carolyn
authors.initials: C
authors.lastname: Keatinge
authors.forename: Cary
authors.initials: C
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000367:Age Factors; D015982:Bias; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011594:Psychometrics; D021641:Recognition, Psychology / Q000502:physiology*; D012680:Sensitivity and Specificity