Low rate of performance validity failures among individuals with bipolar disorder

J Int Neuropsychol Soc. 2023 Mar;29(3):298-305. doi: 10.1017/S1355617722000145. Epub 2022 Apr 11.

Abstract

Objective: Assessing performance validity is imperative in both clinical and research contexts as data interpretation presupposes adequate participation from examinees. Performance validity tests (PVTs) are utilized to identify instances in which results cannot be interpreted at face value. This study explored the hit rates for two frequently used PVTs in a research sample of individuals with and without histories of bipolar disorder (BD).

Method: As part of an ongoing longitudinal study of individuals with BD, we examined the performance of 736 individuals with BD and 255 individuals with no history of mental health disorder on the Test of Memory Malingering (TOMM) and the California Verbal Learning Test forced choice trial (CVLT-FC) at three time points.

Results: Undiagnosed individuals demonstrated 100% pass rate on PVTs and individuals with BD passed over 98% of the time. A mixed effects model adjusting for relevant demographic variables revealed no significant difference in TOMM scores between the groups, a = .07, SE = .07, p = .31. On the CVLT-FC, no clinically significant differences were observed (ps < .001).

Conclusions: Perfect PVT scores were obtained by the majority of individuals, with no differences in failure rates between groups. The tests have approximately >98% specificity in BD and 100% specificity among non-diagnosed individuals. Further, nearly 90% of individuals with BD obtained perfect scores on both measures, a trend observed at each time point.

Keywords: affective disorders; bipolar disorder; effort performance; neuropsychology; performance validity; test of memory and malingering.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bipolar Disorder*
  • Humans
  • Longitudinal Studies
  • Malingering / diagnosis
  • Malingering / psychology
  • Memory and Learning Tests
  • Neuropsychological Tests
  • Reproducibility of Results