B-176: Examining Differences in Performance Validity Test Failure by Estimated Premorbid Functioning in Solid Organ Transplant Candidates

Abstract

Objective: Performance validity tests (PVTs) are used to assess engagement in neuropsychological evaluation to ensue clinical interpretability of data independent of cognitive dysfunction. PVTs have been shown to have lower sensitivity in samples with lower baseline functioning. However, this relationship has not been explored directly in populations with end stage organ failure (ESOF). This study examined the extent to which estimated premorbid functioning differs by number of PVT failures in adults with ESOF. Method/Data Selection: The sample included adult kidney and liver transplant candidates referred for neuropsychological evaluation at an academic medical center (n=53; 45% female, mean age=55). Premorbid functioning was estimated using the Test of Premorbid Functioning (TOPF), specifically Simple Demographics and TOPF estimated Full Scale Intelligence Quotient (eFSIQ). All patients were administered two freestanding PVTs (Test of Memory Malingering [TOMM]; Coin-in-Hand [CIH]) and three embedded PVTs (WAIS-IV Reliable Digit Span [RDS]; California Verbal Learning Test - 3rd Edition - Brief Form Forced Choice [CVLT FC]; Brief Visuospatial Memory Test-Revised Recognition Discriminability [BVMT RD]). Number of PVT failures were grouped as 0, 1, or ≥2, and separately as 0–1, or ≥2 failures. Groups were compared using one-way ANOVAs. Results/Data Synthesis: No significant differences in eFSIQ were found between three-level PVT fail groups (0, 1, ≥2; F=1.9; p=0.16) nor two-level groups (0-1, ≥2; F=3.1; p=0.09). Conclusions: Findings suggest estimated premorbid functioning does not differ on number of PVT failures, indicating reliability of PVTs across levels of eFSIQ. Future research is needed to explore what possible threats affect PVT performance and establish appropriate cutoff scores for performance validity determination.