© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com. https://doi.org/10.1093/arclin/acab038 Advance Access publication 28 May 2021 Archives of Clinical Neuropsychology 37 (2022) 146–159 Examining Traditional and Novel Validity Indicators from the Medical Symptom Validity Test Across Levels of Verbal and Visual Memory Impairment Brian M. Cerny 1,2, * , Zachary J. Resch 1,3 , Tasha Rhoads 1,3 , Kyle J. Jennette 1 , Palak G. Singh 1,3 , Gabriel P. Ovsiew 1 , Jason R. Soble 1,4 1 Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA 2 Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA 3 Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA 4 Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA *Corresponding author at: University of Illinois College of Medicine, Department of Psychiatry, 910 S. Wood Street (MC 913), Chicago, IL 60612, USA. E-mail address: bcerny1@hawk.iit.edu (Brian M. Cerny). Received 19 February 2021; revised 5 April 2021; Accepted 1 May 2021 Abstract Objective This cross-sectional study examined accuracy of traditional Medical Symptom Validity Test (MSVT) validity indicators, including immediate recognition (IR), delayed recognition (DR), and consistency (CNS), as well as a novel indicator derived from the mean performance on IR, DR, and CNS across verbal, visual, and combined learning and memory impairment bands. Method A sample of 180 adult outpatients was divided into valid (n = 150) and invalid (n = 30) groups based on results of four independent criterion performance validity tests. Verbal and visual learning and recall were classified as indicative of no impairment, mild impairment, or severe impairment based on performance on the Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-Revised, respectively. Results In general, individual MSVT subtests were able to accurately classify performance as valid or invalid, even in the context of severe learning and memory deficits. However, as verbal and visual memory impairment increased, optimal MSVT cut-scores diverged from manual-specified cutoffs such that DR and CNS required cut-scores to be lowered to maintain adequate specificity. By contrast, the newly proposed scoring algorithm generally showed more robust psychometric properties across the memory impairment bands. Conclusions The mean performance index, a novel scoring algorithm using the mean of the three primary MSVT subtests, may be a more robust validity indicator than the individual MSVT subtests in the context of bona fide memory impairment. Keywords: Performance validity; assessment; psychometrics; forensics; memory Introduction Current practice standards in clinical neuropsychology dictate that establishing the accuracy and credibility of neuropsy- chological test results depends on the repeated sampling of performance validity via objective measures throughout clinical and forensic evaluations (Bush et al., 2005; Heilbronner et al., 2009; Boone, 2013). Performance validity tests (PVTs) are typically used to accomplish this goal, many of which are designed to assess for noncredible memory-based deficits. One such test is the Medical Symptom Validity Test (MSVT; Green, 2004), a widely used, computer-administered PVT designed as a briefer analog of the Word Memory Test (WMT; Green, 2003). The MSVT includes three primary validity subtests, namely Downloaded from https://academic.oup.com/acn/article/37/1/146/6287889 by guest on 20 May 2023