title: Embedded Measures of Performance Validity in the Rey Complex Figure Test in a Clinical Sample of Veterans.
abstract: The purpose of this study was to determine how well scores from the Rey Complex Figure Test (RCFT) could serve as embedded measures of performance validity in a large, heterogeneous clinical sample at an urban-based Veterans' Affairs hospital. Participants were divided into credible performance (n = 244) and noncredible performance (n = 87) groups based on common performance validity tests during their respective clinical evaluations. We evaluated how well preselected RCFT scores could discriminate between the 2 groups using cut scores from single indexes as well as multivariate logistic regression prediction models. Additionally, we evaluated how well memory error patterns (MEPs) could discriminate between the 2 groups. Optimal discrimination occurred when indexes from the Copy and Recognition trials were simultaneous predictors in logistic regression models, with 91% specificity and at least 53% sensitivity. Logistic regression yielded superior discrimination compared with individual indexes and compared with the use of MEPs. Specific scores on the RCFT, including the Copy and Recognition trials, can serve as adequate indexes of performance validity, when using both cut scores and logistic regression prediction models. We provide logistic regression equations that can be applied in similar clinical settings to assist in determining performance validity.
authors.affiliation: a John D. Dingell Veterans Affairs' Medical Center , Detroit , Michigan.|b Department of Psychology , Wayne State University , Detroit , Michigan.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Sugarman
authors.affiliation: c Department of Psychology, James A. Haley Veterans' Hospital , Tampa , Florida.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Holcomb
authors.affiliation: d Department of Psychology, John D. Dingell DVAMC , Detroit , Michigan.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Axelrod
authors.affiliation: e Meyers Neuropsychological Services , Mililani , Hawaii.
authors.forename: John E
authors.initials: JE
authors.lastname: Meyers
authors.affiliation: f Department of Psychology, Henry Ford Health System , Detroit , Michigan.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Liethen
mesh_terms: D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008306:Malingering / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology*; D021641:Recognition, Psychology / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
keywords: Rey Complex Figure Test; effort; logistic regression; performance validity