Concordance of Performance and Symptom Validity Tests Within an Electrical Injury Sample

Survivors of electrical injury often undergo neuropsychological evaluations to assess for post-injury cognitive and emotional sequelae, often in a medical-legal context as these injuries tend to be work-related. During these evaluations, neuropsychologists evaluate symptom and performance validity to ascertain whether the examinee is credibly reporting symptoms and adequately engaged in cognitive testing, respectively. Previous studies have separately identified (1) a high rate of invalid test performance among this population and (2) evidence of elevated symptom-reporting on the Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). However, no studies have evaluated the concordance between these two types of validity assessment within an electrical injury sample. As such, this study examined the concordance between symptom over-reporting scores on the MMPI-2-RF and performance validity test results. Concordance rates varied based on number on the number of symptom validity scale elevations employed to determine invalid symptom reporting, as well as evaluating for differences based on any symptom over-reporting versus definite over-reporting ranges. Highest concordance between validity performance was found when using (1) ≥ 3 validity scale elevations in the possible over-reporting range, or (2) ≥ 1 scale elevation indicative of definite over-reporting. This variability in performance and symptom validity concordance rates suggests that although the validity constructs are related, they are measuring nonredundant information in an electrical injury sample.